There is simply no easy way to say “I have cancer” to a child, but it is important to prepare them for what’s to come and how it might affect them. As a general rule, the younger the child, the less detail required. It is also advised to keep the conversation open and ongoing—as your health situation evolves, keep your children in the loop with updates on how you’re doing and if they should anticipate any more changes.

Approaching this difficult topic

It is essential to let your children know that you are still there for them and that they are loved. After giving yourself some time and space to process the news, find an appropriate time and place where you won’t be interrupted to start the conversation, knowing that questions might bubble up for days and weeks after.

The following tips can help you share the news of your cancer diagnosis:

• Get the support you need. Invite a partner, family member, or close and trusted friend to provide moral support for both you and your children. They may not need to say a single word, but a shoulder to cry on or a hand to hold can go a long way. Make sure you and your partner are on the same page as far as what you will discuss.
• Be honest while keeping it simple. While it might be tempting to sugar-coat the situation for kids, it is important to share the type of cancer you have, your expected treatment regimen and how long it might last, what changes they might see in you, and how your kids’ lives will likely be impacted during this time. If you will be undergoing chemo, for example, you can let them know that you might lose your hair or feel nauseous. Avoid big medical terms, which can be scary and overwhelming, and stick to the basics, using words your kids will understand.
• Let them know you’re in this together. It is okay to express emotions, including sadness and uncertainty, while reassuring your kids that you are doing your best and that you are still a strong team. You can also let them know when you need their help throughout cancer treatment. For instance, telling them you could use a movie night and early bedtime because you are fatigued is a good way to empower them as helpers, and may help you get the rest you need.
• Give plenty of time and space for questions. Always try to answer their questions as honestly as possible without delivering an overwhelming amount of detail or medical jargon. Your answers might even sound like “I don’t know” or “I’m not sure” or “I’ll get back to you.” That’s okay, too. Just be sure to follow up with them when you have an answer. This lets them know that you are always willing to consider and respond to their questions.

Finally, make sure that you continue to check in with your children throughout this process, asking how they are doing, if they have further questions, and if they need anything to help them cope. Some children may think you getting cancer is their fault or blame themselves; you can reassure them that this is definitely not the case, and look into potential support groups for children whose parents have cancer.

Just as you express your feelings, you can encourage your children to regularly share their thoughts and emotions, even the negative or scary ones.

What to say

It may be helpful to practice aloud what you will say when approaching the topic of cancer with young children. You can put the following statements into your own words as your share your news with your kids. These phrases can be altered and expanded based on the age and developmental level of your children as well.

“I have something called cancer. That means I am sick. But I am doing everything I can to get better.”

“Mommy is sick, but the doctors are helping me get better. We’ll get through this together.”

“While I’m sick, I might act a little bit different than normal, but it’s still me, and I still love you.”

“There might be some days that I feel sad, and I might even cry. That’s because I’m tired or frustrated, but it will pass. A hug from you might help.”

“I love you. Thank you for being patient with me and helping me through this.”

Finally, it is important to recognize that younger children may react in a variety of different ways, including temper tantrums, disruption to sleep or eating schedules, withdrawal, and more. You may want to let other adults in their life—such as teachers, friends’ parents, or neighbors—know about your cancer diagnosis as well so they can provide understanding and support.

Additional resources

You are not alone in this conversation. In addition to local support groups, therapists, and camps for kids whose parents have cancer, the following resources may also help:

• The Bright Spot Network offers free children’s books on this topic that you can order. It comes with a resource for parents with age-appropriate examples on talking with kids about cancer.
• This Kid-to-Kid: Your Parent Has Cancer video from MD Anderson explains what cancer is, how it’s treated, ways kids can help support their parents, and ways they can express their feelings and emotions.
• The American Cancer Society also shares helpful and practical tips on talking with kids of different age groups about cancer.
• Little Hearts of Hope is a faith-based organization that sends monthly, hope-filled activity packets to children who have a parent or sibling facing cancer.

National Breast Cancer Foundation is here for you and your family as you navigate a breast cancer diagnosis. Visit our website to learn about NBCF breast cancer support groups, obtain free educational resources, or find a patient navigator in your area.

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Important Names in Breast Cancer History

Beginning in the 1940s, each decade of American history has been marked by extraordinary accomplishments and voices of activism from women in the pursuit of supporting and improving the outcomes of those facing a breast cancer diagnosis.

1940s

Breast cancer was considered a taboo “women’s disease” in the 1940s. But thanks to vocal women who intuitively knew the importance of advocating for themselves and others, that mindset began to slowly change.

Mary Lasker

After losing a friend to cancer in 1943 and learning how little money was directed toward cancer research, Mary Lasker began advocating that more funds be directed to cancer research, leading to massive donations made to the American Cancer Society (ACS) and later to governmental funding for the National Cancer Institute (NCI). Mary’s relentless drive to invoke change and her accomplishments in advocacy and fundraising began to have an immediate impact on breast cancer patients, and began to change how women were perceived in circles of power and influence.

1950s

The 1950s saw some improvements in breast cancer treatment options, as well as the rise of women demanding better care and support during and after their breast cancer treatment.

Terese Lasser

After undergoing a traumatic radical mastectomy for a malignant growth in 1952, Terese Lasser was disappointed in the lack of physical and emotional follow-up care offered by her surgeon. As a result, Terese founded the Reach to Recovery program in 1954 to address issues medical professionals at the time did not feel were important, such as the stigma surrounding breast cancer, intimacy after breast cancer, physical rehabilitation, and access to prostheses, paving the way for the women’s health movement by providing social support and encouragement to women experiencing breast cancer.

1960s

The medical breakthroughs in breast cancer diagnosis and treatment of the 1960s led to many important and meaningful discoveries, some spearheaded by women in the fields of science and medicine.

Dr. Jane C. Wright

Hailed for her pioneering work in chemotherapy—shifting it from an experimental, last-resort treatment to a more effective option—Dr. Wright, known as the “godmother of chemotherapy,” spearheaded research on the drug methotrexate to treat breast and skin cancers, paving the way for millions of cancer patients and survivors. Today, methotrexate remains one of the main chemotherapy drugs for treating breast cancer, as well as lung cancer, leukemia, and many other types of cancer.

At the culmination of her 40-year career, Dr. Wright had changed the face of chemotherapy and medicine, published a wealth of articles that continue to serve as the basis for modern cancer treatment, and established a legacy of innovation worthy of continued recognition. Read more about Dr. Wright’s incredible contributions to the field of breast cancer research in Dr. Jane C. Wright’s Powerful Legacy of Firsts.

1970s

The 1970s saw many influential and high-profile women come forward publicly to share their personal experiences with breast cancer. These women chose to share about their diagnoses through national television and print media as a way to support other breast cancer patients, raise awareness for the disease, and empower women to play active roles in their healthcare decisions.

Babette Rosmond

Famed author and editor of Better Living and Seventeen Magazine, Babette Rosmond was diagnosed with breast cancer in 1971 after finding an olive-sized lump in her breast. Not satisfied with her first doctor’s treatment approach, Babette was vocal about her decision to seek a second opinion. Babette’s act of self-advocacy empowered women nationwide to take more active roles in their healthcare and patient-doctor relationships. 

Shirley Temple Black

Shirley Temple Black was diagnosed with breast cancer in 1973, a time when breast cancer was rarely discussed in public. Rather than remain silent, Shirley spoke openly about her diagnosis and mastectomy, helping other women feel comfortable to do the same. Though she was most famous for being an adored child star, Shirley used her fame to bring awareness to breast cancer and comfort to women experiencing it.

First Lady Betty Ford

First Lady Betty Ford was diagnosed with breast cancer in 1974, shortly after her husband became President. The First Lady openly addressed her diagnosis and became a leading voice in the benefits of early detection. Within weeks of her diagnosis, thousands of women nationwide began visiting cancer centers for early detection screenings.

Second Lady Happy Rockefeller

Happy Rockefeller, wife of Vice President Nelson Rockefeller, was diagnosed with breast cancer in 1974 after finding a lump in her left breast during a breast self-exam. Happy underwent a radical mastectomy of her left breast, followed by a prophylactic (preventative) mastectomy of her right breast. Happy’s experience further emphasized the importance of early detection and immediate treatment to women across the nation.

1980s

As breast cancer started to become less of a taboo topic in the 1980s, many women began advocating for themselves as survivors while encouraging and supporting other women facing disease, treatment, and survivorship.

Audre Lorde

Lauded African-American poet Audre Lorde was diagnosed with breast cancer in 1980 at the age of 44. Audre became the first woman to vocally oppose societal views that women with mastectomies should wear a prosthesis or have reconstructive surgery. Audre’s writings served as a galvanizing force to bring previously alienated survivors together in mutual support and solidarity and set the stage to make the physical realities of the disease more visible in the public eye.

1990s

As mortality rates from breast cancer began to drop in the 1990s, a testament to the increased impact of screening mammography and improved treatment for breast cancer, individuals and organizations began focusing on supporting patients at all stages of the breast cancer journey, from diagnosis through treatment and into survivorship.

Janelle Hail

After personally experiencing breast cancer in 1980, Janelle Hail committed her life to educating and advocating for women everywhere by founding National Breast Cancer Foundation (NBCF) in 1991. NBCF’s mission is to provide help and inspire hope to those affected by breast cancer through early detection, education, and support services. Because of Janelle’s determination that no one face breast cancer alone, NBCF has served over one million women since 1991 and continues to be a leading organization in breast cancer support and education.

Dr. Marisa C. Weiss

Radiation oncologist Dr. Weiss was concerned about the lack of support and resources available to her cancer patients. Dr. Weiss founded Living Beyond Breast Cancer (LBBC) in 1991 to address the after-care needs of her patients. LBBC now provides trusted information and support to people nationwide who are affected by breast cancer.

Evelyn Lauder

After surviving breast cancer, Evelyn Lauder founded Breast Cancer Research Foundation (BCRF) in 1993 to address the lack of funding in breast cancer research. In 1992, Evelyn co-created the signature pink ribbon and launched the first Breast Cancer Awareness campaign within the Estée Lauder company. Through her high-profile advocacy, Evelyn raised awareness by placing breast health front and center in the public eye.

2000s

Today, many women continue to advocate for advancements in breast cancer prevention, patient care, and research. The attention these women bring to the cause generates the support women need when faced with a diagnosis.

Angelina Jolie

After losing her mother to ovarian and breast cancer, megastar Angelina Jolie tested positive for the BRCA1 gene mutation, which increases a person’s chances of developing breast cancer. In 2013, Angelina underwent a prophylactic (preventative) double mastectomy to reduce her risk of developing cancer. Her story has inspired increasing numbers of women to undergo genetic testing and preventative care, reducing their risk of breast cancer.

Joan Lunden

Longtime Good Morning America host Joan Lunden was diagnosed with triple negative breast cancer (TNBC) in 2014. She later learned that she had dense breast tissue, a risk factor for breast cancer. In Joan’s 2015 book, Had I Known: A Memoir of Survival, Joan wrote candidly about what she learned from her breast cancer experience, and educated women on the risks that dense breast tissue pose. An advocate for women everywhere, Joan has shared her experience with thousands nationwide, encouraging them to persevere and thrive despite a cancer diagnosis.

Those affected by breast cancer today have better access to education, treatment, and resources due to the culmination of efforts by passionate women impacted by breast cancer who were never satisfied with the status quo and who gave their expertise and voices to the ongoing quest to eradicate breast cancer. We celebrate these women and their achievements this Women’s History Month!

National Breast Cancer Foundation is here for you and your loved ones. Whether you need support, education, or help during treatment, we have a team dedicated to getting you the help you deserve.

The post Women Who Changed the <br> Face of Breast Cancer appeared first on National Breast Cancer Foundation.

Palliative care can be a very valuable tool in an advanced cancer patient’s life. But palliative care is often misunderstood and even feared by patients, their caregivers, and their loved ones. Here is what you need to know when considering palliative care if you or a loved one has a serious illness, such as advanced-stage cancer.

Palliative care explained

Sometimes called “supportive care,” palliative care does not replace a patient’s primary treatment. Palliative care is specialized medical care that focuses on the management of symptoms or side effects that are disruptive to a patient’s quality of life. It is designed for those who have a serious, life-threatening, or terminal illness. Palliative care can be thought of as quality-of-life preservation or quality-of-life restoration.

Palliative care often involves managing and treating a patient’s pain in ways other than prescribing opioids (medications prescribed by doctors to treat persistent or severe pain). For example, palliative care specialists may treat a patient’s pain through administering nerve blocks (injections that block pain from specific nerves) or even through targeted radiation therapy, especially if the pain is in the spine or other bones. Palliative care specialists are also skilled in helping patients who may feel ill to be able to eat by using drugs to stimulate the appetite, rather than only treating the nausea they may be experiencing. There are many other ways palliative care specialists can help make a patient feel more comfortable, decrease their pain, manage their side effects, and increase their quality of life.

Palliative care professionals are also trained and comfortable with having difficult conversations with patients and family members, such as about their prognosis, what to expect going forward, and even how to talk with their children or other family members about their illness and what they should expect.

Palliative care is different from hospice care

Though the two often work hand-in-hand, palliative care and hospice care are separate and distinct. In hospice care, the focus is on preserving quality of life near or at the end of life. Palliative care, on the other hand, can and should be integrated into a patient’s treatment plan from the point of their initial diagnosis, when they are not yet near the end of their life, in order to improve their quality of life.

Receiving palliative care does not necessarily mean that the end of life is near, or even that a diagnosis is terminal. Patients with a serious diagnosis may receive palliative care at any point during their illness.

The chart below from the National Institutes of Health outlines the differences and similarities between palliative care and hospice care:

Who should receive palliative care?

Palliative care is a resource available to anyone diagnosed with a serious illness whose symptoms of the disease or the side effects of its treatment will negatively impact their quality of life.

Palliative care is not only reserved for cancer patients or those with a terminal diagnosis. Anyone diagnosed with a serious, life-altering illness, at any age, can benefit from palliative care, including but not limited to those with cancer, degenerative or advanced diseases, and even advanced age.

Palliative care is most helpful when provided early

Palliative care can be helpful at any stage of a patient’s illness and is best implemented soon after diagnosis. A palliative care specialist should be consulted early in the patient’s diagnosis if or when a treating physician is not able to get the symptoms of the patient’s disease or the side effects of treatment controlled and diminished.

It is advised to consult with a palliative care specialist even before symptoms or side effects begin affecting the quality of a patient’s life in order to discuss future expectations and options, and when to begin implementing palliative care measures.

How to request palliative care

The treating physician should refer a patient to a palliative care specialist upon diagnosis of a serious or life-altering illness. However, if the physician does not provide a referral upfront, the patient or their caregiver should ask for a referral to a palliative care specialist or team.

If the patient’s medical facility doesn’t offer palliative care specialists, or they don’t have referrals for specialists, ask the facility’s nurse or patient navigator, or hospital social worker, if there are palliative care specialists within the patient’s local community that they can be referred to.

Sometimes physicians or oncologists will claim to be able to control and relieve a patient’s symptoms and side effects without consulting a specialized palliative care team. However, it is always advised that a patient seeking palliative care receive their care from the specialists themselves, rather than through their regular physician or oncologist.

Palliative care for metastatic breast cancer

A person diagnosed with Stage 4 metastatic breast cancer (MBC) is a prime candidate to receive palliative care immediately after receiving their diagnosis. An MBC patient should advocate for themselves by asking for palliative care referrals during their initial consultation with their medical oncologist. Sometimes a medical oncology office will already include palliative care specialists as part of their multidisciplinary team. Other times, if palliative care staff is not integrated into the oncology office, the patient may need to be referred to specialists within the community for care.

Those diagnosed with MBC face a unique and profound set of physical and emotional challenges. As a breast cancer specialist and survivor myself, I encourage women with MBC to remember that, at a certain point, quality of life may become more important than quantity of life. Palliative care can help a patient with MBC feel good enough to experience the joys life still has to offer, despite a terminal diagnosis.

Palliative care doesn’t need to be entered into with fear, uncertainty, or misinformation. It can be a valuable resource in a patient’s treatment plan, relieving them of their symptoms and side effects, preserving or restoring their quality of life, and empowering them to be in control of their own diagnosis and treatment journey.

National Breast Cancer Foundation is here for you and your loved ones. Whether you need support, education, or help during treatment, we have a team dedicated to getting you the help you deserve.

Sources:
National Institutes of Health
National Hospice and Palliative Care Organization

The post Palliative Care: <br> Essential Information for Patients and Families appeared first on National Breast Cancer Foundation.

When you are deemed a “breast cancer survivor,” most people will expect you to feel pure joy, relief, and gratitude. However, these emotions are often drowned out with other feelings, including worry, anxiety, and sadness, which are all normal. While your physical health as a breast cancer survivor is clearly important, your emotional health also matters. Below are answers to most-asked questions on navigating emotional health as a breast cancer survivor.

Question: I finished breast cancer treatment, but am uncomfortable celebrating—what if I jinx myself? Is this a normal concern?

Lillie Shockney: This is very common. You may have been looking forward to completing treatment and having a party to celebrate this milestone, but change your mind as active treatment ends. Many women fear that they will be tempting fate by celebrating this victory and worry about their cancer coming back. While you may have felt comfortable and confident when you saw your treatment team on a more frequent basis, that confidence can drift away when you transition to fewer maintenance appointments. To help with this transition, you may find it helpful to join a survivor support group, begin seeing a counselor or therapist, or practice mindfulness and meditation.

Q: How can I avoid dwelling on every ache or pain, fearing it is a sign of cancer recurrence?

LS: Prior to facing cancer, aches and pains may have been ignored, but diagnosis and treatment are both life-altering. You may have had no signs or symptoms of breast cancer, possibly receiving a diagnosis following a screening mammogram. Because of this, many breast cancer survivors don’t trust their bodies anymore.

If you are worrying and fretting about aches and pains constantly, are doing breast self-exams in the shower every morning, or are trying to self-diagnose any physical symptom you have, then you are not enjoying the life that was saved for you. You are allowing breast cancer to be in control. But you are in control of your body now. A good general rule of thumb is that if you experience a new physical symptom like hip pain or low back pain that persists for more than three weeks, and you haven’t done anything to explain its cause (such as heavy lifting), then it makes sense to reach out to your medical oncologist and arrange for an x-ray.

Read more about recurrence in the free Breast Cancer Recurrence eBook, written by Lillie Shockney.

Q: How can I explain to my family, friends, and coworkers that this has been a life-altering experience?

LS: Many people expect life to go back to normal now that treatment is completed. They are not aware that the way you see the world now is different. You have faced mortality through this experience. Parts of your personality may change. For example, you may go from being very detail-oriented to no longer wanting to sweat the details. A cancer diagnosis may also alter your goals and expectations. You may even decide to change jobs, realizing you didn’t enjoy what you had been doing for the last decade.

Your personal relationships can also change. It is important have candid and frank conversations with family members, friends, and coworkers to tell them how your breast cancer experience has made you look at the world differently. You can tell them what you are experiencing emotionally, or how you want to embrace your life in different ways going forward. You can also let them know if you are fearful of breast cancer recurrence so they know you need support.

A conversation about these changes could start like this: Having breast cancer and experiencing all the treatment to beat it really changed my outlook. While I feel less bothered by some of the little things, I’m also really scared that the cancer will come back. Would you please support me by checking in on how I’m feeling emotionally a couple times a week? I think talking about things with you would help.

Things will not go back to how they were prior to your diagnosis. This doesn’t mean that your entire world changes, but it does mean you need to explain your life goals now, which may be different from what they were pre-diagnosis.

Q: Would I benefit from seeing a counselor or therapist for help with fear of recurrence?

LS: Many patients and survivors benefit from seeing a counselor or therapist. Sometimes couples therapy is of benefit as well. Fear of recurrence is a form of post-traumatic stress disorder (PTSD), and many breast cancer survivors also meet the medical criteria for having clinical depression, which often goes untreated. ^1-7

Mental health issues are starting to be focused on and prioritized locally and nationally, making many patients feel more comfortable to seek out needed services. Many cancer centers have therapists available as part of their support services, which makes it easier to find someone who has experience with cancer survivorship concerns and thoughts. I also encourage patients and survivors to practice mindfulness, meditation, and yoga. These are ways to reduce stress that have proven to be of benefit to cancer survivors.

Q. I’ve heard about setting new life goals after treatment is completed. What does that mean and why is that important?

LS: We all have life goals, though you may not think of them by that title. Some examples of life goals may include marriage and family, getting a promotion at work, or earning a degree. Some of these life goals may even be in process at the time of diagnosis.

After treatment, I encourage survivors to think about setting new life goals, such as going back to school to get a degree, reducing their work schedule so that more time can be spent with children or grandchildren, or transferring into a new position that allows for more personal and family time going forward.

Setting new goals or reframing old ones can help survivors focus on the hope their future holds, rather than on the trauma of their past diagnosis and treatment. Many survivors also find it helpful to have something to keep their mind off of recurrence.

Q. Why am I not getting routine scans or blood work as a breast cancer survivor? That would make me feel more at ease.

LS: Early on in treatment, your healthcare team should explain the game plan for treatment, including when you will have imaging studies or blood work done and why, and what happens after treatment is completed. If this plan wasn’t or hasn’t been explained to you, advocate for yourself by asking what will happen when your treatment is complete.

For many patients, consistently seeing their oncologist and getting scans and blood work done is something they’ve become accustomed to over the course of treatment. When they are suddenly told that they don’t need appointments, blood work, or scans anymore (unless they develop symptoms), they may begin to panic and feel insecure. It’s important for healthcare teams to explain the plan to patients early so they are prepared for this diminished follow-up care and can mentally prepare for it.

While routine follow-up scans and blood work was the norm a few decades ago, research over time has shown that these frequent follow-ups were more harmful than helpful to survivors due to the prevalence of false negatives and the psychological impact those false results had on survivors. Therefore, the professional organizations that set treatment guidelines deemed it better to rely on signs and symptoms of survivors rather than frequent and unnecessary tests. The only exception is mammograms. Breast cancer survivors should still receive an annual mammogram unless they had a bilateral mastectomy with or without reconstruction.

Q. Can I request to get scans and blood work done at least annually or semi-annually?

LS: As a breast cancer survivor, you generally will not receive annual or semi-annual scans and blood work, and insurance won’t cover these tests unless there is a medical reason. This often makes survivors nervous, especially if you were diagnosed with Stage 3 breast cancer. But be reassured that patients who were diagnosed with Stage 3 breast cancer are usually followed closer than others since they are at highest risk of experiencing local, regional, and/or distant recurrence.

Since it’s likely you will not experience routine scans and blood work as a breast cancer survivor, it’s important that you monitor your own health and report any significant changes to your physician. A good rule of thumb is that you should report any pain, discomfort, or other symptoms you may experience for more than three weeks, that doesn’t have an explainable cause, such as heavy lifting or extraneous activity.

Q. How is metastatic breast cancer (Stage 4) diagnosed?

LS: Once breast cancer spreads (metastasizes) to other areas of the body, it is considered Stage 4 metastatic breast cancer (MBC). MBC usually occurs within the first few years of survivorship, but can occur anytime. If it metastasizes, breast cancer usually spreads to the bone, lung, and/or liver. However, bone is commonly the first location. Signs and symptoms that may be linked to breast cancer metastasis are a physical pain that lasts consistently more than three weeks and has no corresponding activity that can explain its cause, and should be reported to your doctor. For example, if persistent back pain occurs without a corresponding activity to explain it, you should contact your medical oncologist. Additionally, feeling unusual shortness of breath when climbing stairs and new onset of fatigue are also signs of possible metastasis. Prolonged abdominal pain, changes in menstruation, and changes in bowel movements may also warrant a more in-depth look by your physician.

Unfortunately, breast cancer survivors are not excluded from getting other acute or chronic diseases. Heart disease, COPD, diabetes, arthritis, and more still can happen, so you shouldn’t assume that any new symptoms can only be related to cancer.

Remember, the stage of your original cancer doesn’t correlate which how much you may worry about metastatic disease. Regardless of your original diagnosis and stage, almost all women will worry; it’s part of survivorship. But the more you can focus on other things, such as family, hobbies, and living life to the fullest—while still listening to your body—the more likely you are to decrease your levels of worry and anxiety over recurrence.

As a breast cancer survivor, your mental health after treatment ends is just as important as your physical health. Ask questions. Find a support team. Breathe deeply. Your survival journey may be different than anyone else’s—honor your path and your wisdom on your way to living emotionally healthy as a breast cancer survivor.

NBCF is here for you, at every stage of your breast cancer journey. Feel free to drop a question in the comments below, or reach out to help@nbcf.org for support.

Sources:

[1] https://pubmed.ncbi.nlm.nih.gov/28749617/
[2] https://pubmed.ncbi.nlm.nih.gov/23173836/
[3] https://pubmed.ncbi.nlm.nih.gov/21884450/
[4] https://pubmed.ncbi.nlm.nih.gov/26447012/
[5] https://pubmed.ncbi.nlm.nih.gov/29938451/
[6] https://pubmed.ncbi.nlm.nih.gov/29938451/
[7] https://pubmed.ncbi.nlm.nih.gov/19458878/

The post Emotional Wellness After Breast Cancer appeared first on National Breast Cancer Foundation.

Eating seasonally is by no means a new concept (it was the only option available before mass transportation of food became a thing), but it has recently regained so much popularity that you can find many restaurants around the country using phrases like “seasonal menus” and “farm to table” in their marketing. But what exactly is seasonal eating, and is it something you should be doing?

Seasonal eating is exactly what it sounds like – eating foods that are in season. Different foods grow better in different times of the year, therefore affecting its peak harvest season. Have you ever noticed how when you get strawberries in the summer, they are often juicy and have a deep red color all the way through? But if you bit into a strawberry in the middle of winter, there is a good chance you would find that it is mostly white on the inside and not nearly as flavorful. This is due to the variations in quality between foods that are in season versus out of season.

Now that it is winter, there are so many incredible fruits and vegetables starting to grow! Keep reading to learn more about the benefits of eating seasonally and to learn what foods are in season now that winter is here.

Click here to download NBCF’s Winter Food Guide.

Benefits to Eating Seasonally

1. Foods are actually higher in nutrients when they are in season.

The nutrient content of fruits and vegetables is typically highest when it is at its peak ripeness, which is generally when produce that is “in season” is picked. However, foods that are not in season are typically flown in from other areas where they are growing better. Because of this transportation process, most produce that is not in season is harvested long before it is ripe, so it never develops its full nutrition potential or its proper flavor. Produce also begins to lose some of its nutrients after it has been harvested.^1,2 Therefore, the longer it has been since a fruit or vegetable has been harvested, the more nutrients it has lost.

With that being said, fruits and vegetables that are not in season are still very nutritious and healthy (so don’t be afraid to get them if you really want to!); they just won’t have as high of nutrient content as they do when they are in season.

2. Eating seasonally ensures you are getting a wide variety of foods in your diet throughout the year.

Not all foods contain the same nutrients, which is why it is so important to include a variety of different foods in your diet. This is the reason for the old saying, “eat the rainbow.” Eating seasonally helps ensure that you will be eating a variety of fruits and vegetables throughout the entire year, therefore maximizing your nutrient intake.

3. Eating seasonally is more sustainable.

Eating seasonally helps lower the environmental toll associated with food transportation because foods that are in season can be purchased more locally. This helps cut back not only on fuel emissions directly from the transportation process but also reduces the amount of energy needed for refrigeration during transportation and storage.³ Purchasing food locally also helps support local communities and farmers!     

4. Eating seasonally is often more cost-effective.

The great news is that eating seasonally is also good for your bank account! The simple concept of supply-and-demand states that as the supply of an item increases, the cost will go down. This is exactly what happens with food. When a food is in season, there is a lot more of it, so grocery stores are able to price it at a lower cost.

The Takeaway: Eating seasonally is a great, easy way to boost your nutrient intake, save money, reduce your environmental footprint, and support local farmers! What’s not to love?

However, it may not always be possible to eat only what is in season. It is important to prioritize overall fruit and vegetable consumption, and you can take advantage of foods that are in season while doing this!

Winter Seasonal Food Guide

Below is a list of some of the foods that are in season during winter! Something to keep in mind is that the foods that are in season do vary by region. I always recommend stopping at the local farmer’s market if you have one near you to get familiar with what food is grown in your area and to support your local community. You can also use the Seasonal Food Guide and search by your state of residence for more information on what food is grown in different times of the year.^4,5

Fruits

Vegetables

Download NBCF’s Winter Food Guide by clicking here.

Whether you purchase your fruits and vegetables at a grocery store or farmer’s market, remember to wash all fresh produce well by rubbing them under cold running water. You should do this regardless of if you are eating the skin or if the item is going to be cooked versus eaten raw. This will help get rid of the bacteria that may be on these foods and promote overall food safety, which is extremely important, especially when your immune system is low during cancer treatment. You can also use a vegetable scrubber to help clean anything with thick skin, but the FDA and CDC do not recommend using soaps, bleach, or commercial produce washes as these can leave residues behind that have not been tested for their safety.^6–10

Note: The information presented in this post may not be suitable for every person or during rigorous treatments for breast cancer. Please seek advice from your doctor or medical team if you have any concerns before implementing a change in your diet.

Hungry for More?

If you’re looking for more on nutrition care, food safety, and managing cancer treatment side effects with a balanced diet, download the free Nutrition Care for Breast Cancer Patients eBook today!

Looking for more seasonal eating guides? Check out our guides for spring, summer, and fall!

Resources:

1. Managa MG, Tinyani PP, Senyolo GM, Soundy P, Sultanbawa Y, Sivakumar D. Impact of transportation, storage, and retail shelf conditions on lettuce quality and phytonutrients losses in the supply chain. Food Science & Nutrition. 2018;6(6):1527-1536. doi:10.1002/fsn3.685
2. Wunderlich SM, Feldman C, Kane S, Hazhin T. Nutritional quality of organic, conventional, and seasonally grown broccoli using vitamin C as a marker. Int J Food Sci Nutr. 2008;59(1):34-45. doi:10.1080/09637480701453637
3. Hammond ST, Brown JH, Burger JR, et al. Food Spoilage, Storage, and Transport: Implications for a Sustainable Future. BioScience. 2015;65(8):758-768. doi:10.1093/biosci/biv081
4. Seasonal Food Guide. Accessed March 13, 2023. https://www.seasonalfoodguide.org/why-eat-seasonally
5. Seasonal Produce Guide. SNAP Education Connection. Accessed March 13, 2023. https://snaped.fns.usda.gov/seasonal-produce-guide
6. Nutrition C for FS and A. Selecting and Serving Produce Safely. FDA. Published online March 23, 2023. Accessed April 30, 2023. https://www.fda.gov/food/buy-store-serve-safe-food/selecting-and-serving-produce-safely
7. Steps to Safe and Healthy Fruits & Vegetables. Centers for Disease Control and Prevention. Published January 31, 2023. Accessed April 30, 2023. https://www.cdc.gov/foodsafety/communication/steps-healthy-fruits-veggies.html
8. Food Safety During Cancer Treatment. Accessed April 30, 2023. https://www.cancer.org/treatment/survivorship-during-and-after-treatment/coping/nutrition/weak-immune-system.html
9. CDCES MM RD, MS, LDN. Washing Produce—The Do’s and Don’ts. PearlPoint Nutrition Services®. Published August 11, 2020. Accessed April 30, 2023. https://pearlpoint.org/washing-produce-the-dos-and-donts/
10. Danielle. 3 Myths About Washing Fruits and Veggies — and How to Do it Right. Community Cancer Center. Published May 26, 2021. Accessed April 30, 2023. https://www.communitycancercenter.org/nutrition/3-myths-about-washing-fruits-and-veggies-and-how-to-do-it-right/

The post A Guide to Seasonal Eating: Winter Edition appeared first on National Breast Cancer Foundation.

Keira Kotler, a San Francisco-based visual artist and marketing professional, was shocked when her world was rocked by a breast cancer diagnosis at age 40. After her bilateral mastectomy, Keira was even more shocked to realize that one of the greatest obstacles she faced was her inability to find comfortable, supportive—and beautiful—garments to wear to facilitate her healing journey.

After speaking with other breast cancer patients and survivors who shared that they, too, struggled to find functional, comfortable, and attractive garments post-surgery, Keira knew there had to be a better way. She set out to bridge the disconnect between fit, comfort, and beauty for breast cancer patients and survivors, eventually founding Everviolet, an intimate apparel and loungewear brand whose mission is to design garments that nurture all women’s bodies, including those facing breast cancer diagnosis and treatment.

Keira recently shared her personal story, and the story of Everviolet, with the NBCF team. Everviolet is a corporate partner of NBCF.

NBCF: Can you share your story with us, and why the topic of women’s intimate apparel is important to you and others affected by breast cancer?

Keira: I am the founder and CEO of Everviolet, a brand that creates beautiful and adaptive intimate apparel for the immediate and ongoing needs of women after cancer and other physical challenges. The brand was born out of my personal experience with breast cancer—and my struggle to find lingerie that was comfortable, well-fitting, and pretty—following a bilateral mastectomy. My old lingerie no longer fit, and garments designed for after surgery were synthetic, scratchy, and, quite frankly, ugly. I tried on over 200 bras in a 6-month period, and none of them met my satisfaction.

After suffering in silence, I finally started speaking with other women, only to find this issue to be universal. But not just with newly diagnosed women like me. Rather, women who were 10, 20, 30-year survivors claimed there were no brands that offered them the combination of fit and femininity they desired. In speaking with them further, I learned that the inability to start each day free of discomfort, pain, or traumatizing memories represented a barrier to healing on deep psychological and emotional levels. And it was with this realization that I vowed to pay my good prognosis forward and solve this problem for others.

At Everviolet, our mission is to help women reclaim or renew a sense of self and femininity following change, helping them feel comfortable and confident no matter where they are in their journey, and empowering them to feel like people first and patients last. Our mantra is #beautyofchange, because we strongly believe that beauty shines from within. When we face challenging situations, like breast cancer, we’re forced to find strength, resilience, and presence. These are the qualities that make us beautiful, and we all deserve to feel that way every day.

What are some struggles women may face in the time immediately after breast cancer surgery as they are healing? 

Keira: The needs of women during breast cancer vary based on which type of breast surgery and treatment they undergo, as well as potential side effects or complications they endure. That said, ALL women will come out of breast cancer surgery with extreme sensitivity around the incision site and surrounding tissue. Most often, lymph nodes are removed, so in addition to scars on or around the breast, the underarm can be sore as well. Mobility will also be a consideration–especially for those who undergo mastectomies–and many will have surgical drains for weeks following surgery.

Are there certain types of undergarments that are better for women who may have surgical drains, stitches, need compression, or face other post-surgical concerns?

Keira: Garments should be selected based on surgery type, treatment type, and resulting chest types. For example, a camisole with internal drain pockets is a wonderful piece for immediately after surgery. It helps keep surgical drains close to the body and prevents them from pulling or tugging on sensitive skin. We often recommend sizing up during this phase of healing to accommodate swelling.

Garment needs vary widely depending upon whether someone has had a mastectomy vs. lumpectomy. Following a mastectomy, first, there is the drain pocket phase, as described above. Once the drains have been removed and bandages taken off, needs are determined by whether someone has started the process of tissue expanders, gone for immediate reconstruction, or is flat. Bras, at this stage, serve several roles. They can offer support for any natural tissue that is remaining or in the case of a flap reconstruction. These bras also offer discretion, helping conceal scarring or other formations on the skin during this acute healing process. And last, they provide a protective barrier between the surgical site and outside clothing. For all these requirements, soft, natural fabric is recommended in order to promote breathability, avoid irritation, and nurture sensitive skin. Garments with more support will be preferable for those with natural tissue. For those who opt for aesthetic flap closure or have implants/tissue expanders, garments that offer a protective barrier and discretion are best. Following a lumpectomy, doctors often recommend wearing garments that have light compression.

What are the garment needs for women undergoing chemotherapy and radiation?

Keira: For those going through chemotherapy and/or radiation, comfort is key! Soft, natural fabrics that can be easily laundered and offer softness are best, as are garments that are adjustable and adapt to swelling and irritation. I also recommend avoiding garments with abrasive hardware such as zippers, rough fasteners such as Velcro, and any synthetic fabrics. Underwires are also not recommended, as they can dig in and cause irritation.

What are the ongoing challenges and considerations for women who have completed treatment for breast cancer?

Keira: What many women don’t realize is that after surgery, there can be many ongoing sensitivities long after the body has technically healed. Radiation can leave skin very thin and fragile. Lymph node removal will incur a lifetime risk of lymphedema, or the swelling of the lymphatic system, causing edema (swelling caused by too much fluid trapped in the body’s tissues). Scars can remain sensitive to the touch, and nerves can be permanently damaged. Such conditions may change over time, for both the better and worse, so it’s important to be mindful of any changes and select clothing that doesn’t exacerbate or irritate them.

Choosing intimate apparel that avoids irritating these ongoing sensitivities can be achieved while simultaneously promoting comfort and enhancing one’s femininity. For example, there are several bras that may look like regular bras, but they contain many built-in details to help soothe these ongoing conditions and promote all-day comfort. Adjustable straps and fasteners, along with stretch fabrics are essential for fluctuating bodies. Many women also quickly enter menopause following treatment, both naturally and chemically, so garments that help regulate body temperature and are moisture wicking (hello hot flashes!) are also important.

What would you say to a woman whose “after breast cancer” body looks and feels different from her “before breast cancer” body?

Keira: Chest types will vary after breast cancer, and our mission is to celebrate all of them. Look for products that fit women with natural tissue, implants, asymmetry, and those who are flat. Every woman deserves to feel comfortable and beautiful.

Beyond the physical side, however, virtually all women who face breast cancer will go through the emotional and psychological process of adjusting to a new body. Whether due to scarring, the loss of breasts, or the emotional trauma of receiving a cancer diagnosis, women are forever changed post-diagnosis. These changes can bring silver linings and profound growth, but they can also bring grief, body image issues, and trauma.

I believe that true beauty resides within, and that no matter what changes our body has endured, the strength and grace we gain from navigating these changes are what make us even more beautiful. We share stories of resilience, with the intent of helping others on their own healing journey. We believe that knowledge is power and that together, we can conquer all challenges. We are real, authentic, and together, we celebrate the beauty of change. #beautyofchange

National Breast Cancer Foundation is here for you and your loved ones. Whether you need support, education, or help during treatment, we have a team dedicated to getting you the help you deserve.

NBCF does not endorse any specific brand or product.

The post Rediscovering Undergarment Fit, Function, and Femininity After Breast Surgery appeared first on National Breast Cancer Foundation.

In 1990, Dr. Harold P. Freeman, a renowned surgeon at Harlem Hospital in NYC, started the first patient navigation program in the United States.

After two decades as a surgeon, Dr. Freeman was overwhelmed by the amount of cancer patients diagnosed at late stages when the disease is most deadly and difficult to treat. He knew that many of his patients were dying of diseases like breast cancer that may have been caught earlier if screening techniques such as mammograms were more widely used. 

Dr. Freeman also noted that patient outcomes were better just a few blocks south in the more affluent areas of Manhattan, where screening rates were higher, and patients didn’t have to wait as long before being treated.

He believed that patient navigators—trained professionals who guide patients through the healthcare system—could help identify and prioritize those that needed screening the most, help remove their barriers to care, and ensure timely treatment after diagnosis. He really wanted to see the same outcomes for his patients as he saw in the more affluent areas of the city. 

Today, patient navigation is standard in most cancer hospitals across the U.S. The emergence and use of patient navigation has likely helped reduce the mortality rate of breast cancer by over 40% in the U.S. since the early 90’s.¹

Location Matters

An uncomfortable fact about breast cancer is that where you live could impact your chances of being diagnosed with breast cancer and, more importantly, your chances of survival. 

Key Terms:

• Cancer mortality rate: Also called a cancer death rate, the number of deaths, with cancer as the underlying cause of death, occurring in a specified population during a year.²
• Cancer incidence rate: The number of new cancers of a specific type occurring in a specified population during a year.³

The Center for Disease Control and Prevention (CDC) cautions against interpreting or comparing state rankings for cancer incidence and mortality, but it’s hard not to ask questions when the data is so very clear, especially for diseases like breast cancer.

It’s also hard not to attempt to interpret the rankings through data visualization tools that use shading and coloring to highlight which states have the highest incidence and mortality rates of each type of cancer. 

Comparison of Female Breast Cancer Incidence & Death Rates

Based on nationwide breast cancer incidence and death (mortality) rates provided by the CDC, the following information can be inferred⁴:

• Rhode Island has the highest breast cancer incidence rate in the country.
• Hawaii has the highest screening rate in the country.
• Hawaii has the highest breast cancer survival rate. 
• California has the highest number of new breast cancer cases in the country.*
• California has the highest number of breast cancer deaths.*
• The most common type of breast cancer is Invasive Ductal Carcinoma (IDC). IDC makes up about 70-80% of all breast cancers. 

*Though California has both the highest number of new breast cancer cases and the highest number of breast cancer deaths in the country, California maintains a statewide screening program for all residents, regardless of the ability to pay or insurance coverage. As a result of this screening program, NBCF does not fund free mammograms in California. However, NBCF does fund patient navigation programs in areas of the state with the highest mortality rates.

One thing that is noticeable right away is that higher incidence rates of breast cancer does not equate to higher mortality rates.

That is, in an area with higher number of breast cancer diagnoses (incidence rate), that area does not necessarily have a higher number of breast cancer deaths (mortality rate). In fact, in some ways, it can be almost the opposite.  

For example, the breast cancer incidence rate is much higher in the Northeast in states like Connecticut, Rhode Island, and Massachusetts.

However, the mortality rates are much lower in those states than in southern states like Mississippi, Oklahoma, Georgia, and Louisiana, where breast cancer incidence rates are lower.

Breast Cancer Factors Aren’t Simple

Why would a state like Connecticut have more women diagnosed with breast cancer, but also a higher survival rate? The answer is not simple. 

Unfortunately, it’s not entirely clear what causes breast cancer. Genetics play a role, but it is unclear the impact of environment.

Some have theorized that some breast cancer clusters in the Northeast could be caused by hereditary factors^5,6,7.

The higher survival rate is likely a result of several factors, including overall health of the population, access to early detection, ease-of-access to treatment, and better education and awareness about the importance of early detection.

A more important question is: Why is the mortality rate higher in states that may have a lower incidence rate? Could this be easier to explain?  

We know that the best way to survive breast cancer is to detect it early. Early detection is critical to finding and treating breast cancer. Unfortunately, not all places in the United States have free, easy access to screening mammograms or quality treatment within reach.

Many of the states with the highest mortality rate also share the highest percentage of uninsured⁸. Patients in these areas are less likely to get screened and have longer wait times⁹. Their general health is often poorer, and they face barriers to care not present in areas like the Northeast.

If you live in Connecticut, you can get almost anywhere in the state in a couple hours.

However, there are parts of Texas that may require multiple hours of travel to find a higher quality screening and treatment facility.

The distance to travel for screening and treatment, the cost of treatment, language barriers, and general mistrust in the medical systems – these all could possibly contribute to differences in states’ breast cancer mortality rates.

Race may also play a role. Black and Hispanic women have a lower incidence of breast cancer, but a much higher mortality rate¹⁰. As a result, racial demographics in states could impact the overall breast cancer incidence and mortality rate.

Weight and lifestyle choices are also important factors in breast cancer incidence and mortality rates. Several studies suggest that the overall breast cancer incidence rate could be significantly reduced by up to 30% through incorporating a healthy diet and regular vigorous exercise¹¹.

States with higher breast cancer mortality rates also share higher obesity rates¹².  

Even though data behind state cancer registries may not tell the whole story, it does illustrate that where you live could play a role – statistically speaking – in how breast cancer may impact you. 

Moving Forward with Help & Hope

That’s why NBCF looks for partnerships and areas of the country to invest in that are focused on eliminating barriers to care, ensuring health equity, and investing in the lifestyle choices and variables we can control.

By continuing to expand in areas of the country that have higher mortality rates, NBCF may be able to impact more people, save more lives, and bring health equity to all. 

National Breast Cancer Foundation is here for you and your loved ones. Whether you need support, education, or help during treatment, we have a team dedicated to get you the help you deserve. To learn more about NBCF’s programs and where we serve, click here.

Sources:
¹ American Cancer Society https://www.cancer.org/research/acs-research-news/report-breast-cancer-death-rates-down-40-percent-since-1989.html 
² National Cancer Institute https://seer.cancer.gov/statistics/types/mortality.html#:~:text=A%20cancer%20mortality%20rate%20is,Cancer%20Deaths%20%2F%20Population
³ National Cancer Institute https://seer.cancer.gov/statistics/types/incidence.html#:~:text=A%20cancer%20incidence%20rate%20is,per%20100%2C000%20population%20at%20risk.
⁴ American Cancer Society https://cancerstatisticscenter.cancer.org/#!/cancer-site/Breast
⁵ National Library of Medicine https://pubmed.ncbi.nlm.nih.gov/15516849/
⁶ Brandeis University https://www.brandeis.edu/cmjs/noteworthy/ssri/american-jewish-2012.html
⁷ Library of Congress https://www.loc.gov/exhibits/haventohome/haven-century.html
⁸ The Commonwealth Fund https://www.commonwealthfund.org/publications/scorecard/2023/jun/2023-scorecard-state-health-system-performance
⁹ Becker’s Hospital Review https://www.beckershospitalreview.com/oncology/5-states-with-the-highest-lowest-mammogram-rates.html
¹⁰ American Cancer Society https://www.cancer.org/research/acs-research-news/breast-cancer-death-rates-are-highest-for-black-women-again.html
¹¹ National Library of Medicine https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2677576/
¹² Centers for Disease Control and Prevention https://www.cdc.gov/obesity/data/prevalence-maps.html

The post Breast Cancer by State: How Different States Rank in Breast Cancer Mortality Rates appeared first on National Breast Cancer Foundation.

What is Triple Negative Breast Cancer (TNBC)?

Triple negative breast cancer is considered the most aggressive and hard-to-treat form of breast cancer. The term “triple-negative” comes from this type’s lack of three markers, or receptors, commonly found in other types of breast cancer. TNBC lacks receptors for:

• Estrogen
• Progesterone
• HER-2

Since TNBC lacks these three receptors, the cancer is less likely to respond to hormone therapy, a common form of breast cancer treatment. However, chemotherapy, among other options, is still an effective option for the treatment of TNBC.

Read more about triple negative breast cancer and prognosis.

Treatment Options for Metastatic TNBC

Metastatic breast cancer (MBC) is classified as Stage 4 breast cancer. In MBC, the cancer has spread to other parts of the body, which usually includes the lungs, liver, bones, or brain. When TNBC spreads to other parts of the body, it is considered metastatic TNBC.

Although metastatic TNBC is not curable, it is usually treatable, with the focus being on quality of life for the patient. Several factors influence treatment selection for metastatic TNBC, including disease stage, histology (tissue structures), subtype, previous treatments, and patient preferences. The best treatment available is the one that is tailored to the patient’s specific disease, goals, tolerances, and quality of life.

Surgery and radiation are not primary treatments for metastatic TNBC—these treatment options are often used in early-stage disease. For metastatic TNBC, surgery and radiation are considered palliative options that may be used to shrink tumors to make them easier to treat.

Chemotherapy includes oral or IV medicines used to destroy cancer cells in order to shrink a tumor before or after surgery or after the tumor spreads.

Immunotherapy is a relatively new form of treatment for women with MBC. Immunotherapy helps the body’s own immune system fight the cancer. Pembrolizumab and atezolizumab are approved immunotherapy options for metastatic TNBC.

Targeted therapy is treatment directed towards specific markers. Targeted drugs often have less severe side effects than standard chemotherapy drugs. There are two types of targeted therapies currently available for TNBC: antibody-drug conjugates and PARP inhibitors.

• Antibody-drug conjugates (ADCs) attach to chemotherapy drugs to deliver the chemotherapy directly to a specific protein which destroys cancer cells while sparing healthy cells. ADCs that are currently available for TNBC include sacituzumab govitecan and trastuzumab deruxtecan.

• PARP inhibitors block cancer cells from copying themselves. They work best in tumors with certain genetic markers or mutations, like BRCA. There are currently two PARP inhibitors approved for TNBC: olaparib and talazoparib.

What are Metastatic TNBC Treatment Side Effects?

It’s important to have open discussions with your doctor and care team about how you may feel before, during, and after starting treatment.

Questions to ask your doctor or care team when discussing treatment plans:

• What are my medication or treatment options?
• How will this medication/treatment help me?
• What are the side effects of this treatment?
• Will taking this medication make anything worse?
• Will I still be able to do my favorite activities or enjoy my favorite meals?

Some cancer treatment and medication side effects include:

• Nausea or vomiting
• Hair loss
• Memory problems or trouble thinking
• Pain
• Infections

If you experience these or other side effects for an extended period of time, contact your care team.

Clinical Trials

A clinical trial is an approved research study that some doctors believe has a strong potential to improve standard treatments. Clinical trials are often used to learn if a new treatment is more effective than currently available care. There are new ways to treat TNBC being investigated and researched all the time. Clinical trials have many advantages, including:

• Additional treatment option(s) if current treatments aren’t effective
• Access to new medications before they’re widely available
• Extra monitoring and check-ups from a care team while in the trial
• Ability to help move research forward to help others

Check with your care team about the availability of clinical trials in your area.

As with all treatment options, each patient should work with their medical team to determine the best approach to treating their specific type and stage of breast cancer.

National Breast Cancer Foundation is here for you and your loved ones. Whether you need support, education, or help during treatment, we have a team dedicated to getting you the help you deserve.

This post has been produced in partnership with CancerCoachLive and MedLive and presented by Tiffany A. Traina, MD, FASCO; Sara Donahue, MPH, NP, AOCNP; and Jennifer Witt, RN, MSN, OCN, CBCN. The full webinar can be viewed here.

The post Metastatic Triple Negative Breast Cancer Treatment Options appeared first on National Breast Cancer Foundation.

Trying to maintain good nutrition is important while undergoing cancer treatment because your body needs nutrients in order to fuel cells, repair tissues, maintain muscle mass, and more. Unfortunately, many of the side effects of chemotherapy and radiation can make eating much more difficult.

Some treatment side effects include reduced appetite, changes in or lack of taste, nausea, dry mouth, or mouth sores. Cancer patients may experience all these side effects, or they may have none at all. Everyone’s body responds differently, and the type of treatment you are receiving can also greatly impact what side effects you experience. Side effects may also vary throughout different stages of your treatment. For example, you may have less nausea and be able to taste food more just before a chemo session since it may have been a few weeks since your last treatment. In that situation, make sure to take advantage of those times that you are feeling better to try to eat more and have some of the foods you love.

With that being said, it is important to note that there is no “one-size fits all” meal plan when it comes to food to eat during cancer treatment, but the foods discussed below can be used as a guide if you are struggling with deciding what foods to even try. A food that one cancer patient may love may not sit well on your stomach or cause your mouth sores to hurt more. If that’s the case, stay away from it. The most important thing is that you are eating something, so try different things and see what works best for you.

Oatmeal

Oatmeal is one of my favorite foods to recommend to cancer patients because not only is it soft and therefore unlikely to irritate mouth sores, but it is also often easier to tolerate compared to many other foods when you are feeling nauseous. If you are struggling with dry mouth, try making your oatmeal a little more watery so that it is easier to swallow.

In addition to being generally well-tolerated by cancer patients, oats and oatmeal also contain many beneficial nutrients. It is a great source of soluble fiber which can help regulate bowel movements and prevent diarrhea and constipation (both of which may be side effects of cancer treatment). Unfortunately, fiber is less successful at helping prevent opioid-induced constipation,¹ which many cancer patients struggle with due to frequently requiring prescription pain management, though it is still recommended to consume an adequate amount of fiber. The type of fiber that is in oats, called beta-glucan, also has many other health benefits, including helping to lower cholesterol, improve blood sugar control, and more. There are even some studies that indicate that beta-glucan helps improve immune function, fight against infections, and may even reduce the growth of cancerous tumors.² Other nutrients found in oats and oatmeal include manganese, phosphorus, magnesium, iron, zinc, and some B vitamins.³

Try adding a tablespoon of protein powder or nut butter to your oatmeal if you are having a hard time eating enough high-protein foods. Other great additions to oatmeal include fresh fruit (make sure to wash them well), nuts or seeds, cinnamon, coconut flakes, or maple syrup if you are wanting something a little sweet.

Eggs

Just in case you haven’t heard it enough from your doctors or registered dietitian, I’ll say it again – protein is so important while undergoing treatment! Really any protein-rich foods you can tolerate are great options, but many cancer patients tend to tolerate soft protein foods best, especially if they are nauseous or have mouth sores. In this instance, eggs are a great choice.

Don’t be afraid to eat the whole egg either unless you have specifically been told by your doctor or registered dietitian to only have egg whites. While egg whites are high in protein and low in fats, they do not contain many other nutrients. Egg yolks, on the other hand, are great sources of several B vitamins, as well as vitamins A and D, choline, and many important minerals.⁴ The fats in the egg yolk can also be helpful to get extra calories if you are struggling with eating enough in general and have lost weight.

While it is true that egg yolks, and therefore whole eggs, are high in dietary cholesterol (aka cholesterol found in food), many studies indicate that dietary cholesterol does not have a significant effect on the cholesterol levels in your blood and that eating whole eggs is not associated with increased risk of heart disease or stroke.^5–8

Make sure that your eggs are cooked all the way while your immune system is low during cancer treatment in order to reduce the risk of foodborne illness (that means no soft-boiled, poached, or any other form of eggs with a runny yolk).

Yogurt

Sticking with the theme of soft protein foods, yogurt is another great option! I typically recommend Greek or Icelandic yogurts, which are often higher in protein compared to regular yogurt. If you are unsure, just look at the nutrition label to see how much protein a specific product has. Try to find a yogurt with about 15 grams of protein per serving (it may be a few grams more or less, depending on the product). Unfortunately, most plant-based yogurts are not good sources of protein, so make sure to include other protein sources in your diet if you prefer plant-based options. Another important nutrient found in yogurt is calcium, which helps support strong bones. This is important because breast cancer treatment increases the risk of bone loss and osteoporosis.⁹

Yogurt also contains microorganisms called probiotics, which are bacteria that are good for your health. Probiotics provide many benefits, such as helping improve gut health, promoting regular bowel movements, and more.¹⁰ They also make some vitamins that your body can then use.¹¹ One study even suggests that probiotics may help reduce the effects that chemotherapy has on concentration, memory, and attention span in breast cancer patients.¹²

Despite the many health benefits that probiotics provide, there may be times during your treatment when your doctor advises you to limit probiotics when your immune system is at its lowest (however, this is usually regarding probiotic supplements and not necessarily probiotics found in food). Always defer to your doctor or registered dietitian’s recommendations throughout the course of your treatment.

Hummus

Hummus is a great source of protein and is especially good for people who are following a plant-based diet. Hummus also contains anti-inflammatory fats, fiber, and a wide variety of vitamins and minerals.¹³

Hummus is traditionally made from chickpeas (also called garbanzo beans), tahini (roasted sesame paste), lemon juice, garlic, and spices, but may contain additional ingredients for added flavor. Keep in mind that hummus that has additional ingredients, such as red peppers, may be irritating to mouth sores. One of the most popular ways to eat hummus is, of course, as a snack with crackers, pita bread, veggies, or spread on rice cakes, but you can also add it to salads, bowls, sandwiches, and wraps.

Cottage Cheese

Another great soft protein option is cottage cheese, which contains approximately 14 grams of protein per half-cup serving. It also contains a range of vitamins and minerals, such as vitamin B12, riboflavin, calcium, phosphorus, and selenium.¹⁴ You can eat it by itself, as a dip for fruits and vegetables, spread on toast, and many other ways.

Bananas

Bananas are a great food to have on hand while undergoing cancer treatment for many reasons. They are soft and, therefore, likely easier to tolerate if you have any mouth sores, and they are full of nutrients. Bananas are an especially good option if you are struggling with nausea and vomiting because they are easy to digest, so they likely won’t further upset your stomach, and they can help replenish any potassium that has been lost from vomiting.¹⁵ 

Avocado

Avocados contain a wide variety of important nutrients, but for cancer patients, the main thing to care about is that they are high in calories (which is a good thing!) It is common to lose weight both from cancer itself as well as due to the side effects of cancer treatment. While you may be excited about this weight loss to a degree, it is not recommended to lose weight as a result of illness. Unintentional weight loss can lead to loss of muscle mass, which is associated with negative health outcomes.^16,17 If you have been losing weight, try eating avocados by themselves, spread on toast, in smoothies, and in any other form you can think of! Like bananas, avocados are also high in potassium which can be helpful if you have been vomiting frequently. However, you may want to wait to eat them until the nausea subsides because the high fat and fiber content of avocadoes will likely be harder on your stomach.

Apple Sauce

Apple sauce can be a great food to keep on hand because it is soft and moist, which makes it easier to swallow if you are having problems with dry mouth and is less likely to irritate mouth sores. It is also easy to digest and, therefore, a good choice for those struggling with nausea. While there is a wide range of nutrients in apple sauce, they are in pretty small amounts. If you or a family member feel up to making homemade apple sauce, you can improve its nutrient content by including the apple skins, which are higher in fiber and vitamins and minerals compared to the rest of the apple.¹⁸ Just make sure to wash the apples well before blending them up!

Broths and Soups

Broths and soups are generally well tolerated while undergoing cancer treatment and can have a good amount of nutrients. When it comes to soups, try to stay away from those that contain a lot of fat, such as cream, if you are nauseous. Instead, try something that is more broth based. It also may be easier to tolerate vegetables that are in soups because they soften during the cooking process, making them easier to chew and for your body to digest. You can also try soups that have ingredients such as chicken, beef, or beans to help boost your protein intake.

Broth itself may also be a particularly good option for you if you are struggling with severe nausea or if your doctor wants you on a clear liquid diet (this is usually right after having surgery). A popular food trend you may have heard of is bone broth, which is typically higher in nutrients than regular broth and frequently contains higher amounts of protein as well as some vitamins and minerals. Something to keep in mind is that the nutritional quality of bone broth does vary based on how it was prepared and the ingredients used. If you are purchasing bone broth at the store, compare the nutrition labels of a few different products to see which has a higher nutrient content.

Smoothies

Something that I often find with cancer patients who have a low appetite is that it is usually easier for them to drink something rather than eat a full meal. Smoothies are great because they can be packed with nutrients and may not cause much irritation to mouth sores, especially if you stay away from acidic ingredients such as oranges, pineapple, strawberries, or grapefruit. There are so many different variations of smoothies you can make based on your taste preferences, dietary restrictions, and how you are feeling. Click here for a simple guide on how to build smoothies and learn about the health benefits of various smoothie ingredients. 

Nuts and Seeds

I always recommend having snacks on hand, both for when you are out and about going to doctor appointments and treatment sessions and when you are at home, because they are great ways to squeeze in additional nutrients throughout the day. Nuts and seeds are great snack options because they are packed with protein, healthy fats, and vitamins and minerals. If whole, intact nuts are too hard and irritate your mouth sores, try nut butters. You can even add seeds, nuts, and nut butters to other foods, such as oatmeal or smoothies. Nuts are also great to keep eating after you have completed your cancer treatment, as a recent study suggested that regular consumption of nuts was associated with reduced breast-cancer recurrence and greater overall survival.¹⁹

Bread or Crackers

Carbohydrates are the easiest type of macronutrient for your body to digest, which makes it a great choice if your stomach is upset. As hard as it can be to believe this when you are feeling nauseous, getting something in your stomach may actually make you feel better. Bland carbohydrates such as crackers and toast can be useful in these situations, so I recommend keeping them close by to snack on throughout the day. If you are also having a lot of pain from mouth sores, try a non-toasted, soft bread.

While whole grain breads and crackers are more nutritious, save these for when your stomach is not as upset, as the fiber in these foods could worsen nausea. If you are feeling well enough, try spreading nut butters, hummus, avocado, cottage cheese, or any other foods that sound good to you on your bread or crackers to help maximize your nutrient intake.

Jello or Gelatin

While jello is not considered a “nutrient-dense” food (meaning it does not contain very many vitamins or minerals), it may be one of the only things you can tolerate at times. If that is the case, don’t let the minimal nutrients it contains deter you from eating it. Eating jello or gelatin is better than eating nothing because you will at least be getting some calories and small amounts of protein. I always tell cancer patients that when they have no appetite or are feeling really sick, the most important thing is that they are eating something. You can always work on improving the nutritional quality of what you are eating later. Like broth, jello is also a great option if your doctor tells you they only want you to eat and drink clear liquids.

Popsicles

Eating popsicles can also be a great way to try and get some calories in if you are having a hard time tolerating everything else. While many patients find the cold temperature of popsicles soothing, some may find that they make their mouths hurt worse. As always, pick and choose the foods that your body responds best to.

Popsicles made from real fruit will have more nutrients compared to those made with artificial flavors. You can even make homemade popsicles with your family by blending fresh fruit of your choice (make sure it has been washed) with ½ tsp honey or some Greek yogurt, pouring the mixture into a popsicle mold, and leaving it in the freezer for at least 8 hours.

Ginger, Chamomile, or Peppermint Tea

Various herbs have been used for centuries to help reduce symptoms such as nausea and upset stomach. Several studies done on ginger, chamomile, and peppermint extract show that these three herbs are effective at improving nausea, including chemotherapy-induced nausea in breast cancer patients.^20–25 One study even suggested that peppermint extract may help prevent loss of appetite.²⁴ While these studies were mostly done with extracts of these three herbs, teas may also have the same benefits.

For more information on managing the nutrition-related side effects of breast cancer treatment, click here. You can also access a free cookbook with recipes to try here. Download our free grocery list here.

Disclaimer: The information provided in this article should serve as a general guide and should not be used for the diagnosis or treatment of a medical condition. Please ask your doctor or your registered dietitian if there are certain foods that you need to avoid due to other medical conditions or nutrient interactions with medications you may be taking.

Sources

The post 15 Foods to Keep Stocked When Facing Cancer appeared first on National Breast Cancer Foundation.

There are two types of mammograms:

• Screening mammogram: Women who are 40 years old and over who have no known breast cancer risk factors and are not experiencing any signs or symptoms of breast cancer should receive a screening mammogram once a year. 
• Diagnostic mammogram: Women whose initial screening mammogram results showed something abnormal, those who are at increased risk of developing breast cancer, or women who are experiencing signs or symptoms of breast cancer should receive a diagnostic mammogram. Check with your healthcare provider to determine which type of mammogram and screening timeline is recommended for you.

Whether you are preparing for a screening mammogram or a diagnostic mammogram, knowing what to expect and how to prepare is essential to the successful completion of this important screening. There are several mammogram prep tips to keep in mind as you prepare for your mammogram. After you read the tips below, print our Mammogram Prep Checklist or check it off on your device as you prepare for your mammogram.

How to prepare before your mammogram

Discuss recent changes or problems in your breasts with your healthcare provider

Any time you experience a change in shape, size, or texture, or feel a lump in either breast or surrounding area, you should see your healthcare provider to discuss the changes and determine the next steps to take. 

If you are experiencing breast changes, your doctor will likely recommend you receive a diagnostic mammogram. 

While it is important to keep in mind that most breast changes or breast lumps are not cancer, all changes and lumps should be investigated quickly and thoroughly. 

Choose the right facility

If it is time to receive your annual screening mammogram, or if your healthcare provider has recommended you receive a diagnostic mammogram, do not put off scheduling this important screening. 

You should choose an imaging facility that specializes in mammograms and does many mammograms a day. 

Also try to choose a facility that offers 3D mammograms, or tomosynthesis. This type of modern mammogram detects cancer more accurately than older X-ray analog mammograms.

Some women may face barriers when it comes to scheduling or receiving a mammogram, such as finding a mammogram facility near them, being able to afford a mammogram, or even knowing what to say when scheduling. 

Read How to Schedule a Mammogram for a list of free or low-cost mammogram facilities and other tips on how to receive your mammogram in a timely manner. Or search the FDA Mammogram Facilities database using your zip code to find a mammogram facility near you.

Schedule your mammogram when your breasts are the least tender or swollen

Due to naturally occurring hormone fluctuations within the body, many women experience tender or swollen breasts at some point during their monthly menstrual cycle. 

To ease unnecessary discomfort during your mammogram, avoid scheduling your mammogram the week before and during your period, when your breasts are in their most tender state. 

If possible, try to schedule your mammogram for one to two weeks after your period starts.

For more tips on how to advocate for your best, most comfortable mammogram experience, read 4 Things to Share at Your Next Mammogram.

Gather your documents

Below is a list of documents to have on hand when you are preparing to schedule your mammogram. 

You should also take these documents with you to your mammogram appointment:

• Proof of identification, such as a driver’s license or government-issued ID card
• Proof of address, if required by your mammogram facility
• Health insurance card or policy information, if applicable
• Household income information (if you are receiving a free or low-cost mammogram, you may be required to provide documentation of your household income)

Prepare prior mammogram images and information

If you have had previous mammograms but are going to a new facility for your upcoming mammogram, be sure to request in advance your previous mammogram images and reports from your prior mammogram facility. 

Sometimes the old facility will be able to digitally send your images and reports to the new facility, but in some cases, you may have to pick up the physical copies to deliver to the new facility.

Make sure your new facility receives the following information before your scheduled appointment:

• List of dates and places of previous mammograms
• Images or films, including written reports, of mammograms you have received before
• Images and reports from any other breast procedures you’ve had done before, such as ultrasounds or biopsies

How to prepare the day of your mammogram

There are often strict guidelines to follow on the day of your mammogram. Check with your mammogram facility for any specific guidelines they may have, and follow the best practices listed below.

Don’t use any deodorant or other health and beauty products before your mammogram

Wearing certain health and beauty products on the day of your mammogram can interfere with the mammogram reading. 

On the day of your mammogram, avoid applying the following types of products to your breasts, chest, and underarms:

• Deodorants
• Antiperspirants 
• Lotions
• Creams
• Powders
• Cosmetics
• Perfumes

If you already have deodorant or other products applied to your breasts, chest, or underarms on the day of your appointment, remove it with soap and water before your mammogram. However, if you are unable to shower or bathe before your appointment, don’t worry—the mammogram facility will have wipes available for you to remove any products from your body.

Consider pain medication

Because mammograms apply pressure to the breasts and surrounding tissue, some discomfort is to be expected. 

However, keep in mind that this discomfort will only last for a few seconds at a time. If you are worried about experiencing pain during your mammogram, or if you have experienced pain during a previous mammogram, talk to your doctor about taking an over-the-counter pain medication about 1 hour before your mammogram. 

You can also ask if your mammogram facility provides mammogram cushions. These cushions are placed on the surface of the image detector and can help provide more comfort during the screening.

Wear a two-piece outfit and comfortable shoes

You will only need to remove your top and bra for a mammogram. Therefore, it is best to wear a two-piece outfit, such as an easily removable shirt with pants, shorts, or a skirt. 

You will also be standing (if there aren’t any physical limitations) during the mammogram, so wearing comfortable shoes as opposed to high heels is also recommended. 

Don’t wear any neck jewelry

You will need to remove any neck jewelry and long earrings for the mammogram. Leave jewelry at home to avoid the risk of losing it.

You can eat and drink as you normally would

Some people ask if they need to avoid eating or drinking before their mammograms. 

It is not necessary to avoid food or drink before your mammogram, so eat or drink as you normally would the day of your appointment.

Take your daily medications

If you take daily medications, or are on some sort of medication regimen, you can and should take your medications as you normally would on the day of your appointment. 

During your appointment, you may be asked about any medications you take, so be prepared to list your medications and dosages to the facility nurse or technician if you are asked.

Share important information with your mammogram technician

It is important that you communicate the following information to your mammogram technician before the screening begins:

• Any breast changes or problems you are experiencing
• If you have breast implants
• If you have trouble standing or holding still (without a cane or walker)
• If you are breastfeeding
• If you are or think you might be pregnant

FAQs about how to prepare for a mammogram

Can I take a shower before a mammogram?

Yes, you can shower or bathe before a mammogram. Just remember to not apply any antiperspirants, deodorants, lotions, creams, powders, perfumes, or cosmetics to your breasts, chest, or underarms after showering or bathing.

Can I use soap before a mammogram?

Yes, you can use soap in the shower or bath as you normally would before a mammogram. Just remember not to apply the following products to the breasts, chest, or underarms after a shower or bath: antiperspirants, deodorants, lotions, creams, powders, perfumes, or cosmetics.

Can I shave my armpits before a mammogram?

Yes, you can shave your armpits before a mammogram. Just remember not to apply antiperspirants or deodorants to your armpits before your mammogram.

Can I put lotion on my face or body before a mammogram?

You can apply lotion to your face and parts of your body except your breasts, chest, and underarms before a mammogram.

Can I wear makeup to my mammogram?

You can wear makeup on your face to your mammogram. Do not apply makeup or other cosmetics to your breasts, chest, or underarms before your mammogram.

Can I use hairspray before a mammogram?

Yes, you can use hairspray and other hair products before your mammogram. Just be careful that it does not spray on your breasts, chest, or underarms while you are applying it.

Can I get a mammogram while on my period?

Yes, you can get a mammogram while you are on your period. However, keep in mind that women’s breasts are at their most tender the week before and during their period, which could cause discomfort during the screening. If possible, try to schedule your mammogram for one to two weeks after your period starts.

Mammograms are the key to early detection. Take the NBCF Mammo Pledge today to encourage yourself and your loved ones to prioritize their breast health in the coming year! 

For more details on what to expect and how to prepare for a mammogram, download our free eBook, Mammogram 101.

NBCF is here to provide help and inspire hope to those affected by breast cancer through early detection, education, and support services. If you want additional information on how to prepare for a mammogram, or need other support, please leave a comment below.

The post How to Prepare for a Mammogram appeared first on National Breast Cancer Foundation.

Eating seasonally is by no means a new concept (it was the only option available before mass transportation of food became a thing), but it has recently regained so much popularity that you can find many restaurants around the country using phrases like “seasonal menus” and “farm to table” in their marketing. But what exactly is seasonal eating, and is it something you should be doing?

Seasonal eating is exactly what it sounds like – eating foods that are in season. Different foods grow better in different times of the year, therefore affecting its peak harvest season. Have you ever noticed how when you get strawberries in the summer, they are often juicy and have a deep red color all the way through? But if you bit into a strawberry in the middle of winter, there is a good chance you would find that it is mostly white on the inside and not nearly as flavorful. This is due to the variations in quality between foods that are in season versus out of season.

As fall approaches, there are so many incredible fruits and vegetables starting to grow! Keep reading to learn more about the benefits of eating seasonally and to learn what foods are in season during fall (September, October, and November).

Click here to download NBCF’s Fall Food Guide.

Benefits to Eating Seasonally

1. Foods are actually higher in nutrients when they are in season.

The nutrient content of fruits and vegetables is typically highest when it is at its peak ripeness, which is generally when produce that is “in season” is picked. However, foods that are not in season are typically flown in from other areas where they are growing better. Because of this transportation process, most produce that is not in season is harvested long before it is ripe, so it never develops its full nutrition potential or its proper flavor. Produce also begins to lose some of its nutrients after it has been harvested.^1,2 Therefore, the longer it has been since a fruit or vegetable has been harvested, the more nutrients it has lost.

With that being said, fruits and vegetables that are not in season are still very nutritious and healthy (so don’t be afraid to get them if you really want to!); they just won’t have as high of nutrient content as they do when they are in season.

2. Eating seasonally ensures you are getting a wide variety of foods in your diet throughout the year.

Not all foods contain the same nutrients, which is why it is so important to include a variety of different foods in your diet. This is the reason for the old saying, “eat the rainbow.” Eating seasonally helps ensure that you will be eating a variety of fruits and vegetables throughout the entire year, therefore maximizing your nutrient intake.

3. Eating seasonally is more sustainable.

Eating seasonally helps lower the environmental toll associated with food transportation because foods that are in season can be purchased more locally. This helps cut back not only on fuel emissions directly from the transportation process but also reduces the amount of energy needed for refrigeration during transportation and storage.³ Purchasing food locally also helps support local communities and farmers!     

4. Eating seasonally is often more cost-effective.

The great news is that eating seasonally is also good for your bank account! The simple concept of supply-and-demand states that as the supply of an item increases, the cost will go down. This is exactly what happens with food. When a food is in season, there is a lot more of it, so grocery stores are able to price it at a lower cost.

The Takeaway: Eating seasonally is a great, easy way to boost your nutrient intake, save money, reduce your environmental footprint, and support local farmers! What’s not to love?

However, it may not always be possible to eat only what is in season. It is important to prioritize overall fruit and vegetable consumption, and you can take advantage of foods that are in season while doing this!

Fall Seasonal Food Guide

Below is a list of some of the foods that are in season during fall! Something to keep in mind is that the foods that are in season do vary by region. I always recommend stopping at the local farmer’s market if you have one near you to get familiar with what food is grown in your area and to support your local community. You can also use the Seasonal Food Guide and search by your state of residence for more information on what food is grown in different times of the year.^4,5

Fruits

Vegetables

Download NBCF’s Fall Food Guide by clicking here.

Whether you purchase your fruits and vegetables at a grocery store or farmer’s market, remember to wash all fresh produce well by rubbing them under cold running water. You should do this regardless of if you are eating the skin or if the item is going to be cooked versus eaten raw. This will help get rid of the bacteria that may be on these foods and promote overall food safety, which is extremely important, especially when your immune system is low during cancer treatment. You can also use a vegetable scrubber to help clean anything with thick skin, but the FDA and CDC do not recommend using soaps, bleach, or commercial produce washes as these can leave residues behind that have not been tested for their safety.^6–10

Note: The information presented in this post may not be suitable for every person or during rigorous treatments for breast cancer. Please seek advice from your doctor or medical team if you have any concerns before implementing a change in your diet.

Hungry for More?

If you’re looking for more on nutrition care, food safety, and managing cancer treatment side effects with a balanced diet, download the free Nutrition Care for Breast Cancer Patients eBook today!

Looking for more seasonal eating guides? Check out our guides for winter, spring, and summer!

Resources:

1. Managa MG, Tinyani PP, Senyolo GM, Soundy P, Sultanbawa Y, Sivakumar D. Impact of transportation, storage, and retail shelf conditions on lettuce quality and phytonutrients losses in the supply chain. Food Science & Nutrition. 2018;6(6):1527-1536. doi:10.1002/fsn3.685
2. Wunderlich SM, Feldman C, Kane S, Hazhin T. Nutritional quality of organic, conventional, and seasonally grown broccoli using vitamin C as a marker. Int J Food Sci Nutr. 2008;59(1):34-45. doi:10.1080/09637480701453637
3. Hammond ST, Brown JH, Burger JR, et al. Food Spoilage, Storage, and Transport: Implications for a Sustainable Future. BioScience. 2015;65(8):758-768. doi:10.1093/biosci/biv081
4. Seasonal Food Guide. Accessed March 13, 2023. https://www.seasonalfoodguide.org/why-eat-seasonally
5. Seasonal Produce Guide. SNAP Education Connection. Accessed March 13, 2023. https://snaped.fns.usda.gov/seasonal-produce-guide
6. Nutrition C for FS and A. Selecting and Serving Produce Safely. FDA. Published online March 23, 2023. Accessed April 30, 2023. https://www.fda.gov/food/buy-store-serve-safe-food/selecting-and-serving-produce-safely
7. Steps to Safe and Healthy Fruits & Vegetables. Centers for Disease Control and Prevention. Published January 31, 2023. Accessed April 30, 2023. https://www.cdc.gov/foodsafety/communication/steps-healthy-fruits-veggies.html
8. Food Safety During Cancer Treatment. Accessed April 30, 2023. https://www.cancer.org/treatment/survivorship-during-and-after-treatment/coping/nutrition/weak-immune-system.html
9. CDCES MM RD, MS, LDN. Washing Produce—The Do’s and Don’ts. PearlPoint Nutrition Services®. Published August 11, 2020. Accessed April 30, 2023. https://pearlpoint.org/washing-produce-the-dos-and-donts/
10. Danielle. 3 Myths About Washing Fruits and Veggies — and How to Do it Right. Community Cancer Center. Published May 26, 2021. Accessed April 30, 2023. https://www.communitycancercenter.org/nutrition/3-myths-about-washing-fruits-and-veggies-and-how-to-do-it-right/

The post What Foods to Eat This Fall appeared first on National Breast Cancer Foundation.

Metastatic breast cancer, also known as Stage 4 breast cancer, occurs when breast cancer cells have spread to other parts of the body, such as the bones, liver, lungs, or brain. Though metastatic breast cancer is not curable, treatment can help mitigate, or lessen, symptoms and prolong the patient’s life. Having metastatic breast cancer means that cancer will be a part of your life for the rest of your life. To support those living with metastatic breast cancer, who often feel isolated from other breast cancer patients and survivors, NBCF hosts weekend retreats to recognize and address their unique needs.

One of the topics covered at these metastatic retreats is hospice care. Hospice is designed to provide supportive care to individuals during the final phase of a terminal illness, such as metastatic breast cancer. Hospice care focuses on patient comfort and quality of life rather than treating the disease, with the ultimate goal being for the patient to be pain-free and spend her remaining time as she chooses. It also includes preparation for the end of life for the patient and their loved ones.

One of the great ironies of hospice care is that patients often begin to feel better once they begin hospice. This is because they have stopped treatments such as chemotherapy, and the toxic drugs—and their side effects—are leaving their system. Even though the cancer will continue to grow, patients may enjoy a greater quality of life during hospice care by spending time with family and friends, doing the things they love most, and getting closure as they approach the end of life.

It is incredibly important to understand what hospice care actually is. When discussing hospice care, it is appropriate to be optimistic while remaining realistic and keeping in mind what lies ahead.

Hospice is getting support, not giving up

When a patient is first diagnosed with a terminal illness like metastatic breast cancer (MBC), they may initially hope for a miracle. While maintaining a hopeful outlook is important, it is equally important to remember that MBC is a chronic illness that will be treated for the purpose of mitigating symptoms and prolonging life, rather than a cure. The goal of treatment is to have good longevity and quality of life. Eventually, an MBC patient will exhaust or go through all available therapies. When this happens, it is now the time to discuss the reality of shorter longevity with the goal of preserving quality of life.

Some people assume that enrolling in hospice means the patient has given up or that they failed in some way—failed themselves, disappointed their doctors, or disappointed their family. But opting for hospice care is NOT giving up. It is about patients retaking control of their lives and spending their remaining time as they want.

Family members may find their loved one’s decision to enter hospice hard to accept and be tempted to encourage them to “just keep fighting.” But it is important for loved ones to remember that the patient is in charge, and this decision lies with her alone. While hard to hear and accept, her family needs to love her enough to respect her wishes, even if that includes letting her go. Family members should never force a loved one to take a treatment she doesn’t want.

A common misconception of hospice care is that the patient will feel abandoned by their oncology team, and they will be given narcotics that make them sleep around the clock. But this is not the case. The goal of hospice is to keep the patient as physically comfortable as possible, not to simply incapacitate them through the administration of drugs. Hospice care workers also provide emotional and spiritual support for patients and are with them throughout their time together; patients will not be abandoned or alone.

The ins and outs of hospice care

Most hospice care is actually provided at home, although some patients may not have at-home support or may prefer to spend their final days in a hospice facility. These thoughtful discussions should take place between the patient and their primary caregiver, usually a family member or loved one, to determine what is best for each situation. Some patients will begin by receiving hospice care at home and later transfer to a hospice facility.

Hospice care is designed to last up to six months. Unfortunately, in the United States, most patients receive an average of only five days in hospice care. This is typically due to the patient’s doctor insisting they continue to receive treatment, or sometimes fear and uncertainty surrounding the purpose of hospice care prevent a patient from choosing to enter hospice earlier. As an expert in the field, my opinion is that 2 to 3 months in hospice care is an ideal length of time.

If a patient in hospice care exceeds the 6-month timeframe, they will be re-evaluated to determine the right time to resume this type of supportive care. In some cases, of course, it is immediate.

Benefits of hospice care for patients and caregivers

Hospice care is not just for the patient but also for family members. As part of hospice care, caregivers will receive education on how to manage specific aspects of the patient’s home care, such as:

• How to help a patient up from the bed and into a chair without anyone getting injured
• Nursing care and support with bathing, feeding, and more
• How to administer pain or other medications to improve comfort
• What the caregiver will observe as their loved one gets sicker, and what these signs and symptoms mean
• Spiritual care for the patient and family members
• Advice on how to get closure with a loved one, including if the caregiver has had a rocky relationship with the patient
• Grief counseling is also offered, and many hospice programs have therapy dogs for the patient and their family members

All hospice programs offer palliative care, which is specialized medical care that focuses on managing symptoms that are disruptive to a patient’s quality of life. This may be one of the most important services provided. These talented palliative care specialists, most of whom are medical oncologists themselves, focus on methods to relieve cancer patients of their side effects.

Making the most of time

Many patients, particularly those who have been sick from treatments, understand and accept the need for hospice.

There may be circumstances where a patient would like to live long enough to experience a specific event or milestone—like the birth of a grandchild, for example. In this specific case, if the baby is due to be born soon, that may be a reasonable goal. However, an unreasonable goal would be for the patient to anticipate living long enough to see their grandchild grow up and start kindergarten. In this case, there needs to be a conversation about what kind of timeframe is practical and how to fulfill their hopes in alternative ways, such as writing letters for the grandchild as he or she reaches special milestones.

It is extremely important to remember that quality of life may outweigh longevity. I often ask oncologists if their patients are simply existing, or if they are experiencing a reasonably comfortable and fulfilling quality of life. My belief is that the goal is not how many days a person lived, but how many days they lived well, free from pain and discomfort.

Putting patient-centered care at the forefront

Simply put, patients deserve patient-centered care: Treat the whole patient, not just the cancer. The patient is far more than her diagnosis or prognosis. We need to ask the patient many questions about what is important to her and keep asking these questions over time.

The questions I ask my patients include:

• How much do you know about your metastatic breast cancer? We need to ensure everyone has the same understanding of the disease, where it is located, what treatments she may be a candidate to receive, and that the goal of treatment is control, not cure.
• How much do you want to know about your metastatic breast cancer? Some patients want to know everything, and others are too overwhelmed and want information in phases as they see their treatment team.
• What are you hoping for?
• What are you most worried about?
• What is important to you?
• Tell me three things that bring you joy.

I ask these questions each time I see a patient, and the answers usually change over time as the disease eventually progresses.

Hospice care doesn’t have to be entered into with fear or uncertainty. Ask questions. Listen to the answers. Be open to hospice care at home or in a facility. And honor the wishes of your loved one.

For more information about NBCF Metastatic Breast Cancer Retreats, click here.

National Breast Cancer Foundation is here for you and your loved ones. Whether you need support, education, or help during treatment, we have a team dedicated to getting you the help you deserve.

The post At the Heart of Hospice: <br> Hopes, Fears, and How to Plan for What’s Next appeared first on National Breast Cancer Foundation.

Smoothies are one of my absolute favorite breakfast go-to’s because they are super quick to make and can be packed with nutrients and great flavors! Many people have a hard time meeting the recommended five servings of fruits and vegetables per day, so why not start your day with some of these nutritious foods in your breakfast?

Use this article as a guide to make your own smoothies, but feel free to customize it! If you want more or less of a certain ingredient, don’t be afraid to try it. The great thing about smoothies is that there is an endless number of variations, and you can really tailor them toward your own preferences.

As a quick note: Before you get started, you can use either fresh or frozen fruits and vegetables, but don’t forget to wash any fresh fruits or vegetables well by rubbing them under cold running water before adding them to the blender! This will help get rid of the bacteria that may be on these foods and promote overall food safety, which is extremely important, especially when your immune system is low during cancer treatment. You can also use a vegetable scrubber to help clean anything with a thick skin, but the FDA and CDC do not recommend using soaps, bleach, or commercial produce washes as these can leave residues behind that have not been tested for their safety.^{1–3,4(p3),5}

First Things First – Choose a Liquid

I recommend using about 1 cup of liquid for your smoothie base.

There are so many different options out there now for “milk” including regular cow’s milk, almond milk, oat milk, coconut milk, and more. Any of these options are completely fine to use as your base, but you should know that they are not all created equally when it comes to nutrition.

In terms of plant-based milks, soy milk is the closest nutritionally to cow’s milk (which is generally much higher in nutrients than most plant-based milks) and contains roughly the same amount of protein, while other non-dairy milks are typically much lower in this nutrient.⁶ You may have heard that there is quite a lot of controversy surrounding soy and breast cancer. Soy contains compounds called isoflavones, which has a similar structure to the estrogen found in your body. While there are some older studies using laboratory animals that indicated soy might increase the risk for breast cancer, more recent studies done with humans contradict this. Experts believe that these conflicting results are due to the fact that animals and humans may process soy differently.⁷ In fact, there are many studies done in humans that show that consuming these isoflavones may actually reduce the risk for breast cancer or recurrence.^8–12  The consensus among experts is that moderate consumption of soy-based foods is safe, but to avoid soy or isoflavone supplements which are much more concentrated.^7,13,14  With that being said, there are some doctors who still recommend limiting soy foods just to be on the safe side. Feel free to talk to your doctor or registered dietitian for more information!

If you want to stick with plant-based milk but are not comfortable with the isoflavones in soy milk, there are plenty of other great options. As mentioned above, these milks do tend to be lower in other nutrients, especially protein, so you just need to make sure to get these nutrients from other sources (keep reading for more information on protein options for smoothies).

If you opt for a non-dairy milk, try getting one that says it is fortified with calcium and vitamin D. That means that it has had these two nutrients added to it to enhance its nutritional quality and make it a little more similar to cow’s milk.

Pick a Green

While I always add approximately 1 cup of green vegetables to my smoothies, feel free to use less if you are new to the idea of vegetables in smoothies and gradually increase the amount as you prefer.

If you are not used to having vegetables in your smoothie, it may sound a bit odd, but there are plenty of reasons why you should try it! Vegetables are a great source of fiber, which does so many great things for your body, including lowering the risk for developing certain types of cancer, promoting gut health, helping to maintain good blood sugar control, reducing blood cholesterol levels, and so much more! Green vegetables are also packed with antioxidants which help protect the cells in your body from damage due to the environment.

Here are some of my favorite greens to add to smoothies:

• Spinach: I love to use spinach in my smoothies because it has a mild flavor compared to some other greens (so your smoothie won’t taste too earthy), but it is still packed with nutrients. Spinach is a great source of plant-based iron, which helps transport oxygen throughout your body. You can help increase the absorption of the iron in spinach by pairing it with foods that are high in vitamin C such as mangoes, cherries, kiwi, papaya, strawberries, and oranges.¹⁵

• Zucchini: This vegetable also has a very mild flavor, and it creates a smoothie with a creamy texture. Zucchini is very hydrating because it is approximately 95% water and contains electrolytes such as potassium and magnesium.¹⁶

• Mixed greens: These salad greens have a slightly stronger taste than spinach. The great thing about mixed greens is that because they contain a wider variety of vegetables than if you were to buy just a bag of spinach or lettuce, they also contain a wider range of nutrients!

• Broccoli: Broccoli is an excellent source of vitamin C (an antioxidant that helps support your immune system) and vitamin K (helps with blood clotting and bone health).¹⁷ There is also some research showing that cruciferous vegetables such as broccoli and kale (see below) may help lower the risk for certain types of cancer, including breast cancer.^18–23 Because broccoli can make a smoothie a bit thicker, I typically only use about ½ a cup of this ingredient when using it in my smoothies instead of 1 cup. I also recommend using fresh (rather than frozen) broccoli that is chopped into small florets so that the blades in your blender can cut through them more easily.

• Kale: This is probably the most “earthy tasting” green vegetable that is sometimes added to smoothies, which is great if you don’t like things that are too sweet. If kale is too bitter for you, you can always add more fruit. As mentioned above, kale is a cruciferous vegetable that has been associated with a reduced risk for developing breast and other types of cancer. Also, like broccoli, kale is a great source of vitamins C and K as well as many other important nutrients.²⁴

Add Some Fruit

I recommend using a total of 1 cup of fruit for your smoothies. If you are using more than one fruit, divide them up so that the total volume is approximately 1 cup.

I love to use frozen fruit for smoothies because it is ready to go (no washing, peeling, or slicing required) and is usually cheaper too! Using frozen fruit also means that you don’t have to add any ice to your smoothies, so that’s one less step before your breakfast is ready! If you do opt for fresh fruit instead of frozen, make sure to remove any pits from stone fruits such as cherries, apricots, peaches, and dates, and as always – make sure to wash them well!

Just about any fruit is delicious in smoothies, but here are some of my favorites:

• Blueberries: Blueberries have long been touted as a “superfood” because of their high nutrient content, and particularly because of their antioxidant properties. Some studies suggest that the antioxidants in blueberries may lower the risk for chronic diseases such as cancer, heart disease, and diabetes as well as improve brain function and memory.^25–30 There are also studies that show that “wild blueberries,” which are much smaller than the standard blueberries you typically see at the store, are even higher in antioxidants than other varieties.³¹ So if you see “wild blueberries” in the frozen food section, make sure to grab some!

• Cherries: Cherries are also packed with antioxidants and have been shown to help reduce inflammation.³² One recent study showed that cherry antioxidant extracts may inhibit the growth of breast cancer cells as well as prevent them from spreading to other tissues.³³ Cherries also contain a compound called melatonin,³⁴ which plays a vital role in sleep (the National Cancer Institute estimates that roughly half of all cancer patients suffer from some form of sleep disorder).³⁵ While these studies looking at the effect of cherries on breast cancer and sleep have shown promising results, they were conducted with very concentrated forms of cherry juice and cherry antioxidants. More studies need to be conducted to know if having regular cherries in your diet has the same effects, but there’s no harm in trying, right? 

• Mango: Mangoes are one of my favorite fruits to add to smoothies because they have a bright, sweet flavor, and they are packed with important nutrients. Just one cup of mangoes contains 67% of the daily value of vitamin C and 10% of the daily value of vitamin A as well as many other nutrients.³⁶ Both vitamin C and A help to support a healthy immune system.

• Blackberries: The one downside to using blackberries in your smoothies is that the small seeds, while high in fiber and great for you, do tend to get stuck in your teeth. They can also be irritating to your mouth if you are struggling with mouth ulcers as a side effect of your treatment. However, if you are able to tolerate them, blackberries provide a great flavor and contain a variety of nutrients such as vitamin C, vitamin K, and a mineral called manganese that helps promote wound healing, improve bone mineral density, and supports the immune system.^37–39

• Bananas: Bananas are very commonly seen in smoothies because they are usually pretty easy to find at the grocery store, and make smoothies taste really sweet. While bananas contain a wide range of nutrients, they are most famous for being a good source of potassium, a mineral that promotes heart health.⁴⁰

The list could go on and on about different types of fruit that are great in smoothies and have a wide range of healthy benefits. Some other ideas of fruit to try in your smoothies are oranges, papayas, pineapple, peaches, raspberries, strawberries, and many more!

Select a Protein

Regardless of what protein source you are using, I recommend aiming for at least 20-25 grams of protein per smoothie unless you have problems with your kidneys or have been advised otherwise by your doctor or registered dietitian. Look at the nutrition labels to see how much protein is in the ingredients you are using.

The most common reason that I recommend smoothies to cancer patients is to increase their protein intake. I find that when someone’s appetite is low, it is often easier for them to drink something rather than eat a large meal, and protein is one of the main cancer patients often focus on. Whether you prefer plant-based proteins, collagen proteins, or whey-based proteins, the most important thing is to get protein!

Protein serves many important roles in your body, such as helping build and repair tissues, maintaining lean muscle mass, managing hormones, and more.41 Including protein in your meals also helps prevent a sharp spike in your blood sugar after eating and helps keep you feeling full longer.⁴²

If you are using protein powders, it is important to keep in mind that the serving size may vary between brands. For example, many protein powders come with a scoop in the container, and a serving may be either one or two scoops. I always recommend using one full serving of protein powder, so make sure to read the nutrition label to see how much a serving is for the product you are using.

If you don’t like the taste of protein powders, you can also add Greek Yogurt to your smoothies. Your registered dietitian or doctor may also suggest using a commercial protein supplement in your smoothies for added calories, vitamins, and minerals, particularly if you are having a hard time keeping your weight up. Popular examples of these include Ensure, Boost, Premier Protein, Glucerna, Fairlife, Orgain, Kate Farms, and many more.

Add in Some Fun Extra Items

You can further personalize your smoothies by adding in some extra ingredients and things that you love. Here are just a few examples and their recommended serving sizes:

• Nuts or Nut Butters: Not only are nuts and nut butters (such as peanut butter or almond butter) great to use as an extra source of protein, healthy fats, and other vitamins and minerals, but they also make smoothies taste delicious!⁴³ I typically use 1-2 Tbsp of nut butter or a small handful of intact nuts when using them in smoothies.

• Avocado: Try adding half of a small avocado to your smoothies to make them thick and creamy and to get an extra dose of healthy fats, potassium, and fiber.⁴⁴

If you are struggling with excessive weight loss from cancer, then nuts, nut butters, and avocado are especially great options for you to try because they are high in calories.

• Psyllium Husk, Chia Seeds, or Hemp Seeds: These three ingredients may be small in size, but they are packed with nutrients!  Psyllium husk and chia seeds are great sources of fiber and, therefore, may help promote regular bowel movements, improve heart health, and promote good blood sugar control.^45,46 Both chia seeds and hemp seeds also contain small amounts of protein, healthy fats called polyunsaturated fats, and many different vitamins and minerals.^46,47 I recommend using 1 Tbsp of psyllium husk or chia seeds or up to 3 Tbsp of hemp seeds per serving. However, if you are not used to getting very much fiber in your diet, you may want to start off with a smaller amount and increase it gradually to allow your gut to adjust to getting more fiber. It is also important to drink plenty of fluids while increasing your fiber intake.

• Raw Cacao or Cacao Nibs: While these less-processed forms of chocolate may not be very sweet (something remedied by the fruit in smoothies), they will give your smoothies a delicious chocolatey taste as well as provide a variety of antioxidants and help to reduce inflammation.⁴⁸ Try adding 1 Tbsp of cacao powder or cacao nibs to your smoothies. Cacao nibs are also delicious used as a topping for your smoothie rather than just blended in.

Remember, if you try one smoothie variation and don’t like it, try another! Feel free to mix up the amounts of different ingredients and play around with it until you find combinations that you really like. This article is just a guide to help you get started and to learn more about the amazing health benefits of popular smoothie ingredients.

Something important to keep in mind is that while antioxidants play many important roles in your body and have been shown to help reduce the risk for cancer, it is important to talk to your doctor before taking a supplement form of any antioxidant. While the concentration of antioxidants found in foods is considered safe, higher doses, such as those seen in some supplements, may have negative effects and can even interact with cancer treatments and make them less effective. Always share any medications and supplements (including herbal supplements) with your doctor.

Disclaimer: The information provided in this article should serve as a general guide and should not be used for the diagnosis or treatment of a medical condition. Please ask your doctor or your registered dietitian if there are certain foods that you need to avoid due to other medical conditions or nutrient interactions with medications you may be taking.

Sources

The post 5-Step Ultimate Smoothie Guide appeared first on National Breast Cancer Foundation.

Eating seasonally is by no means a new concept (it was the only option available before mass transportation of food became a thing), but it has recently regained so much popularity that you can find many restaurants around the country using phrases like “seasonal menus” and “farm to table” in their marketing. But what exactly is seasonal eating, and is it something you should be doing?

Seasonal eating is exactly what it sounds like – eating foods that are in season. Different foods grow better in different times of the year, therefore affecting its peak harvest season. Have you ever noticed how when you get strawberries in the summer, they are often juicy and have a deep red color all the way through? But if you bit into a strawberry in the middle of winter, there is a good chance you would find that it is mostly white on the inside and not nearly as flavorful. This is due to the variations in quality between foods that are in season versus out of season.

Now that it is summer, there are so many incredible fruits and vegetables starting to grow! Keep reading to learn more about the benefits of eating seasonally and to learn what foods are in season now that summer is here (June, July, and August).

Click here to download NBCF’s Summer Food Guide.

Benefits to Eating Seasonally

1. Foods are actually higher in nutrients when they are in season.

The nutrient content of fruits and vegetables is typically highest when it is at its peak ripeness, which is generally when produce that is “in season” is picked. However, foods that are not in season are typically flown in from other areas where they are growing better. Because of this transportation process, most produce that is not in season is harvested long before it is ripe, so it never develops its full nutrition potential or its proper flavor. Produce also begins to lose some of its nutrients after it has been harvested.^1,2 Therefore, the longer it has been since a fruit or vegetable has been harvested, the more nutrients it has lost.

With that being said, fruits and vegetables that are not in season are still very nutritious and healthy (so don’t be afraid to get them if you really want to!); they just won’t have as high of nutrient content as they do when they are in season.

2. Eating seasonally ensures you are getting a wide variety of foods in your diet throughout the year.

Not all foods contain the same nutrients, which is why it is so important to include a variety of different foods in your diet. This is the reason for the old saying “eat the rainbow.” Eating seasonally helps ensure that you will be eating a variety of fruits and vegetables throughout the entire year, therefore maximizing your nutrient intake.

3. Eating seasonally is more sustainable.

Eating seasonally helps lower the environmental toll associated with food transportation because foods that are in season can be purchased more locally. This helps cut back not only on fuel emissions directly from the transportation process but also reduces the amount of energy needed for refrigeration during transportation and storage.³ Purchasing food locally also helps support local communities and farmers!     

4. Eating seasonally is often more cost-effective.

The great news is that eating seasonally is also good for your bank account! The simple concept of supply-and-demand states that as the supply of an item increases, the cost will go down. This is exactly what happens with food. When a food is in season, there is a lot more of it, so grocery stores are able to price it at a lower cost.

The Takeaway: Eating seasonally is a great, easy way to boost your nutrient intake, save money, reduce your environmental footprint, and support local farmers! What’s not to love?

However, it may not always be possible to eat only what is in season. It is important to prioritize overall fruit and vegetable consumption, and you can take advantage of foods that are in season while doing this!

Summer Seasonal Food Guide

Below is a list of some of the foods that are in season during summer! Something to keep in mind is that the foods that are in season do vary by region. I always recommend stopping at the local farmer’s market if you have one near you to get familiar with what food is grown in your area and to support your local community. You can also use the Seasonal Food Guide and search by your state of residence for more information on what food is grown in different times of the year.^4,5

Fruits

Vegetables

Download NBCF’s Summer Food Guide by clicking here.

Whether you purchase your fruits and vegetables at a grocery store or farmer’s market, remember to wash all fresh produce well by rubbing them under cold running water. You should do this regardless of if you are eating the skin or if the item is going to be cooked versus eaten raw. This will help get rid of the bacteria that may be on these foods and promote overall food safety, which is extremely important, especially when your immune system is low during cancer treatment. You can also use a vegetable scrubber to help clean anything with thick skin, but the FDA and CDC do not recommend using soaps, bleach, or commercial produce washes as these can leave residues behind that have not been tested for their safety.^6–10

Hungry for More?

NBCF offers free eating guides for every season. Check out our guides for winter, spring, and fall!

Note: The information presented in this post may not be suitable for every person or during rigorous treatments for breast cancer. Please seek advice from your doctor or medical team if you have any concerns before implementing a change in your diet.

Resources:

1. Managa MG, Tinyani PP, Senyolo GM, Soundy P, Sultanbawa Y, Sivakumar D. Impact of transportation, storage, and retail shelf conditions on lettuce quality and phytonutrients losses in the supply chain. Food Science & Nutrition. 2018;6(6):1527-1536. doi:10.1002/fsn3.685
2. Wunderlich SM, Feldman C, Kane S, Hazhin T. Nutritional quality of organic, conventional, and seasonally grown broccoli using vitamin C as a marker. Int J Food Sci Nutr. 2008;59(1):34-45. doi:10.1080/09637480701453637
3. Hammond ST, Brown JH, Burger JR, et al. Food Spoilage, Storage, and Transport: Implications for a Sustainable Future. BioScience. 2015;65(8):758-768. doi:10.1093/biosci/biv081
4. Seasonal Food Guide. Accessed March 13, 2023. https://www.seasonalfoodguide.org/why-eat-seasonally
5. Seasonal Produce Guide. SNAP Education Connection. Accessed March 13, 2023. https://snaped.fns.usda.gov/seasonal-produce-guide
6. Nutrition C for FS and A. Selecting and Serving Produce Safely. FDA. Published online March 23, 2023. Accessed April 30, 2023. https://www.fda.gov/food/buy-store-serve-safe-food/selecting-and-serving-produce-safely
7. Steps to Safe and Healthy Fruits & Vegetables. Centers for Disease Control and Prevention. Published January 31, 2023. Accessed April 30, 2023. https://www.cdc.gov/foodsafety/communication/steps-healthy-fruits-veggies.html
8. Food Safety During Cancer Treatment. Accessed April 30, 2023. https://www.cancer.org/treatment/survivorship-during-and-after-treatment/coping/nutrition/weak-immune-system.html
9. CDCES MM RD, MS, LDN. Washing Produce—The Do’s and Don’ts. PearlPoint Nutrition Services®. Published August 11, 2020. Accessed April 30, 2023. https://pearlpoint.org/washing-produce-the-dos-and-donts/
10. Danielle. 3 Myths About Washing Fruits and Veggies — and How to Do it Right. Community Cancer Center. Published May 26, 2021. Accessed April 30, 2023. https://www.communitycancercenter.org/nutrition/3-myths-about-washing-fruits-and-veggies-and-how-to-do-it-right/

The post Fruits and Veggies to <br> Eat this Summer appeared first on National Breast Cancer Foundation.

Eating seasonally is by no means a new concept (it was the only option available before mass transportation of food became a thing), but it has recently regained so much popularity that you can find many restaurants around the country using phrases like “seasonal menus” and “farm to table” in their marketing. But what exactly is seasonal eating, and is it something you should be doing?

Seasonal eating is exactly what it sounds like – eating foods that are in season. Different foods grow better at different times of the year, therefore affecting its peak harvest season.

Have you ever noticed how when you get strawberries in the summer, they are often juicy and have a deep red color all the way through? But if you bit into a strawberry in the middle of winter, there is a good chance you would find that it is mostly white on the inside and not nearly as flavorful. This is due to the variations in quality between foods that are in season versus out of season.

Now that it is spring, so many incredible fruits and vegetables are starting to grow! Keep reading to learn more about the benefits of eating seasonally and to learn what foods are in season now that spring is here (March, April, and May).

Click here to download NBCF’s Spring Food Guide.

Benefits of Eating Seasonally

1. Foods are actually higher in nutrients when they are in season.

The nutrient content of fruits and vegetables is typically highest when it is at its peak ripeness, which is generally when produce that is “in season” is picked.

However, foods that are not in season are typically flown in from other areas where they are growing better. Because of this transportation process, most produce that is not in season is harvested long before it is ripe, so it never develops its full nutrition potential or its proper flavor.

Produce also begins to lose some of its nutrients after it has been harvested.^1,2 Therefore, the longer it has been since a fruit or vegetable has been harvested, the more nutrients it has lost.

With that being said, fruits and vegetables that are not in season are still very nutritious and healthy (so don’t be afraid to get them if you really want to!), they just won’t have as high of a nutrient content as they do when they are in season.

2. Eating seasonally ensures you are getting a wide variety of foods in your diet throughout the year.

Not all foods contain the same nutrients, which is why it is so important to include a variety of different foods in your diet.

This is the reason for the old saying, “eat the rainbow.” Eating seasonally helps ensure that you will be eating a variety of fruits and vegetables throughout the entire year, therefore maximizing your nutrient intake.

3. Eating seasonally is more sustainable.

Eating seasonally helps lower the environmental toll associated with food transportation because foods that are in season can be purchased more locally.

This helps cut back not only on fuel emissions directly from the transportation process but also reduces the amount of energy needed for refrigeration during transportation and storage.³

Purchasing food locally also helps support local communities and farmers!     

4. Eating seasonally is often more cost-effective.

The great news is that eating seasonally is also good for your bank account! The simple concept of supply-and-demand states that as the supply of an item increases, the cost will go down.

This is exactly what happens with food. When food is in season, there is a lot more of it, so grocery stores are able to price it at a lower cost.

The Takeaway: Eating seasonally is a great, easy way to boost your nutrient intake, save money, reduce your environmental footprint, and support local farmers! What’s not to love?

With that being said, it may not always be possible to eat only what is in season. It is important to prioritize overall fruit and vegetable consumption, and you can take advantage of foods that are in season while doing this!

Spring Seasonal Food Guide

Below is a list of some of the foods that are in season during spring! Something to keep in mind is that the foods that are in season do vary by region.

I always recommend stopping at the local farmer’s market if you have one near you to get familiar with what food is grown in your area and to support your local community.

You can also use the Seasonal Food Guide and search by your state of residence for more information on what food is grown at different times of the year.^4,5

Fruits

Vegetables

Download NBCF’s Spring Food Guide by clicking here.

Whether you purchase your fruits and vegetables at a grocery store or farmer’s market, remember to wash all fresh produce well by rubbing them under cold running water. You should do this regardless of if you are eating the skin or if the item is going to be cooked versus eaten raw.

This will help get rid of the bacteria that may be on these foods and promote overall food safety, which is extremely important, especially when your immune system is low during cancer treatment.

You can also use a vegetable scrubber to help clean anything with thick skin, but the FDA and CDC do not recommend using soaps, bleach, or commercial produce washes as these can leave residues behind that have not been tested for their safety.^6–10

Hungry for More?

NBCF offers free eating guides for every season. Check out our guides for winter, summer, and fall!

Note: The information presented in this post may not be suitable for every person or during rigorous treatments for breast cancer. Please seek advice from your doctor or medical team if you have any concerns before implementing a change in your diet.

Resources:

1. Managa MG, Tinyani PP, Senyolo GM, Soundy P, Sultanbawa Y, Sivakumar D. Impact of transportation, storage, and retail shelf conditions on lettuce quality and phytonutrients losses in the supply chain. Food Science & Nutrition. 2018;6(6):1527-1536. doi:10.1002/fsn3.685
2. Wunderlich SM, Feldman C, Kane S, Hazhin T. Nutritional quality of organic, conventional, and seasonally grown broccoli using vitamin C as a marker. Int J Food Sci Nutr. 2008;59(1):34-45. doi:10.1080/09637480701453637
3. Hammond ST, Brown JH, Burger JR, et al. Food Spoilage, Storage, and Transport: Implications for a Sustainable Future. BioScience. 2015;65(8):758-768. doi:10.1093/biosci/biv081
4. Seasonal Food Guide. Accessed March 13, 2023. https://www.seasonalfoodguide.org/why-eat-seasonally
5. Seasonal Produce Guide. SNAP Education Connection. Accessed March 13, 2023. https://snaped.fns.usda.gov/seasonal-produce-guide
6. Nutrition C for FS and A. Selecting and Serving Produce Safely. FDA. Published online March 23, 2023. Accessed April 30, 2023. https://www.fda.gov/food/buy-store-serve-safe-food/selecting-and-serving-produce-safely
7. Steps to Safe and Healthy Fruits & Vegetables. Centers for Disease Control and Prevention. Published January 31, 2023. Accessed April 30, 2023. https://www.cdc.gov/foodsafety/communication/steps-healthy-fruits-veggies.html
8. Food Safety During Cancer Treatment. Accessed April 30, 2023. https://www.cancer.org/treatment/survivorship-during-and-after-treatment/coping/nutrition/weak-immune-system.html
9. CDCES MM RD, MS, LDN. Washing Produce—The Do’s and Don’ts. PearlPoint Nutrition Services®. Published August 11, 2020. Accessed April 30, 2023. https://pearlpoint.org/washing-produce-the-dos-and-donts/
10. Danielle. 3 Myths About Washing Fruits and Veggies — and How to Do it Right. Community Cancer Center. Published May 26, 2021. Accessed April 30, 2023. https://www.communitycancercenter.org/nutrition/3-myths-about-washing-fruits-and-veggies-and-how-to-do-it-right/

The post 4 Reasons to Eat Seasonally <br> This Spring appeared first on National Breast Cancer Foundation.

Hi, I’m Louise Lubin, and I’ve had the privilege as a psychologist to work with women with breast cancer for 40 years. Today I want to talk to you about hope. Obviously, what each of you has as your hopes and dreams are as unique and individual as each of you.

However, what’s hope? Hope is a way of thinking and believing that you have the power to create change in your life. Hope is like a muscle that requires exercise. Hope’s been called a verb because it requires action. Of course, what you hope for has to change as life circumstances change. But we all need hope, and we all need tools to help us maintain that hope after a diagnosis like cancer.

One of the tools in my book, Your Journey Beyond Breast Cancer, is from Dr. Rick Hanson. It’s called “Take in the Good.” Each of our brains is wired to anticipate the worst, and we worry about things—it’s all very normal. However, negative experiences tend to stick like Velcro, whereas positive experiences tend to be more like Teflon. We easily forget them.

So, we have to work because we can rewire our brain. We have to work at creating the connections that allow us to hold onto more positive experiences, which bring a sense of hope.

I want you to think about the word “heal.”

• H of heal means have a positive experience. Create a small daily pleasure. It could be something as simple as listening to the birds or having a time to create, watching a child do something adorable. Something small, but allow yourself to find a positive experience.
• The E in heal is enrich that experience, meaning you want that experience to soak into your body. You may want to lower your shoulders or relax your face or breathe deeply but allow the experience and the sense of it in your body and take an extra 10, 20, even 30 seconds to let it into your body and experience it through your body.
• The A in heal is absorb it. Really savor it, and bring that experience into your body.
• The L is to link that experience—if you can. When you’re having a tough time, try to remember parts of that positive experience and the way it felt inside your body.

This is not a one-stop fix. We have to keep trying and trying to rewire our brains to be able to maintain and hold onto those positive experiences. But I hope this is a helpful one for you, and I wish you all the best as you move forward on your healing journey. Take care.

Read Louise’s three-part blog series on navigating fear and uncertainty with tools to harness fear and restore your mind, body, and spirit here.

National Breast Cancer Foundation is here for you and your loved ones. Whether you need support, education, or help during treatment, we have a team dedicated to getting you the help you deserve.

The post 4 Steps to Finding Hope appeared first on National Breast Cancer Foundation.

At your mammogram appointment, a mammographer will be present in the room with you. This person is there to perform the imaging and to help make the process as comfortable, efficient, and successful as possible for you.

You should tell your mammographer if…

1. You are concerned about a certain area or breast change.

You should know what your body’s “normal” looks and feels like. Get to know your “normal” by performing monthly breast self-exams. It’s also important to know the symptoms and signs of breast cancer. If you need a reminder, download our free Know the Symptoms Guide. Any time you notice an abnormality or anything different about your breasts, let your doctor know. Abnormalities may include:

• A change in how the breast or nipple looks or feels. This may include nipple tenderness or a lump or thickening in or near the breast or underarm area, a change in the skin texture, or a lump in the breast.
• A change in the breast or nipple appearance. This may include an unexplained change in the size or shape of the breast, dimpling anywhere on the breast, inverted nipple, or if the breast becomes scaly, red, or swollen.
• Any nipple discharge, particularly if clear or bloody.

2. You are at high risk of developing breast cancer.

You may be considered at high risk for developing breast cancer if you have:

• Dense breast tissue. (Not sure what this is? View our free Dense Breasts Q&A Guide.)
• A family history of breast cancer.
• Have tested positive for the BRCA1 or 2 gene mutation.
• Have been told by a doctor that you are at high risk.

If you are at high risk, you should ask your provider for supplemental screenings, such as tomosyntheses (3D mammograms), ultrasounds, and MRIs, in addition to regular screening mammograms.

If there is a family history of breast cancer, you may be advised to begin annual screening mammograms earlier than the recommended age of 40.

Generally, it is advised that women begin receiving some form of breast cancer screening 10 years before the age a first-degree relative was diagnosed with breast cancer.

For example, if your mother (or other first-degree relative) was diagnosed with breast cancer at the age of 48, your doctor may recommend you begin screenings at the age of 38. Consult with your healthcare provider about what screening—and when—is appropriate.

3. You feel anxious about getting your mammogram.

Feeling anxious about getting a mammogram, or any medical test, is normal. Sharing how you feel with your mammographer will help them address any concerns you might have.

Knowing you have the best team handling your care can help ease your anxiety. You can ask for a breast imaging radiologist (versus a general radiologist) to read your mammogram.

Breast imaging radiologists specialize in interpreting images of the breast. They read mammograms, breast ultrasounds, and breast MRIs, and perform diagnostic breast procedures that can help diagnose and treat breast cancer. T​​​​o find a breast imaging radiologist, visit the website of your chosen facility and read the radiologist bios. You can also call and ask the facility directly.

Building positive relationships with staff at your mammogram facility will likely set you at ease. You can ask to see the same mammographer each time to build that relationship and help you feel more comfortable.

4. You experience unreasonable pain during your mammogram.

Some level of slight discomfort is expected during a mammogram due to the pressure applied by the testing equipment.

However, if you have experienced extreme pain during a past mammogram, or experience extreme pain at your upcoming mammogram, let your mammographer know immediately so they can help you have the best, most comfortable experience possible.

A mammogram may be uncomfortable depending on:

• Hormones. If the mammogram is performed close to the beginning of your menstrual cycle, your breasts may be more sensitive. Consider avoiding scheduling your mammogram the week before your period.
• Breast size or implants. Those with large breasts or breast implants may need additional images, slightly lengthening the time of the procedure by one or two minutes.
• Positioning. Some positions may be more uncomfortable to you than others, or sometimes skin can be inadvertently pinched by the imaging plates. If you feel extreme pain due to positioning during your mammogram, let the mammographer know. They may be able to adjust your position to lessen discomfort.

Mammogram cushions are also available to help relieve discomfort. These cushions are placed on the surface of the image detector, providing a softer, more comfortable mammogram.

Clear and open communication is key to advocating for your breast health. Begin by sharing important information with your mammographer and prepare for a positive, if not completely comfortable, mammogram experience.

The post 4 Things to Share at Your Next Mammogram appeared first on National Breast Cancer Foundation.

In Their Own Words: What Really Helps During Chemo

From warm baths, music, and milkshakes to meal trains, extra-long phone chargers, and journaling, we received great advice from those going through chemo and survivors:

“Even on the bad days, I find something to make me laugh, I look for beauty in small things, and I think to myself what a strong incredible woman I am!” – Mel

“I called the chemo days my ‘rainbow’ days and pictured healing thoughts as I received my infusions. This helped me to stay positive and endure the most difficult time of my life.” – Gina

“I did a countdown of the treatments—mentally it helped me to see that number getting smaller and know the end was in sight.” – Selena

“Family, Faith, and Friends.” – Edwina

“My chemo nurses made it feel like I was hanging out with friends.” – Michelle

“Two days after my chemo treatments I went back into the chemo center for IV fluids, every week for 20 weeks. The extra fluids really helped and I recommend it to everyone if possible.” – Dena

“Friends and family who would listen to me complain endlessly without judgement, meal delivery immediately following infusions, cards from relatives sharing strength and love, and a port-accessible sweatshirt (so I didn’t have to undress for port access).” – Brandi

Top 5 Recommendations from Survivors Who Completed Chemo

We are fortunate to have an amazing community of women who have completed chemo and who are willing to share their valuable insights on the experience. To help breast cancer patients prepare for and get through chemo, we compiled a list of helpful tips from this community.

• Rest—or move
  During treatment, many women share newfound passions for walking, cycling, and other activities while others note the importance of giving yourself permission to rest. This advice will vary day by day, depending on how you are feeling and what helps to boost your energy level.
• Nourish yourself
  Nutrition can make a big difference in how you feel during chemo. Protein smoothies are a great option if you need nutrition on the go or are experiencing lack of appetite or mouth sores—hydration is also key. Learn more through the free “Nutrition Care for Breast Cancer Patients” eBook. Meal trains can also be a wonderful option when you’re too tired to cook. And we can’t count the number of women who recommend the healing properties of chocolate! NBCF also offers a free “Healthy Recipes for Cancer Patients” eBook with recipes for meals that are easy to prepare and safe to eat.
• Surround yourself with support
  From friends and family to organized support groups, having a team on your side can make a tremendous difference before, during, and after chemo. Surround yourself with positive energy and people willing to offer a listening ear or a helping hand.
• Find something to believe in
  Many turn to faith and spiritual support to provide light during challenging times. Prayer and meditation can provide solace and a sense of calm and connection.
• Cuddle up with a furry friend
  Several people who responded to our query shared that they got a dog prior to chemo as a companion that could always be counted on to offer unconditional love.
  
  A sense of humor, a good driver, camping trips, and a positive attitude also made the list. One woman shared that “Pedialyte and mashed potatoes” were a lifesaver when she felt sick or dehydrated and another recommended “plastic flatware, applesauce, and saltine crackers.” Word games, puzzles, and blankets were also appreciated by many.

Resources from NBCF

National Breast Cancer Foundation provides support to women throughout the chemo process. We are proud to offer free resources including:

• Chemo Messages: Inspiring email and video messages during treatment, Chemo Messages offer messages of care from survivors who have been there as well as helpful resources and the reassurance you need to take the next step.
  
• HOPE Kits: Thoughtful items that patients have told us are comforting and encouraging, HOPE Kits may include fuzzy socks, tea, unscented lotion, a journal and pen, lip balm, and more as an expression of hope and care.
  
• Support groups: In-person and online groups can reduce the stress and anxiety that come with a breast cancer diagnosis and provide a community of support, no matter where you live.

Join the conversation! If you’ve gone through chemotherapy, comment below what was most helpful during your experience.

National Breast Cancer Foundation is here for you and your loved ones. Whether you need support, education, or help during treatment, we have a team dedicated to get you the help you deserve.

For the full comment thread of recommendations from survivors, check our Facebook post here.

The post What Helps During Chemo? Patients and Survivors Share Tips & Advice appeared first on National Breast Cancer Foundation.

If you, too, have felt overwhelmed by the never-ending list of responsibilities, it is important to remember that you can—and should—prioritize your health, starting with routine screenings.

Step 1: Educate yourself on your screening needs

Learning more about how you can take ownership of your health is a step in the right direction.

As a general rule, women 40 and older should have mammograms every 1 or 2 years; your doctor can help you determine the best schedule for regular screenings.

Women younger than 40 with risk factors for breast cancer should ask their healthcare professional whether mammograms are advisable and how often to have them.

Women younger than 40 with no known risk factors should continue with clinical exams and breast self-exams.

Even women who have no symptoms and no known risks for breast cancer should have regularly scheduled mammograms to help detect potential breast cancer at the earliest possible time.

To learn more about breast cancer screenings and early detection, download our free eBook, 3 Steps to Early Detection.

Step 2: Reach out to NBCF if you can’t afford your mammogram or are uninsured

If you have financial concerns, NBCF’s National Mammography Program can help. This program provides free or low-cost mammograms in partner hospitals across the country.

See if we partner with a hospital in your area, view our breast cancer resources page, or submit this form for personalized support.

Step 3: Schedule your mammogram or well-woman exam

Many women encounter barriers when trying to schedule a mammogram. Often, concerns over cost or not knowing who to call can be discouraging when setting up an appointment. Read our article How to Schedule a Mammogram to learn tips and essential information so you don’t miss this important exam.

Once your mammogram is scheduled, read How to Prepare for a Mammogram for tips on how to prepare before and on the day of your mammogram appointment.

Step 4: Find an accountability partner

Whether you’re trying to eat healthier, work out more, or prioritize your health in general, it’s often hard to stay motivated. To combat this, find an accountability partner—a friend, loved one, spouse, co-worker, or someone facing a similar circumstance. This person can help keep you stay motivated toward your goals and cheer you on every step of the way. Their simple reminders and presence may be all you need to reach your goals!

Step 5: Browse free meditation apps

Meditation is a great way to untangle your thoughts and the emotions associated with them.

When we’re stressed or distracted by something overwhelming or frustrating, we tend to focus on our reactions. But meditation teaches us to separate ourselves from our reactions and simply observe them, without attaching emotion or creating additional stress. This awareness allows us to remain in the present moment, understand our thought patterns, and learn more about our emotions and ourselves.

Meditation Studio is offering NBCF supporters free access to the Cancer Comfort Meditation Series. Check it out here.

Step 6: Review NBCF’s resource library (it’s free!)

NBCF is dedicated to delivering comprehensive, educational information on breast health and healthy living. From understanding the importance of early detection to knowing how to prepare for a mammogram, NBCF’s online resources and guides aim to empower women and men with useful information. Start with our eBook quiz! Or see the full library of free resources here.

Step 7: Choose one way to prioritize yourself every day (big or small!)

You can find a way, no matter how big or small, to prioritize yourself daily! You can take a 10-minute break to enjoy a cup of tea, a short walk, or a favorite blog.

You can make a gratitude list or make your own breakfast first. You can schedule things that you look forward to—getting together with a friend, a community event, or a haircut, for example—so that you find regular highlights on your calendar.

Remember: Self-care is not selfish. Ultimately, when you take good care of yourself, you’re better able to care for the others in your life, too. Self-care shows self-respect, and you’re worth it.

National Breast Cancer Foundation is here for you and your loved ones. Whether you need support, education, or help during treatment, we have a team dedicated to getting you the help you deserve.

The post 7 Steps to Self-Care appeared first on National Breast Cancer Foundation.

In this three-part series, she shares thoughtful tools for taking care of yourself, harnessing fear, and restoring mind, body, and spirit. Read the first part, Using Breath & Awareness to Calm Your Body, here. Read the second part, 4 Steps to Overcoming Anxiety, here.

Each of you reading this will be at a different point in your life—or even on the timeline of your cancer diagnosis. Your cancer journey may be different from anyone else’s. Finding your way forward will require that you have the tools to navigate the road that is best for you.

Embrace Your Spirit

When you focus on your spirit, you identify and connect to your inner essence, soul, or higher power. Your spirit can also be your sense of being part of a universe greater than yourself. Some find this in organized religion, nature, creativity, or in relationships with others. Rituals can help you honor your feelings and provide healing to your spirit.

Create Your Personal Ritual

A ritual is “any detailed method or procedure faithfully followed or practiced.” A healing ritual can be anything that reflects and creates value for you. Rituals work best when you believe in their power. They can create a sense of hope and faith. Rituals can be as simple as lighting a candle, taking a pleasurable walk in nature, planting something that will grow, or even having a special meal. Whatever it is, it is honoring your experience.

You may want to create a ritual that involves others or mark your special time by yourself. For many, prayer is a ritual that brings comfort and calm. Use your imagination to create a healing ritual. Honor the importance of your experience and find a way to mark it that feels nourishing and healing to you. I have had patients create a special altar in their homes where they go to find refuge and peace. I have had women manage the loss of their hair by creating a special way and time to cut their hair off with important people in their lives.

Tune into the Hope Channel

Hope can be hard to hold on to when you are afraid and unsure of your future health and well-being. Hope is vital for life, yet what you hope for often changes—depending on the circumstances of your life.

Cancer has most likely altered how you approach hope. Most everyone begins with hope for a cure—the absence of any physical evidence of cancer. If you have had a recurrence or must continue treatment to control your cancer, you can still find ways to identify what you hope for, given that you might have to live with—and beyond—cancer. This can be a huge challenge if you have been struggling with pain and the disappointment of limited treatment choices.

Tool: Channels for Hope

Dr. Anthony Scioli has developed a hope scale that focuses on a four-channel emotional network to tune in to hope.

1. The Mastery Channel. It helps to feel a sense of control and have a clearly defined goal. A focus on what you can do now will increase your sense of personal power. Try to imagine someone you have or would like to have as a support person. Ask yourself, “What would my role model do?” See this person in your mind’s eye addressing your issue and helping you see a way forward. What would he or she say to offer encouragement?
2. The Attachment Channel. Feeling a sense of connection and trust with others increases your sense of hope. Join a support group, volunteer locally, or reach out to existing friends. Invite one or two people to lunch and enjoy each other’s company. Many will receive and appreciate your positive energy. There is risk in reaching out, but there is also great reward in connecting with others.
3. The Survival Channel. The stress of illness requires you to continue to learn and grow and to commit to being courageous. Choose a specific behavior you want to change and define a small step to move you forward. Courage is like a muscle that must be exercised. Fear and risk go together—sometimes it helps to just ask yourself, “What is the worst thing that can happen if I ____?”  Don’t compare yourself to anyone else, and try to stay open to new information. You need not be alone on this journey, but your inner compass and navigation must follow your own heart and inner truth. 
4. The Spiritual Channel. It is vital to create a sense of meaning and faith, the building blocks of hope. Actively expose yourself to music, art, dance, prayer, and nature to stimulate the regions of your brain that create a sense of wonder or oneness. Find a practice, such as prayer, meditation, dance, yoga, or walking mindfully, that supports positive energy, self-worth, and value. Try practicing acts of kindness to get into the act of giving and connecting to others with the kindness of your own spirit.

Which channel do you need to tune in to first to build your hope?

Facing cancer requires an integrative approach that focuses on your body, mind, and spirit. You can challenge your internal voice and focus on what is under your control: the present moment, not the unknown future. By honoring your spirit and seeking to find hope, you send compassion and loving energy to empower you to move forward. My hope is that you will take charge of your own healing and seek out the support and guidance you need on your journey beyond breast cancer.

The post Fear & Uncertainty: Healing Your Spirit Through Rituals & Hope appeared first on National Breast Cancer Foundation.

Your bones protect vital organs and allow your body to move throughout the day. Without proper care and nutrition, bones can be susceptible to fractures and restrict your mobility. Barbara Grufferman, writer and speaker with a focus on positive aging, speaks on the importance of self-care and bone health after a breast cancer diagnosis.

She shares below five questions to ask your doctor or health professional after a breast cancer diagnosis when advocating for your bone health:

1. How will my diagnosis impact my bone health?
2. How much Vitamin D is safe for me to take while I’m under treatment for breast cancer?
3. Should I take a calcium supplement?
4. Should I change how I exercise to protect against bone loss while I’m being treated?
5. Should I schedule a bone density test (DEXA Scan)?

Barbara’s three top tips for maintaining and improving bone health are: Eating the right foods, getting enough Vitamin D and calcium, and making sure you incorporate strength training as part of your exercise routine.

To learn more about the impacts of cancer treatment on bone health and ways you can care for your body before, during, and after treatment, click here.

We want to thank our friends at Amgen for their help in sharing this important message on bone health to readers like you. Because self-care is more than skin deep.

National Breast Cancer Foundation is here for you and your loved ones. Whether you need support, education, or help during treatment, we have a team dedicated to get you the help you deserve.

The post 5 Questions Every Breast Cancer Patient Should Ask About Their Bone Health appeared first on National Breast Cancer Foundation.

In this three-part series, she shares thoughtful tools for taking care of yourself, harnessing fear, and restoring mind, body, and spirit. Read the first part, Using Breath & Awareness to Calm Your Body, here.

After the shock of hearing “you have breast cancer,” you began to focus with determination on the task of choosing and beginning the best treatment. It is only later on this journey that you may realize that your body, but also your mind and spirit, have been reshaped.

Redirect Your Mind

Whether you recognize it or not, you are always talking to yourself. Although this “self-talk” is automatic and subconscious, you can redirect your thinking. You are more than your thoughts.

What is self-talk?

• Self-talk is the running dialogue and thoughts in your mind.
• It is automatic. You rarely notice it or the effect it has on you.
• It appears in shorthand. One short word or image can contain a whole series of thoughts, memories, or associations.
• It always sounds like the truth to you.

“It’s hard to fight an enemy that has outposts in your head.” — Sally Kempton

Your self-talk can be encouraging, or it can be deflating. What you think impacts how you feel. When you are in a state of uncertainty and fear, your self-talk often focuses on what could happen.

The uncertainty of cancer creates “what if” thinking. “What if the treatment doesn’t work?” What if ____ (fill in the blank) can send you down many different dark fearful roads. To focus on what is under your control, you must shift gears.

Remember these words:  IT’S NOT WHAT IF, BUT WHAT NOW.

When you start “what if” thinking, gently remind yourself of the above words to bring yourself back to what you can manage right now, in the present moment. Consider putting these words somewhere you can see them as a reminder to focus on what is possible now!

The STOP Tool

The STOP tool is a helpful way to change the spiral of uncertainty. This tool has been a mainstay of my work with all my patients. You can use it anytime you feel caught up in any situation where you want to exercise more control and reason before you react. 

The next time you begin to feel anxious or overwhelmed, imagine this stop sign.

S- STOP: As soon as you begin to notice you are feeling anxious, STOP what you are doing. What are your early warning signs? Do you tense up in your body or in your face? Does your breathing change? Do you raise your voice? What exactly do you do? Pay attention when it is happening and remind yourself, “I must pay attention now!”

T- TAKE A BREATH: When you are emotionally upset, your body and thinking are affected and your breathing shortens. When you slow down with some abdominal breathing, you enhance your ability to think clearly and use better judgment. You use different parts of your brain when you are calm rather than fearful. Let yourself exhale and feel your body relax (like the energy that comes from a sigh). You are then better able to respond rather than react. 

O – OBSERVE: With more calm and clear thinking, you can begin to sort out your feelings.  Ask yourself, “What am I telling myself right now?” “Am I reacting to old patterns?” “What other choices do I have in this situation?” “Is there another way to think about this now?”

P – PRACTICE OTHER CHOICES:  When you are open to change, you can sort out what might be possible. Focus on what might work for you. Avoid thinking what is fair or unfair, right or wrong, or should or should not happen when you are sorting out a situation. Try not to evaluate. Acknowledge what is happening, but don’t judge. Try to meet your needs for this specific situation. Keep the focus on what you can do now. 

In her final blog (coming soon!), Dr. Louise Lubin offers support for the spirit during your breast cancer journey.

The post Fear & Uncertainty: 4 Steps to Overcoming Anxiety appeared first on National Breast Cancer Foundation.

In this three-part series, she shares thoughtful tools for taking care of yourself, harnessing fear, and restoring mind, body, and spirit.

I have walked along this path as a therapist for women with breast cancer for 40 years. This sisterhood of women has been my teacher and provided me with many life lessons.

The challenge of breast cancer is this: It requires you to take charge of your health yet accept that you need not and cannot do it alone. There will be times of fear and uncertainty that may occur long after the initial diagnosis and treatment. This is part of the ever-changing process when you face a serious life challenge. There may be many different life events or triggers that cause you to feel uncertain and anxious. You may worry about how you will manage your treatment or how your family will manage their changing roles and responsibilities. Any event, such as “your cancerversary,” can remind you of what you have been through.

We all need tools when facing any challenge that demands us to change and cope. Anxiety is about the future. Stress is about any change you fear you cannot manage.  To manage this uncertainty, you need knowledge of your body and how to care for it.

Calm Your Body

Your autonomic nervous system, the part of your nervous system that regulates involuntary functions such as breathing, digestion, heart rate, and blood pressure, reacts to your fears about the future as if you were in real physical danger. Try to become aware of how your body reacts when you feel anxious or afraid. Awareness is the first step to creating change.

Abdominal Breathing

The fastest way to calm your body is to use your breath. Here are three steps:

1. Focus your attention on your abdomen.
2. Inhale slowly and deeply through your nose. Imagine your chest and abdomen are like a balloon—filling it with air expands your chest and exhaling takes air out of the balloon. 
3. Pause for a moment and slowly exhale through your nose or mouth.  Be sure to exhale slowly and completely and let your body go. 

It is helpful to breathe in on a count of 1-2-3-4.  Pause and hold your breath for a count of five and slowly exhale to a count of 1-2-3-4-5-6-7 through your nose or mouth. Try to do this for a total of 3-5 minutes. Don’t push or force your breath, and stop to pause if you get light-headed. Keep your breathing smooth and regular. 

When you are anxious, letting air out of the top part of your lungs with a strong exhale can be very helpful. Making an “ahhh” sound can help you to settle back into your body with more awareness. 

Mini Relaxations

Adjust your breathing anyplace and anytime. Try the following with your eyes open or closed, depending on what you are doing:

1. Count slowly from ten to zero, counting one number on each breath out.
2. While taking a breath in, think, “I am,” and on the breath out, think, “At peace.”
3. As you breathe in, count slowly to four, and on the out-breath, count back down to one.
4. The next time you face a difficult situation (e.g., going in for a procedure, making a treatment decision, or talking to someone when you feel upset), take three deep breaths before you begin.

Your breath is with you every moment of every day and can be an anchor, no matter what you are experiencing.

Shifting Your Awareness

Follow these steps to gaining awareness and shifting that awareness as you need:

1. Close your eyes and breathe. Notice your body, how the air feels when you breathe in, how your heart beats, and the sensations you have in your stomach and gut.
2. With your eyes still closed, purposefully shift your awareness away from your body to everything you can hear, see, smell, or feel through your skin.
3. Use your senses to shift your awareness outside yourself.

By shifting your awareness back and forth several times between what’s going on in your body and what’s going on around you, you learn in a physical way that you can control the perspectives of your world—internal or external—that you notice. You can gain a sense of control over how you react to physical sensations and become better able to manage anxiety. You can grow your ability to observe your thoughts and sensations. In a stressful situation, the goal is to respond, not just react.

Look for the next post in this three-part series from Dr. Louise Lubin, with tips on redirecting your mind in times of need, including the powerful “STOP” method.

The post Fear & Uncertainty: Using Breath and Awareness to Calm Your Mind and Body appeared first on National Breast Cancer Foundation.

While it may initially be awkward, talking openly about breast health helps remove stigmas surrounding women’s bodies and women’s health. Open conversations create a comfortable environment that supports health and wellness. It can even increase early detection, which saves lives.

During Women’s Health Week, we want to talk about breast health and make it easier for you to do the same! Thanks to our friends at AMN Healthcare for helping us spread this important message.

Why don’t we talk openly about breast health?

That is a great question!

The reasons can vary from uncertainty and lack of information to a sense of stigma and discomfort in talking through tough topics. However, nothing is too taboo if it means saving a life.

When we better understand the reasons many women hesitate to discuss breast health, we can address them and make room for conversation, growth, and change.

It’s as easy as 1, 2, 3

The following three steps can make it a little easier to discuss breast health with others:

1. Set the stage.

Make sure you have a safe space and comfortable environment for talking about breast health. For instance, busy office spaces, public transportation, and a kids’ sporting event might not be the best options for this discussion. Instead, look for good opportunities—perhaps while taking a walk, having lunch, or catching up with a friend on the phone.

You can share your own experience: “I’m kind of dreading my upcoming mammogram, but I know that it’s important. Have you scheduled yours yet?” You can also let your friend or relative know that you care, and encourage them with words of love and support.

2. Understand the basics—and recognize that many people aren’t aware of them.

It is important to know that:

• Breast cancer is treatable when detected early
• Breast cancer can happen to anyone, at any age
• If your breasts look or feel different, talk to a doctor as soon as possible
• Breast self-exams, clinical exams, and mammograms are critical for early detection

Once you know the basics, you can more readily share that information with others. For example, you could offer: “We hear about breast cancer all the time, but I was surprised by how much I didn’t know about taking care of my breast health.”

3. Address the stigmas.

Honesty is always a good policy. While conversations about breast health can be hard—particularly with those who would prefer not to have them—that doesn’t mean we should avoid them.

Here are three common stigmas and ways to approach them:

Stigma: Talking about my body is personal and private.
Reality: Everyone needs support and encouragement to prioritize their health. Find someone you feel comfortable speaking to about your health—a partner, friend, loved one, or doctor.

Stigma: Breasts are sexual.
Reality: Breasts are a normal part of our bodies. Breast cancer is prevalent, so we can’t be afraid to talk about it.

Stigma: We just don’t talk about breast health or breast cancer in my family.
Reality: We know more about breast cancer than we ever have before. We can change the generational pattern and emphasize early detection for all.

If you’re struggling to bring up the topic, try saying this: “I think of breast cancer as a disease my mom or grandma should worry about—not me—but I just saw a story about a 30-year-old facing breast cancer.”

Let’s face it: For many reasons, women don’t always prioritize their own health. But the more we focus on health, wellness, and self-care, the more we can support others in our lives—we are worth it.

What’s next for keeping your cool while talking about breast health?

To support more open and honest conversations about breast health, you can get our eBook, How to Talk about Breast Health. This free guide shares detailed prompts, ways to handle difficult conversations, and support for you and other women in your life.

You have the power to break stigmas and change lives. This guide can help break the ice and the awkwardness.

Get your free digital copy now!

The post Don’t Overcomplicate It: 3 Easy Steps to Talk About Breast Health appeared first on National Breast Cancer Foundation.

After a breast cancer diagnosis, there are often several questions a patient may have. Who will treat my breast cancer? What specialist should I see? Will I need chemotherapy or radiation? Will I have to have surgery or take medication?

The list below will help explain the answers to some of the most common questions related to your cancer treatment team of doctors, nurses, and specialists. Not all patients will need the services of every specialist listed.

Medical Oncologist

A doctor who specializes in the field of cancer. This doctor will be the primary source guiding you throughout your care journey. The medical oncologist will work with your personalized treatment team to provide guidance for medications, treatment options, or specific details for care evaluating lab values, medication reactions, and results of treatment options.

The National Cancer Institute notes your medical oncologist will continue to be your direct guide from the start of diagnosis throughout your journey of cancer care. After completing cancer treatment, it is general practice to resume routine care with your primary care physician.

Surgical Oncologist

A doctor who specializes in cancer treatments involving removing tumors through a surgical approach. The surgical oncologist may request diagnostic scans to help find the best course of surgical treatment while collaborating with the medical oncologist to better guide your post-surgery outcomes. 

Radiation Oncologist

A doctor who specializes in cancer treatment using radiation. The radiation oncologist can design your treatment plan based on the type of cancer and location of any tumors. Not every cancer patient will need radiation as part of their treatment plan.

If indicated by the radiologist, the radiation team will guide you through the treatment process. The radiation team can include members such as a radiation oncology nurse who can provide patient education and help manage symptoms related to radiation care, along with a radiation technologist who operates the treatment machines.

Plastic Reconstruction Surgeon

A doctor who specializes in reconstruction of breasts with a surgical approach following cancer removal surgery or therapy. The plastic reconstruction surgeon can help guide the best surgical approach for your individualized outcome.

Interested in learning more about breast reconstruction? Click here to get NBCF’s free eBook “Guide to Breast Reconstruction,” including questions to ask at your appointment.

Genetic Counselor

This is a counselor who specializes in medical genetics and evaluates risks a patient may have for a genetic link to cancer. A genetic counselor evaluation is not necessary for every patient. If you have concerns about risks or a family history of breast cancer, speak with your doctor. The counselor may evaluate your family history, study any diagnostic exams, or medical history to help assess your risk. Patients may choose to see a genetic counselor after initial diagnosis.

For individuals with a family history of breast cancer, appointments with a genetic counselor could be taken as a preventative measure. For patients diagnosed with metastatic breast cancer, The National Comprehensive Cancer Network suggests having genetic testing.

Patient Navigator

A patient navigator is an individual such as a nurse, social worker, community health worker, or other healthcare professional, who can help guide patients through and around the barriers in the complex cancer care system. These barriers to care can include things like the cost of treatment and other financial concerns, such as missed time from work, being uninsured, fear surrounding your diagnosis or treatment, misinformation surrounding the disease, or language barriers. Many patients even consider their patient navigators their “lifelines” as they undergo breast cancer treatment. The Centers for Disease Control and Prevention state that the patient navigator can help assist you by coordinating your care with your treatment team, providing educational information about your disease, and will continue to communicate with you throughout your treatment process.

As there may be potential barriers to care, such as transportation concerns, childcare, or financial stress, a patient navigator can connect you to resources and support groups that may be able to help.

Remember, every patient may not need the services of each specialist listed, however, every patient can benefit from their own personalized treatment team.

While a breast cancer diagnosis may seem difficult to manage, you will not have to manage it alone. There is a team of health care professionals specifically designed for your treatment care journey. Providing support, guidance, and most importantly, personalizing your individual care plan with you in mind. 

Have additional questions? Want to share your experience? Leave a comment below to let us know your thoughts.

Sources:

National Cancer Institute. Medical Oncologist. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/medical-oncologist

National Cancer Institute. Radiation Oncologist. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/radiation-oncologist

Cancer.Net. (2020, August). What to Expect when Having Radiation Therapy. https://www.cancer.net/navigating-cancer-care/how-cancer-treated/radiation-therapy/what-expect-when-having-radiation-therapy

Eske, J. (2020, February 5). What is an Oncologist. https://www.medicalnewstoday.com/articles/what-is-an-oncologist#types

Spader, C. (2018, January 19). Surgical Oncologist, Your Cancer Surgeon. https://www.healthgrades.com/right-care/cancer/surgical-oncologist-your-cancer-surgeon

Cleveland Clinic. (2021, September 27). Breast Reconstruction. https://my.clevelandclinic.org/health/treatments/16809-breast-reconstruction

Cancer.net. (2022). What to Expect When Meeting with Your Genetic Counselor. https://www.cancer.net/navigating-cancer-care/cancer-basics/genetics/what-expect-when-meeting-genetic-counselor

Komen.org. Genetic Counseling and Genetic Testing. https://www.komen.org/breast-cancer/risk-factor/gene-mutations-genetic-testing/

Center for Disease Control and Prevention. (2021, December 9). Patient Navigation. https://www.cdc.gov/screenoutcancer/patient-navigation.htm

The post Understanding Your Breast Cancer Treatment Team appeared first on National Breast Cancer Foundation.

Many screenings, like mammograms, were canceled in 2020 due to the COVID-19 pandemic. Months later, when it was safe to return to in-person appointments, two big problems emerged:

1. A huge flood of people returning to in-person screening appointments created a bottleneck
2. Millions of people were financially impacted due to the pandemic, increasing the already large number of people who couldn’t afford a mammogram

Bottleneck of appointments

After months of quarantine and canceled appointments, thousands of women are trying to schedule their screening mammograms, but:

• There aren’t enough timely appointments available
• A nationwide shortage of mammographers due to quarantine restrictions and life changes related to family needs and job changes also impacts appointment availability

Many women are waiting months for a mammogram appointment.* We know that screenings save lives and should not be delayed, however, many proactive women are still having to wait.

We went from months without mammograms scheduled to months of non-stop mammograms scheduled. This increase in sudden screenings resulted in more people being diagnosed with breast cancer—and at later stages. A large majority of recent breast cancer diagnoses are from patients who didn’t have a mammogram last year.

More women can’t afford mammograms

Due to the tremendous impact of the pandemic, more women are unable to afford the $150 average cost of a mammogram. They are having to choose between a mammogram and groceries, for example—a choice no one should have to make.

The reality is women are skipping a potentially life-saving screening simply due to cost. The need for financial aid in our hospital partners across the country is at an all-time high.

Historically, we know that women in low-income populations and those who are uninsured have:

• Lower breast cancer screening rates
• Higher breast cancer mortality rates

This means underserved women aren’t getting screened for breast cancer or reporting when they have a lump, so they are being diagnosed when it’s too late.

Access to life-saving screenings needs to be available to everyone, regardless of cost or insurance status.

The breast cancer death rate grows for the first time in 15 years

Because of these screening problems, the projected death rate of breast cancer will increase by 10% in 2021 due to loss of screenings.**

This is the first time the death rate is projected to increase since 2007.

This is the screening crisis. But you can do something to help today.

What you can do:

• Schedule (don’t cancel!) your mammogram or well-woman exam
• Share that you’ve scheduled your mammogram and prioritized your health with others
• Send this post to your loved ones
• Share NBCF’s resources
• Donate to provide free mammograms to uninsured women
• Donate to support patient navigators who remove barriers to ensure women maintain a yearly schedule for mammograms

*If you are experiencing breast cancer symptoms (continuous and persistent pain, redness, lump, discharge, etc. from the breast), ask for a diagnostic mammogram. This is different than a screening mammogram and will not be delayed.
**The current count of breast cancer deaths in 2021 is 44,130. Long-term effects of delayed screenings are still being observed.

National Breast Cancer Foundation is here for you and your loved ones. Whether you need support, education, or help during treatment, we have a team dedicated to get you the help you deserve.

The post The Breast Cancer Screening Crisis Explained appeared first on National Breast Cancer Foundation.

Like the disease, disparities in breast cancer are bigger than any one organization. The problem is complex, and the solution requires all of us.

One reason cancer is so destructive is that it hijacks the very structure of the body—the cell.

Similar to health disparities, cancer thrives off vulnerabilities and environments where it can grow unchecked.

And that’s just it—health disparities also exist in a world unchecked. Health equity is possible, but it will take a reckoning to achieve.

Here’s a start that paints a small picture of what is possible. We must first:

Collaborate

It may be hard to imagine, but there are thousands of breast cancer charities in the U.S., each with its own mission and goals. All of them want to help or make life better in some way for those affected by breast cancer. Since we know disparities in breast cancer are bad for everyone and we know the problem is bigger than just the disease (societal, socio-economic, etc.), we have more reason to come together to tackle an issue bigger than all of us—inequality. 

When the pink ribbon and National Breast Cancer Awareness Month (October) emerged in the early 1990’s, an industry was born. Breast cancer charities and foundations formed across the country. Breast cancer, a once stigmatized topic, was now front and center—featured on magazine covers and the evening news and cause-marketed on top brands at every local supermarket.  

As the industry grew, competition for fundraising dollars added pressure to the initial synergy. It became hard to collaborate or find common ground on issues that impacted women diagnosed with breast cancer. Promises were made—free mammograms, coverage for the uninsured, equal access to treatment, a cure. But here we are—decades later—with entire swaths of our population carrying the weight of possibilities unfulfilled.

As we celebrate 30 years of progress, we need a reawakening in the breast cancer industry. We need to see problems like disparities in breast cancer as a call to action and an impetus to foster unadulterated collaboration. Anyone trying to move the needle on health disparities in breast cancer should be considered. Anyone accomplishing breakthrough results should be championed by all.

Last year, Susan G. Komen launched a major health equity initiative—Stand for H.E.R.—which focuses on decreasing breast cancer disparities in the black community by 25% in 10 U.S. cities where inequalities are greatest.

Their work is based on landscape analyses and follows a roadmap to success. Everyone in the breast cancer community should be rooting for this work and doing everything they can to help it succeed. Even if not invited to the table of collaboration, there are things we can all do to share their message and support their work, because its success means a move in the right direction toward health equality. Success for this program is lives saved—a common goal for everyone. 

Earn Trust

In Harriet Washington’s award-winning book, Medical Apartheid, she examines one of the roots of health disparities—mistrust.

When fear is forged, trust is lost. For centuries, black Americans were subject to mistreatment and abuse by the medical community. Stories like the Tuskegee Syphilis Study and Henrietta Lacks haunt the psyche of generations of black Americans to this day. As a result, many simply don’t trust the overall medical community to consider their best interests. 

If you don’t have trust in an institution because of a prior experience or historical precedence, it’s easy to understand a reluctance to schedule an annual mammogram or come back for a follow-up biopsy.

Earning trust after it’s broken is hard. You have to apologize, accept responsibility, make amends, and then patiently allow time to bridge trust. If those first steps aren’t taken, it could take even longer.

In 2015, the National Institutes of Health launched the All of Us Research Program, an initiative to accelerate health and medical breakthroughs, enabling individualized prevention, treatment, and care.

The program also has the goal of reestablishing trust in communities historically harmed by medical experimentation. The program is offered in Spanish and English and requires full consent of participants. The goal is to enroll over 1 million participants of ethnically and racially diverse backgrounds. Hundreds of thousands of people have enrolled so far, and the vast majority are historically underrepresented in research—a positive sign that trust can be restored.

If this project works, research will lead to treatment advancements that accelerate lives saved and close the gap in health disparities in diseases like breast cancer. When targeted therapies and personalized medicine are tailored and accessible to the historically underrepresented, health disparities will decline.

Washington continues, “Physicians, patients, and ethicists must also understand that acknowledging abuse and encouraging African Americans to participate in research are compatible goals. History and today’s deplorable African American health profile tell us clearly that black Americans need both more research and more vigilance.” 

Listen & Learn

Listening and learning could arguably be a first step, but putting it last can also serve as a reminder that we must never stop listening and learning. Disparities are a result of fear, ignorance, misinformation, and an unwillingness to listen and empathize with others. Even if we one day end health disparities, growth will always be threatened if we don’t continue to try to understand the suffering of others.

Listening and learning doesn’t have to be hard. Listening could be talking to a neighbor or a breast cancer survivor of a different race or ethnicity and hearing about their lived experience and how it’s shaped their worldview. Listening and learning could be finding and reading a book about how health disparities affect us all. 

Books are a great place to quiet your mind (listen) and learn from the experiences of others. Here are a few that might help you learn about the problem of health disparities from a variety of voices and perspectives.

• Medical Apartheid – Harriet Washington
• The Immortal Life of Henrietta Lacks – Rebecca Skloot
• Bad Blood – James H. Jones
• Mountains Beyond Mountains – Tracy Kidder
• Just Medicine – Dayna Matthew
• Pharmacy on a Bicycle – Eric G. Bing and Marc J. Epstein

What’s most thrilling about the immersive experience of reading is that it illuminates the creativity of the mind. When the creative mind is open and inspired, solutions to problems form.

The Goal

All of us have a role to play in reducing health disparities in breast cancer. The goal is health equity.

According to the Centers for Disease Control and Prevention, health equity is achieved when every person has the opportunity to attain his or her full health potential and no one is disadvantaged from achieving this potential because of social position or other socially determined circumstances.

We may not have arrived, but it’s nice to have a name for the place when we get there—health equity.

National Breast Cancer Foundation is here for you and your loved ones. Whether you need support, education, or help during treatment, we have a team dedicated to get you the help you deserve.

The post What You Can Do to Support Health Equity appeared first on National Breast Cancer Foundation.

Note: An interview with NBCF Medical Advisory Council member, Karen Anderson. Originally published on WTSP; Written by Thuy Lan Nguyen.

Breast cancer impacts so many families. It turns out Black families are more likely to be negatively impacted, as Black women are more likely to die after a breast cancer diagnosis.

“One in 32 African American women will die from it as opposed to our counterparts which is one in 39,” said Karen Anderson, a member of the National Breast Cancer Foundation Medical Advisory Council.

The reasons are multi-faceted, but Anderson says one of the biggest reasons data says Black women are more likely to die is delayed diagnosis. 

“Women of color are often diagnosed at later stages of the disease and often times diagnosed with a more aggressive form of the disease, which causes a higher mortality rate,” she said. 

That’s why regular screenings and self-exams are so critical. Self-exams should be done once a month to check for lumps, thickening, hard knots, or any other changes. Women over the age of 40 should be getting annual mammograms.

There’s been a long-standing mistrust of healthcare in Black communities, forcing many women to skip recommended screenings. 

“There’s a lot of myths and misconceptions out there that just aren’t true,” said Anderson. 

She suggests turning to trusted health professionals with similar backgrounds that can help dispel any rumors.

Studies show there also may be genetic factors that lead to this disparity, as well as environmental child-rearing factors, like breastfeeding.

Anderson says another reason for the racial disparities in surviving breast cancer has to do with conversations around healthcare in Black families. “We have to start breaking down these barriers, and I think having real-life conversations about this disease will benefit all women of color and their daughters to come.”

Here are some resources for screening for breast cancer:

• Breast cancer symptoms and signs
• How to find a screening program near you
• Misconceptions about breast cancer

Want to learn more? Read “Disparities in Breast Cancer Threaten Progress for All.”  

National Breast Cancer Foundation is here for you and your loved ones. Whether you need support, education, or help during treatment, we have a team dedicated to get you the help you deserve.

The post Why Black Women are More at Risk of Dying from Breast Cancer appeared first on National Breast Cancer Foundation.

Though breast cancer is still a leading cause of death for women in the U.S., the mortality rate has dropped by 40% over the last three decades. Some estimate that nearly 400,000 additional lives have been saved as a result of this progress. 

Lower mortality rates could be attributed to a number of factors – improvements in treatment, early detection, and even awareness about the disease and the importance of screening. The good news is that we know what we need to do to continue this trend. 

The bad news is that declining breast cancer deaths have not been equal for everyone. According to a new study published in Cancer Epidemiology, Biomarkers, & Prevention, black women are dying of breast cancer at twice the rate of white women. Though this study is new, the disparity is not. For decades, black women have been dying of breast cancer at a higher rate than white women. Hispanic women (lower incidence rate) diagnosed with breast cancer also have a higher risk of dying of the disease than white women. 

The numbers don’t lie. It is clear that race and ethnicity are major factors in the survivability of breast cancer. Though some research suggests biological factors could play a small role, the overwhelming cause is a lack of access to quality care and socio-economic inequalities.

HealthyPeople.gov defines health disparities as “a health difference that is closely linked with social, economic, or environment disadvantage.” 

How does National Breast Cancer Foundation reduce health disparities in breast cancer?

Some say knowing is half the battle, but when it comes to breast cancer disparities, knowing without acting is a battle lost every time. Action is paramount.

The National Breast Cancer Foundation (NBCF) is committed to reducing health disparities in breast cancer by offering evidence-based programs proven to increase access to care and reduce mortality.

Expand Education & Outreach 

Educating about the importance of early detection of breast cancer and empowering women to take control of their breast health is critical to combating health disparities.

Information about breast health is not readily available in underserved and minority communities or for people in low socioeconomic status brackets in the U.S. Women in these communities are often unaware of the importance of early detection of breast cancer or that services are available to help them navigate the complex healthcare system.

Studies have shown that individuals who are uninformed about their health are less likely to take advantage of early detection services like mammograms. As a result, these women are at a higher risk of dying from breast cancer because they are diagnosed at a later stage when the disease is harder to treat.

That’s why NBCF is reaching these communities and equipping them with education about breast cancer and connecting them to life-saving resources.

Each year, NBCF partners with Convoy of Hope, an organization with a driving passion to feed the world, provide resources to underserved communities, and bring relief in times of disaster. Through this partnership, NBCF hosts outreach events in areas of low income and offers breast health education and connects tens of thousands of women to free, local resources that offer screening and breast health services. 47% of women served at these events are African American and 37% are Hispanic.

We know that interventions only work if people know about them, so we are determined to extend our reach into communities with health disparities and offer education, resources, and easier access to care.

Increase Access to Screening 

Awareness and education about a problem is a first step. We know early detection saves lives, and we know the best way to find breast cancer early is mammography. But, there are still millions of women across the U.S. that are uninsured or underinsured and can’t afford the cost of annual screening mammography. That’s why NBCF funds free screening and diagnostic tests in hospitals across the U.S. Since 2010, NBCF has provided over 305,000 screening and diagnostic breast care services. NBCF funds hospitals that prioritize patients facing health disparities.

One of NBCF’s top screening partners, Parkland Hospital, serves uninsured patients in Dallas, TX. 79% of Parkland’s patients are black or Hispanic. Recently, Parkland identified two zip codes with the highest rate of late stage breast cancer in Dallas County and are now targeting these areas with education, outreach, screening, and follow-up care with the goal of increasing regular screening and finding breast cancers early. By providing funding for free screenings, NBCF is playing a vital role in this project and helping eliminating the barrier of cost. 

Provide Patient Navigation for All

When Dr. Harold Freeman, the pioneer of patient navigation, started working as a surgeon at Harlem Hospital in the late 1960’s, he was overwhelmed by how many patients presented with late stage disease. Most of his patients were African American, and he realized that inequality in access to care accounted for this disparity. He dedicated his entire career in medicine to overcoming disparities in healthcare.

Dr. Freeman launched the first patient navigation program in the early 1990’s, with the purpose of eliminating barrier to timely cancer screening, diagnosis, treatment, and supportive care.

Today, navigators are trained and equipped to also address the social determinates of health. Patient navigators help translate breast cancer information for patients with language barriers. They help them find transportation and childcare, one of the main reasons for missed appointments. Patient navigators also help access financial assistance for uninsured and underinsured patients. The financial burden of a breast cancer diagnosis can be debilitating, but there is help for those willing to put in the time to find it.

NBCF funds patient navigation programs in hospitals across the U.S. with the goal to increase screening, reduce wait times, and ensure access to timely care. Since starting the patient navigation program in 2010, NBCF has provided 1.7 million patient navigation services to women in need.

A few years ago, we reached out to one of our patient navigators in Flint, Michigan. Flint residents were still reeling from the water crisis, so it required the patient navigator to go above and beyond to find solutions. When asked how we could help her current situation, the patient navigator said, “A mattress. I need a mattress.” The patient navigator was navigating a metastatic breast cancer patient sleeping on a perforated air mattress. She said the patient was having to wake up several times a night to fill the deflated mattress with air. This was causing a lack of sleep and made it hard for her to continue life-extending treatment. Finding a suitable place to sleep may not be in the clinical job description of a patient navigator, but it is a reality of working with patients in need of help and dignity.

A disparity can sometimes be environment, like the inability to get a good night’s sleep which is critical to a patient’s outcome. 

NBCF is helping, but can more be done? 

Like the disease, disparities in breast cancer are bigger than any one organization. The problem and solution require all of us. Tune into our next blog post to learn about what we must do to achieve health equity.

National Breast Cancer Foundation is here for you and your loved ones. Whether you need support, education, or help during treatment, we have a team dedicated to get you the help you deserve.

The post Disparities in Breast Cancer Threaten Progress for All appeared first on National Breast Cancer Foundation.

It’s been over a decade since Malcolm Gladwell published his bestselling book, Outliers: The Story of Success. The book debuted at #1 on The New York Times Bestseller List in December 2008, just a couple months after I started working at the National Breast Cancer Foundation. At the time, Outliers was often referenced in business meetings, strategy sessions, and conferences.

In Outliers, Gladwell introduced “The 10,000 Hour Rule”—the idea that it takes a person 10,000 hours of practice, dedication, or attention to a thing in order to master it. According to Gladwell, “To become a chess grandmaster also seems to take about ten years. (Only the legendary Bobby Fisher got to that elite level in less than that amount of time: it took him nine years.) And what’s ten years? Well, it’s roughly how long it takes to put in ten thousand hours of hard practice. Ten thousand hours is the magic number of greatness.” 

So here I am, over a decade later. I’ve done this thing, put in my hard practice for well over 10,000 hours. I’ve given the topic of breast cancer this magic number of greatness, and yet the idea of mastery over breast cancer seems as foreign to me as the day I started. In fact, as I’ve looked over the mysteries of breast cancer, one thing I’ve learned is that when one layer of insight or knowledge is peeled back, another thousand layers unfold.   

I don’t know that I’ll ever master breast cancer, but I am not alone in my uncertainty. After all, there is still no cure for this disease and breakthroughs are often not as impactful as the myriad of headlines suggest. However, to say that I have not gained some level of expertise would be untrue.

I am now an expert in many of the things that matter most—things like uncertainty. I am an expert in what it’s like to lose control, to not be able to fix a problem right in front of you, an expert in feeling helpless.

I am an expert in the pain of loss. I know and understand that little ripple of fear and dread that seems to clamber from an unknown, secreted space within our consciousness. I know it so well that I know it doesn’t take 10,000 hours of practice, but just a single moment. Perhaps the moment a mother, my own even, depleted of platelets, slips on the bathroom floor. It only takes a second, really. And it’s important that I’m an expert in these things because I can’t help what I don’t know.   

I am also an expert in hope. The kind of hope that doesn’t make sense, the kind that seems almost miraculous in its ability to strengthen and repair the most heartbroken. I am an expert in finding the silver lining in the darkest cloud—a dying patient that found a mother to adopt her child after her death, an early stage breast cancer patient afraid of bankrupting her family, then finding financial support, undergoing treatment and surviving, a husband who simply wanted to know the safest way to cuddle with his dying wife. 

The Future of Breast Cancer

The future of breast cancer is uncertain, mysterious, and will require mastery that exceeds all the rules, and I do have an expert-level amount of hope. According to the American Cancer Society, the mortality rate for breast cancer has declined by more than 40% since 1991. The progress is attributed to improvements in early detection. Mortality rates of breast cancer continue to decrease, and I think the progress made will continue to compound in the years to come.

Artificial Intelligence  

In the future, medicine and our understanding of how to treat and diagnose breast cancer will probably flow through a pool of artificial intelligence (AI). Cancer is one of the most complex problems of mankind, and what makes it so complex is its ability to trick and deceive our own cells to turn on us and disrupt the very blueprint of our existence. With AI, cancer’s algorithm may have met its match.

In the U.S., each state is responsible for collecting cancer data through a cancer registry. The amount of data collected is so vast it would be impossible to be thoroughly utilized by researchers and experts to improve outcomes without AI. With AI, this data can be analyzed in a fraction of the amount of time and key learnings can be interpreted to allow more timely and precise treatment recommendations for cancers.

Scientists are also combining behavioral science with AI technology to overcome screening hesitancy and more precisely target populations that may not understand or have access to early detection education. Using AI to target specific groups has already increased screenings rates in areas of low intake.    

Immunotherapy

I’m cautiously optimistic about the future of immunotherapy—a cancer treatment that boosts the immune system to help fight tumors. I’m optimistic because of stories like former President Jimmy Carter, whose metastatic melanoma went into remission after receiving a breakthrough immunotherapy treatment. However, immunotherapy breakthroughs for breast cancer patients have progressed slower.

In recent years, new immunotherapy drugs were approved for patients with late stage triple negative breast cancer. These drugs block the PD-L1 protein on some tumor cells, which triggers the immune system to attack and shrink the tumor. Triple negative breast cancer patients desperately need more targeted therapies, as they have historically had few options outside of the traditional array of surgery, radiation, and chemotherapy. 

Breast Density and Improved Screening and Communication

Breast density has been a hotbed issue for many years. Women with dense breasts are slightly more likely to develop breast cancer, and it’s harder to spot tumors because the tissue is the same color—white—on traditional mammograms. New and improved 3D mammography is helping find tumors earlier, and breast MRIs and ultrasounds have shown to help find cancers masked by dense breast tissue. 

New technology, however, requires improved awareness and regulation. Some states enacted laws, such as Henda’s Law in my state of Texas, that require mammography providers to notify all women with dense breast tissue that the accuracy of their mammograms is less than that of women with lower breast density and that they may benefit from “supplemental screening” in addition to their annual mammogram. However, these kinds of regulations are not standardized across the U.S. 

The FDA recently proposed an amendment to the Mammography Quality Standards Act of 1992, a law that ensures that mammography facilities across the U.S. are providing quality services. One of the proposals will help improve communications between doctors and patients regarding breast density and increase access to higher quality screening options for these patients. 

According to the FDA Principal Deputy Commissioner Amy Abernethy, M.D., Ph.D., “Given that more than half of women over the age of 40 in the U.S. have dense breasts, helping to ensure patient access to information about the impact that breast density and other factors can have on the risk for developing breast cancer is an important part of a comprehensive breast health strategy.”

The future will be improved screening results for patients with dense breast tissues and more cancers found in the earliest, most treatable stage. I believe future lives will be saved by these measures. 

Research

The future of breast cancer is research. We need more well-funded research and more targeted therapies for breast cancer. We especially need breakthroughs in metastatic disease, but also in screening and early detection. Researchers in California recently launched the Women Informed to Screen Depending On Measures of Risk Trial (WISDOM). This trial will introduce precision medicine to the screening process. We know that each breast cancer patient is unique, so undergoing genetic testing could guide when and how often a patient utilizes screening services to ensure the best chances of early detection.

According to the National Cancer Institute, “The goal of the WISDOM trial is to determine whether risk-based screening is as safe as annual screening (that is, no advanced-stage breast cancers compared with the annual screening group) and less morbid (that is, involves fewer mammograms and biopsies).”

Genomic analysis research is also being used to determine which patients will benefit from invasive treatments like chemotherapy and which patients will not.

A diagnosis of triple negative breast cancer means that the three most common types of receptors known to fuel most breast cancer growth–estrogen, progesterone, and the HER-2/neu gene–are not present in the cancer tumor.  Breast cancers that are positive for hormone epidermal growth factor receptor 2 (HER-2), estrogen receptors (ER), and progesterone receptors (PR) all have targeted therapies that can dramatically extend survival, but triple negative does not. We desperately need targeted therapies for triple negative breast cancer and researchers are working around the clock to develop new drugs for this breast cancer subtype.

An End to Health Disparities

We live in a don’t-look-back world, but with breast cancer, we have to look at it all—the past, present, and future. And we are surrounded by disparity in healthcare. Women across America are dying of often treatable breast cancers because they lack access to early detection services and quality and timely care. For example, African American women have a 40% higher mortality rate of breast cancer than white women in the U.S. The future of breast cancer will be dim if we improve technology, research, and regulation, but do nothing to increase access or address biological differences that may increase the risk and mortality of breast cancer.

We have to find a solution to rising healthcare costs and the need for quality care. We have to ensure that all women in America have access to quality screening regardless of their ability to pay. Also, this must extend to treatment. We have many examples of patients that present a suspicious finding on a mammogram, but choose not to follow-up because of work-up costs, which often exceed thousands of dollars. We can’t offer free screening and expect patients to be able to afford follow-up biopsies or treatment.  

We must increase patient navigation services. Every facility that screens, diagnoses, or treats patients for breast cancer should have a patient navigator or have access to one. Patient navigators work to decrease the wait times between screening, diagnostic, and treatment and eliminate barriers to timely care—language, cost, fear, and transportation. Without patient navigators working within the complex cancer care systems across America, patients that face these barriers are less likely to overcome and less likely to survive a breast cancer diagnosis. 

Whatever the future holds, I know it is going to get better for women facing breast cancer. Improvements in research and technology, greater access to better screening methods, and an overall decrease in the mortality rate—these are the building blocks of what I see as a horizon of hope. 

NBCF helps break down the barriers to health access & equality for all regardless of race, sexual orientation, disability, or age so that no one navigates breast cancer alone. No matter where you are in your journey, NBCF can help. Click here to learn more about NBCF’s programs.

The post What I’ve Learned About Breast Cancer After 10,000+ Hours appeared first on National Breast Cancer Foundation.