On Hair Loss

Last week, our Facebook followers shared hundreds of tips for coping with hair loss. Blogger Judy Weinstein wrote this post about her personal experience with hair loss and how she handled the side effect.

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When you get a cold, you feel sick right away. Strep throat? It’s obvious something is wrong! Kidney stones? You are in the hospital crying in pain. Cancer is different.  Cancer silently does its evil damage while you are going about your daily life. You are working, laughing, and likely “sweating the small stuff” while your cancer sneakily divides and tries to conquer.

One day you wake up and realize that something isn’t quite right. You have a slightly unusual lump, a little blood where you shouldn’t, or unexplained pain. Then the bombshell is dropped. “You have cancer.”

For many women who endure chemotherapy, one of our preoccupations is about becoming bald. I was squarely in that category. I generally don’t wear make-up and I don’t spend a long time pondering what to wear.  I did, however, spend a lot of energy over my lifetime thinking about my hair. I will always remember the very first time I cut my long hair up to my chin. I was in 6th grade.  One of my parent’s best friends said “Today we lost our little girl.”  I puffed with pride that a shorter haircut could make me look all grown up. Soon after, I grew it out and curled the front in a desperate attempt to look like Farrah Faucet. Then later came the big hair stage… even with a perm my straight hair didn’t cooperate!

After my third baby was born, my hair began to change. I started to become gray and over time my hair became more wavy, frizzy and unruly.  And did I mention gray?  Those wiry gray strands were the worst!

Figuring out a style that was best became a monthly challenge.  What was the right color for my changing hair? This time it was too blonde…this time too red. Should I go short? Long? Bangs? No bangs? One style was good for the winter and another for the summer humidity. One style worked for pulling it back when I played tennis but wasn’t flattering at other times! My patient hairdresser, now a close family friend, made whatever changes I asked for, knowing that I would always second guess my hair decision.

Once I had a cancer diagnosis and knew I was facing hair loss, thinking about becoming bald was admittedly terrifying. How humiliating to lose what I thought played such a heavy role in defining my looks and by extension, who I am. My cousin told me about the penguin caps one can wear during chemotherapy that works to prevent hair loss. Suddenly my emotions began to shift. The only thing I could think of worse than losing my hair, was to sit for several hours, being infused with toxic chemicals, wearing an ice-pack on my head. I was NOT willing to do that to prevent hair loss.  So maybe, just maybe if I wasn’t willing to go to such great lengths to prevent hair loss, perhaps it wasn’t as important as I initially thought.

I began losing my hair on January 1.  While I had the rest of my uncomfortable treatment ahead of me, I also had the hope and wonder that comes with any new beginnings.  What would this year bring? Finishing treatment, my middle son graduating from high school and starting collage, my youngest son starting high school and thanks to this treatment, celebrating my half century birthday! Never before did I deeply appreciate the thought of reaching this milestone.  As my grandmother used to say “It’s better than the alternative!” Continue reading

I Spy a Clinical Trial: Weighing the Benefits Against the Unknowns

Sometimes your doctor may recommend a clinical trial, a new approach that is being compared to standard treatment to see which is more effective. New LBBC Blogger Judy Weinstein writes about weighing the pros and cons of a trial she joined, ISPY2.

IMG_5627When I think back to the weeks following my breast cancer diagnosis, I picture myself in the middle of a tornado moving along at a frightening speed. One day I was pondering what to pack for my upcoming 25th wedding anniversary trip to Italy and the next I was in a swirl of medical appointment mania. I had to choose a hospital, an oncologist, and a surgeon, endure a slew of medical tests, take it all in emotionally and then break the news to close friends and family. Along the way, as all newly diagnosed cancer patients do, I took a crash course in understanding breast cancer and my particular type so I could make informed choices about my treatment. Just the vocabulary alone was enough to make my head spin! Words like triple-positive, HER2-positive, and neoadjuvant therapy were thrown around and I needed to understand it all. Just when I thought I had it all figured out, another new word was put in front of me that I needed to learn: ISPY2.

No, this was not the fun game you play in the car when you are bored and you say, “I spy with my little eye something blue,” and the other person has to guess what you are seeing. ISPY2 was a Phase II medical trial that, because of the exact nature of my cancer, I was eligible to be a participant. Questions came flooding in. Aren’t trials for people who are dying and have no other options? I know that trials are important to advance research but do I want my body to be the guinea pig? How could I live with myself if I found out the experimental medicine I was on actually doesn’t work, or has long term side effects that the doctors didn’t find out about until years later? Facing chemotherapy was scary enough. Did I want to be a part of a trial that had so many unknowns attached?

I learned that the goal of the trial is to pinpoint how each individual tumor grows and target treatment to a specific tumor type.  Today, most women affected by breast cancer receive standard chemotherapy. Some breast cancers respond to this treatment. Others do not. This study screens promising new targeted medicines that could increase success rates while reducing side effects. After much reading, talking to my doctors and to LBBC, and pondering it deeply with those closest to me, I decided to take the plunge…. well, only halfway. I found out that I could be screened for the trial, told which drug I would be getting, and THEN decide if I wanted to continue. At any point in the trial I could opt out. Continue reading

Embracing Community and Participating in Yoga on the Steps

FullSizeRenderMarisa Gefen, MD is a 35-year-old physician and mother who has now added “patient” to her resume. She was diagnosed last April with ER/PR-positive breast cancer. Marisa reflects on how this journey led her to Living Beyond Breast Cancer and Yoga on the Steps.

After my shocking diagnosis in April 2014, I immediately went into survival mode. I hyper-fixated on getting through the current phase of treatment and onto the next phase. It was a whirlwind of getting a port, quickly followed by starting chemo, managing chemo side effects, finishing chemo, then on to a 9-hour surgery comprised of a double mastectomy, sentinel node biopsy, and free flap breast reconstruction. Soon, I was home recovering from this massive surgery and then stumbling into radiation daily for 5 weeks.

Then, I woke up one morning in January and suddenly realized that active treatment was all over. Now what? In this frightening journey, I was missing a sense of community of others with similar experiences, both past and present. The endless support from my husband, family, and friends, did not fill the entire void.

I heard about Living Beyond Breast Cancer right after my diagnosis. When I happened to be looking for local office space, my tour of commercial real estate ironically took me right through LBBC headquarters, which I toured. The office was warm and full of young, vibrant people. I wasn’t ready at that moment to reach out.

I was reintroduced to LBBC in December, when I tried frantically to interpret the results of the Suppression of Ovarian Function Trial (SOFT). This major trial will likely change the standard of care for me and other women under age 35 with ER-positive breast cancer, by recommending induction of early menopause (as if we haven’t been through enough) and possibly switching from tamoxifen to an aromatase inhibitor. Continue reading

Offering Support for the Newly Diagnosed: Tips for People Who’ve Been There

New LBBC blogger Joanne Hampton posts tips for offering the best possible peer support for people newly diagnosed with breast cancer.

joanne hampton photoMy journey has consisted of nine surgeries, chemotherapy, radiation, and a positive diagnosis of BRCA1. I am an 11 year survivor. I have spoken at numerous events, sat on different committees, ran many successful fundraisers, and yet, I still feel awkward talking to someone who is newly diagnosed. They look up at me like I am about to reveal some great secret advice to get them through this. Tears begin to form in their eyes they ask me questions like “What now?”

Even though I, too, am a breast cancer survivor and have traveled a similar path, I don’t always know what to say. Because of this I was inspired to do some research for myself and other breast cancer survivors who want to offer that glimmer of light at the end of the tunnel for someone recently diagnosed.

I want to focus on some tips to think about when you are asked to speak to someone who is diagnosed with cancer. So that you can make it easier by giving them strength, make a difference by inspiring, and help by holding a hand.

Tip #1: Each person’s reaction is different.

This is very important. I can’t stress this enough. The most miniscule thing to one could be earth shattering to another. To me, losing my hair was the least of my worries. But, I have met a lot of women who were devastated and felt they had lost their dignity along with their hair. A person can’t always help or control how they feel. There’s no rhyme or reason, there’s no right or wrong but, they are real feelings and people will react differently, based on those feelings. Not all wounds are so obvious. Walk gently in her life.

Tip #2: It is not all about you and your journey or the journeys of others.

Be sensitive to her journey. Make sure you do not compare. Try and avoid saying things such as, “I know how you feel,” or “I know how hard it can be”. She needs to be herself and take her own journey. The secret is changing saying “I know” to “I understand”… because to an extent you do. As for comparing, most of the time people don’t even know they’re doing it. We don’t want her to feel bad if she isn’t living up to the expectation she sets for herself based on your experience. Continue reading

Discussing Fertility Preservation with Young Patients Diagnosed with Cancer

Kristin N. Smith, a patient navigator at Robert H. Lurie Comprehensive Cancer Center, blogs about some fertility options healthcare providers could discuss with young patients diagnosed with breast cancer. Ms. Smith is the speaker for our webinar, Fertility and Breast Cancer: Educational Opportunities and Preservation Options. Register now for this program and discover more about how you can help young women learn about fertility after breast cancer.

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Providing care to young cancer patients who wish to pursue fertility preservation prior to initiating cancer treatment requires the collaborative efforts of oncologists, reproductive endocrinologists, nurses and many more within a short time frame.

Being able to effectively communicate and educate patients about the potential gonadotoxicity of cancer therapy, or damage to reproductive organs caused by treatment, and the available options for fertility preservation is essential to improve patient care. Many of the treatments we use to treat cancer for adolescent and young adult (AYA) women can decrease the likelihood of having biological children. High dose alkylating agents and pelvic radiation can destroy the ovarian reserve; radiation to the brain can harm the way the brain communicates to the gonads and surgical resection of reproductive organs can all make family building more difficult for patients.  Continue reading

Addressing a Gap Identified in Our Needs Assessment of Young Women: Discussing Fertility After Breast Cancer

Whether treatment will affect their ability to have children in the future is one of the most common worries among young women who are diagnosed with breast cancer. LBBC’s Arin Ahlum Hanson, MPH, CHES, manager of the Young Women’s Initiative and YWI Program Coordinator Ingrid Mapanao blog about this gap, in anticipation of an upcoming healthcare provider webinar on fertility and breast cancer. 

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LBBC’s Arin Ahlum Hanson, manager of the Young Women’s Initiative (left) and YWI Program Coordinator Ingrid Mapanao (right).

The National Comprehensive Cancer Network guidelines recommend all premenopausal women diagnosed with breast cancer be informed about the potential impacts of treatment on their fertility and asked if they would like to have future pregnancies. LBBC’s national needs assessment of over 1,500 young women affected by breast cancer found that only half of the young women surveyed reported discussing fertility issues with their healthcare providers. Of those women who did discuss fertility impacts with their providers, the majority of those women initiated this important discussion with their healthcare providers rather than having their healthcare providers bring up the subject.

LBBC is working to close this communication gap by educating healthcare providers through an upcoming webinar. Healthcare providers participating in this webinar, Fertility and Breast Cancer: Educational Opportunities and Preservation Options , will learn about fertility preservation options available for young women and how breast cancer treatments impact fertility. The webinar will be held on Wednesday, March 18 from noon-1pm ET and the guest presenter will be Kristin N. Smith, a fertility preservation patient navigator at the Comprehensive Cancer Center of Northwestern University in Chicago.

Free CEUs will be given to the first 150 nurses and 150 social workers who register!

Our hope is that many healthcare providers join our Young Women’s Initiative’s commitment to strengthen and expand programs for young women affected by breast cancer. Healthcare providers can do this by participating in the webinar. If you’re a healthcare provider, register now to learn the roles you can take to educate your young patients about their fertility options.

Everyone Deserves Quality Health Care: On Writing “Breast Cancer inFocus: Getting the Care You Need as a Lesbian, Gay or Bisexual Person”

Josh_blog photoWriter and Web Content Coordinator Josh Fernandez writes about authoring Breast Cancer inFocus: Getting the Care You Need as a Lesbian, Gay or Bisexual Person, and why creating this resource was important to him and LBBC.

I came out to my primary care doctor when I was 16 years old.

I had come out to a few close friends in the weeks before, and they didn’t handle it well. After that, my anxiety gradually increased. I had been meaning to make a doctor’s appointment for other reasons, so this anxiety pushed me to schedule a visit.

There were words before and after “I’m gay,” but I couldn’t help but focus on those two. After I said them, my stomach and chest felt as if they twisted into knots. My doctor’s face didn’t change; she maintained her relaxed facial expression and asked me questions about the anxiety I had. We then talked about what was going on. Before the end of the appointment, she told me not to hesitate to contact her if I had other questions or concerns, or if I needed someone to talk to.

My doctor was affirming, which was something I really needed at that time. That’s not always the case. Among the different barriers and disparities lesbian, gay, bisexual and transgender people face when seeking health care, getting quality care that’s sensitive is a major one. Forms in the doctor’s office or a hospital sometimes offer very limited ways to describe your relationship or gender identity. Providers may make assumptions. Biases may directly or indirectly impact a provider’s approach to care.

This is why it was important to me to write Breast Cancer inFocus: Getting the Care You Need as a Lesbian, Gay or Bisexual Person for Living Beyond Breast Cancer. There are advocacy organizations and other institutions working hard to educate, inform and train healthcare professionals on adequate care for LGBT people. Things are improving – just look at the Healthcare Equality Index – but there is still much work to be done. LGBT people with breast cancer cannot afford to wait for this work to be finished before receiving care. I wanted to create a resource that could empower and help LGBT people while that systemic work continues. I also wanted this publication and related online content to include personal stories of LGBT people affected by breast cancer, so that readers know they’re not alone. Continue reading