Listening to the presentations and engaging with researchers, scientists, and patients raised an important question: how do we communicate findings and data in ways that advance patient care while also fostering trust and meaningful relationships between industry and community?

No one-size-fits-all digital solution

Some of the most recent developments in data and research presented in San Antonio are worth recognizing, not only for what they found, but also for what they can teach us. For example, the YES (Young, Empowered & Strong) study demonstrated the potential of a mobile health (mHealth) app to address quality of life issues and reduce key symptoms in young breast cancer survivors.

While the study presented promising information for this group of patients, it also highlighted some persistent challenges, indicating that there is no one-size-fits-all digital solution. First, it highlighted the continued existence of a digital divide, indicating that equitable patient access to digital devices cannot be assumed. The YES study also pointed out valuably that while improvements were seen in some areas of treatment as a result of mobile technology use, several menopausal and psychological challenges for patients remained that were not significantly addressed.

More information is needed

Data from the oral SERD study are exciting. The study validates the oral SERD (Selective Estrogen Receptor Degrader) approach and sets the stage for further development of novel SERDs and combination strategies. This represents a potentially transformative advance in endocrine therapy for HR+ HER2‑breast cancer. While the study’s findings are promising, longer follow-up, survival data, and subgroup analyses are still needed. In addition, data from a hormone therapy in BRCA1/2 carriers study suggest that while hormone therapy may not increase breast cancer risk, treatment remains highly individualized and requires personalized care and shared decision-making to be as effective as possible.

The Cleveland Clinic’s early triple-negative breast cancer (TNBC) vaccine trials showed promising immune responses and good safety in small studies. These preliminary results are promising, but larger trials are necessary to confirm any real clinical benefit.

Finally, the results of a study on neoadjuvant strategies with radiation + Keytruda showed promise in shrinking tumors and boosting immune responses before surgery. These findings challenge the traditional surgery-first paradigm and further support more personalized care. But these approaches remain early and complex, and are not yet standard.

Wellness doesn’t have to be complicated

While early-phase, the results of trials on acupuncture and integrative therapies suggest that these approaches may help survivors with cognitive symptoms (“chemo‑brain”) and improve their quality of life with minimal side effects. These studies highlight that integrative care can complement, not compete with, conventional treatment.

The broader adoption of these approaches will require clinicians to be aware of, sensitive to, and supportive of personalized wellness. Like with other therapies, there’s no one-size-fits-all approach, but these promising findings remind us that wellness doesn’t have to be complicated, overwhelming or inaccessible.

How do we better communicate scientific updates?

The researchers, scientists, funders, and patients who participate in these studies are critical to advancing care and creating a healthier tomorrow. I’m honored to be part of this ecosystem.

This year’s symposium has also prompted me to reflect: How do we best communicate, rather than commercialize, scientific updates? How can we inform, not inflate? How do we continue to educate without exaggerating? What will allow us to better inspire, not deflate?

While thousands of abstracts are presented each year, only a small fraction ultimately changes clinical practice. So, what can we do to ensure they receive a broader hearing?  I believe that as researchers, scientists, and physicians who rely on communicating the promise and potential of our work and its ability to improve patients’ lives, we should follow these four communication imperatives.

• Prioritize the heart of the story, not the headlines. Headline-first news stories are the norm for those consuming news. While the temptation may be to present your work in the best possible light, including caveats (“early stage,” “with limitations”) that accurately convey the current state of a study or research program can help curb misinformation and limit premature hype.

• Encourage dialogue. It’s crucial to establish connections with disease communities to foster collaborative partnerships that facilitate improved communication and outcomes. Intentionally creating channels for questions or feedback on published studies fosters transparency between the industry and the community.

• Non-updates are still updates. Patients who are waiting for effective treatments rely on honest and open communication to base their decisions on. However, it’s essential to recognize that both positive and negative findings contribute to innovation. Breaking down wins and losses in clear language helps bridge the trust gap between the industry and the community.

• Support for replication and wellness research. Currently, there is no large, dedicated Federal program funding large-scale repeat clinical trials solely for confirmation purposes. Greater investment in replicating research in prevention, while advancing breakthrough therapies, could help actualize a whole-person health approach.

The proceedings of SABCS 2025 and the research presented remind us that progress in cancer treatment and care is iterative, collaborative, and deeply human. They also emphasized that, even as we celebrate exciting breakthroughs, we must recognize that honestly communicating the nuances and limitations of research is also our responsibility. As communicators, that is how we translate the most promising research into meaningful, equitable patient care.

The post Promise, Progress and Perspective: Key Takeaways from SABCS 2025 appeared first on Medika Life.

The FemTech Foundation—and Fault Lines

In 2015, fewer than 300 ventures focused on women’s health existed. That number has tripled to 942, according to the Galen Growth HealthTech Alpha™ platform. These ventures now span the female health continuum—gynecology, menopause, oncology, cardiovascular disease, mental health and beyond.

Yet the investment tide has not fully turned in FemTech’s favor. While partnerships have risen 15.3-fold during the past decade, capital deployment has grown only 1.4 times. Compare that to the 2.6x expansion of digital health investments. In 2024, FemTech secured $2.2 billion in funding, a sliver of the $26 billion digital-health pie.

This disparity isn’t due to a lack of innovation—quite the opposite. The problem is systemic: funding gaps, policy voids, and clinical blind spots that overlook the $360 billion “ghost market” of women’s health. That phrase— “ghost market”—is the report’s haunting term for the opportunities left untouched by current investors and providers alike.

From Fertility to Full Spectrum

One of the report’s most critical takeaways is how much the FemTech category is maturing. Fertility tracking and pregnancy apps put the field on the map. But FemTech today is far more.  It recognizes the vast need for medicine to engage with women’s unique health needs, long unaddressed.

The Galen Growth data shows that while gynecology and oncology account for more than half of all FemTech ventures, menopause, chronic pain, autoimmune conditions, cardiovascular disease and mental health are surging into the investment and innovation spotlight. These are not “niche” categories—they represent common, often underdiagnosed or misdiagnosed conditions that disproportionately affect women and impair their quality of life.

This expansion reflects a growing recognition that women’s health is not a subset—it’s a central pillar of public health. As de Salaberry writes in a soon-to-appear Health Tech World byline: “To be transformative, FemTech must address the entirety of the women’s health continuum, including those therapeutic areas that are not traditionally branded as female-specific but affect women in distinct ways.”

Twice the Clinical Evidence—But Still Under Scrutiny

Perhaps the report’s most sobering—and telling—data point is that FemTech ventures generate nearly twice the volume of clinical trials, peer-reviewed research, and regulatory filings as their digital health peers. Twice. That’s not due to past scientific rigor; these companies are held to a higher standard. Founders and advocates must go the extra mile to validate the clinical value of their solutions.

Despite this, systemic barriers remain. The report shows 71 percent of early-stage FemTech ventures struggle to raise a Series A round. Funding the “middle”—those post-seed but pre-scaleup companies—is an urgent priority. Without it, too many promising solutions will stall before reaching the women who need them.

Let’s be clear: this isn’t just about meeting investor milestones. It’s about delivering equity in care. Cardiovascular disease is the leading cause of death among women, yet it remains underrepresented in FemTech portfolios. Alzheimer’s and autoimmune conditions disproportionately affect women, yet receive comparatively little innovation focus.

Those are not oversight gaps. They are deep, systemic failures – disparities in our health innovation system.

From Direct-to-Consumer to Deep Health Integration

Another significant signal of maturity is the shift away from pure direct-to-consumer (DTC) models. In 2024, 42 percent of FemTech partnerships involved health systems, up from just 10 percent in 2020. That’s a tectonic shift from point solutions to systemic integration.

As de Salaberry puts it, “DTC strategies alone cannot reach underserved populations or secure the reimbursement pathways necessary for scale.” Systemic integration—through payers, providers, and public institutions—is essential for sustainability and access. FemTech must live where care happens, not just on consumers’ cell phones.

Regionally, the picture is just as telling, with Europe leading in clinical rigor, with 50 percent of FemTech ventures demonstrating proven clinical strength. North America leads in funding ($1.3B), while Asia-Pacific remains a hub of AI-driven diagnostics, even amid a dip in capital investment. These trends point to what’s next: a future driven by localization, clinical excellence and technology convergence.

Forces Shaping the Future of FemTech

The report outlines five key factors shaping the FemTech evolution during the next five years. They’re worth noting for anyone investing, innovating or advocating for equitable care with an eye toward return on investment:

• Redefining the Scope: FemTech must look beyond reproductive health to address chronic diseases, aging, and behavioral health.
• Breaking the DTC Mold: Success will be defined by integrated partnerships with employers, insurers, and health systems.
• Balancing Rigor and Agility: Regulatory requirements must support innovation without stifling it.
• Funding the Growth Gap: Series A and B support is critical to help early innovators scale.
• Smart Consolidation: M&A isn’t just about exits—it’s about building category leaders with breadth and credibility.

Infrastructure, Not Hype

The key here is infrastructure. FemTech is not a trend—it’s the scaffolding of women’s health innovation. Investors need to hear that message and invest to make this population health category viable.

With nearly half the global workforce made up of women, the ROI on women’s health is not just moral—it’s macroeconomic. The health ecosystem can no longer afford to treat women’s health as an edge case. It is, in fact, the core of population health.

FemTech’s next chapter will be shaped by evidence, equity and integration. It must also be underpinned by trust from payers, providers, and patients. That trust is earned through data, outcomes and the bold assertion that women’s health is health, full stop. This Galen Growth Report goes a long way to demonstrating the positive outcomes when innovation and investment converge.

As Julien de Salaberry wisely states: “The next generation of Femtech isn’t about visibility—it’s about value, integration, and health systems impact.” That’s not just a forecast—it’s a framework for what’s next.

[Editor’s Note: For a deeper dive into the Galen Growth FemTech 2025 report, visit galengrowth.com. The full report and press release, are available now.]

The post Galen Growth FemTech 2.0 Report: Elevating Women’s Health from Niche to Necessity appeared first on Medika Life.

Many of my patients have recently been asking me what it means to have dense breasts.

They sometimes carry a letter saying that their mammograms showed heterogeneously (or extremely) dense breast tissue.

The U.S. government now mandates that radiologists report breast density on mammogram reports but offers no guidance on how to do so.

In this Breast Cancer Awareness month, I want to provide some information about the implications of having dense breasts.

Breast Density Reporting

Beginning September 10, 2024, the U.S. government mandated this:

“Mammography facilities must provide all patients receiving a mammogram with one of two Federal breast density notification statements (either “not dense” or “dense”).“

Additionally, the mammogram report sent to referring providers must include an assessment of the patient’s breast density.

Defining Breast Density

Dense breasts are a mammographic finding in which the breast tissue appears more glandular or fibrous relative to fatty tissue.

The breast comprises two types of tissue: glandular tissue, which produces milk, and fatty tissue, which provides support and cushioning.

Dense breasts contain more glandular and fibrous tissue and less fatty tissue, which makes them appear denser on a mammogram.

Four Categories of Breast Density

The American College of Radiology classifies breast density into four categories:

1. Almost entirely fatty: The breast comprises fatty tissue and is the easiest to read on a mammogram.
2. Scattered areas of fibroglandular density: Although some areas of glandular and fibrous tissue exist, the breast is still considered primarily fatty.
3. Heterogeneously dense: There are many glandular and fibrous tissue areas, and the breast is considered moderately dense.
4. Extremely dense: This means the breast is very dense, with a lot of glandular and fibrous tissue.

Patient Notifications

A radiologist — a doctor who reads your mammogram — assigns your breasts a density.

As noted above, s/he will place each mammogram into one of the four breast density categories.

Your mammogram report may offer these observations:

• If NOT DENSE: “Breast tissue can be either dense or not dense. Dense tissue makes it harder to find breast cancer on a mammogram and also raises the risk of developing breast cancer. Your breast tissue is not dense. Talk to your healthcare provider about breast density, risks for breast cancer, and your situation.”
• If DENSE: “Breast tissue can be either dense or not dense. Dense tissue makes it harder to find breast cancer on a mammogram and also raises the risk of developing breast cancer. Your breast tissue is dense. In some people with dense tissue, other imaging tests and a mammogram may help find cancers. Talk to your healthcare provider about breast density, risks for breast cancer, and your situation.”

Let’s turn to the implications of breast density.

Breast Density Distribution

The American College of Radiology (ACR) observes the following population distribution of breast density:

About 10 percent have almost entirely fatty breasts. At the other extreme, 10 percent have extremely dense breasts.

Eighty percent fit into one of the middle categories.

What causes dense breast tissue?

It’s unclear why some women have dense breast tissue while others do not. You may be more likely to have dense breasts if you:

• Are younger. Breast tissue often becomes less dense with age.
• Have a lower body mass index. Individuals with less body fat are more likely to have dense breast tissue than women who are obese.
• Take hormone therapy for menopause. Those taking combination hormone therapy to relieve signs and symptoms of menopause are more likely to have dense breasts.

Breast Density Implications

Having dense breasts may increase your chances of getting breast cancer.

Moreover, dense breasts make it more challenging for radiologists (and their artificial intelligence friends) to spot cancer on mammograms.

Unfortunately, dense breast tissue appears white on a mammogram.

Lumps, both cancer and non-cancer, often appear white, too. I often say to my patients that dense breasts make it like you are looking for a snowball in a snowfield.

In summary, dense breasts can raise cancer risk and make mammograms less accurate.

Mammograms Are Still Important

First, while many of my patients with dense breasts initially think that mammograms are useless for them, mammograms are still a part of routine imaging.

After all, mammograms are the only medical imaging screening test proven to reduce breast cancer deaths.

Each week, my radiology team finds cancers on mammograms in women with dense breasts.

What Else Can You Do?

That said, here are some tactics you can use:

• Get digital breast tomosynthesis (DBT or 3-D mammograms). DBT creates breast images in slices from many angles, making abnormalities easier to see. Tomo mammograms increase the number of cancers discovered without other imaging.
• Consider ultrasound and magnetic resonance imaging (MRI). These advanced imaging approaches can help find cancers that a mammogram doesn’t indicate. However, breast MRI and ultrasound show many more findings that aren’t cancer (false positive), resulting in added testing.
• Know your breast cancer risk. We have many calculators (varying in complexity and weighing different factors — including family history).

There is no national standard for following up on dense breast reports.

Screening Recommendations

The American College of Radiology suggests that you talk with your healthcare provider and discuss your breast cancer risk.

Even if you have a low breast cancer risk (and have fatty breasts), you should get annual mammograms beginning at 40.

The U.S. Preventative Task Force recommends that all women get screened for breast cancer every other year, starting at age 40 and continuing through age 74.

The Real Problem

Radiologists must describe breast density on your mammogram report.

However, we don’t know what to do with this information.

For example, the American College of Radiology and the National Comprehensive Cancer Network recommend that women and their doctors consider supplemental screening.

On the other hand, the American College of Obstetricians & Gynecologists and the U.S. Preventive Services Task Force offer there is insufficient evidence of benefit to recommend additional tests.

Additional tests can detect more cancers than mammograms alone. However, we have no evidence that extra testing saves lives.

And This

Some studies raise concerns about the reliability of the system used to label breasts as dense or not dense.

A review article in Annals of Internal Medicine reported that radiologists reclassified up to 19 percent of women into a different breast density category — from dense to non-dense or vice versa — on their subsequent screening mammogram.

For those with dense breasts, we don’t know with certainty what the best practice is at this point.

The post Dense Breasts: The Hidden Risk You Can’t Ignore appeared first on Medika Life.

Amid her surprising news, she discovered the Vancouver, Washington-based Pink Lemonade Project, a source of peer support and empowerment for breast cancer patients. Through their guidance, she rediscovered the strength within and built a new community of friendships.

This is the story of how Lisa Heathman turned medical lemons into “pink lemonade” and how she continues to navigate the maze of breast cancer decisions, drawing on the support of the patient advocacy community created by the Pink Lemonade Project. Her guiding mantra: “Get busy living or get busy dying.”

Gil Bashe:

I‘m going to jump in, and we’re going to explore your story because it is unique to you, and unfortunately, it’s not unique to women. It’s become a medical self-health tradition for women to have an annual mammogram, and I imagine that’s something you’ve been practicing for some time.

Lisa Heathman:

I always made a point of getting my mammogram. I got them regularly, and the diagnostic center always used to send me that letter afterward saying I have dense breast tissue, so the scan techniques were not nearly as accurate. A routine mammogram looks dark, and then if there’s anything alarming, it looks white. On a woman with dense tissue, everything looks white. It’s hard to find an anomaly in it because of the white-on-white. That is core to the problem. Because even though I was getting those mammograms regularly, they didn’t see the problem.

Bashe: 

You know, for women who have dense breast tissue, and it’s not a small number. It affects cardiovascular scans and mammograms – leading to the danger of false negatives.  I hear about this too often. 

Heathman: 

It’s pretty darn common.

Bashe: 

It’s the equivalent of going through the motions but not having a mammogram; It’s a public health risk worthy of greater awareness and physician-patient conversation.

Heathman:

Exactly. According to my doctor, I’m doing what I needed to happen from a self-care standpoint; there wasn’t a family history. My grandmother did have breast cancer, but my grandmother is just one-quarter of my genes. My physician didn’t regard me as particularly high risk. So when I kept getting those notifications that the screening tool wasn’t wholly accurate (and we talked about this for two years in a row), he told me not to worry.  Accessing advanced screening is challenging; the insurance companies wouldn’t cover it. That meant I had to get the screening and pay out of pocket. On top of that, I would have had to do that every year. We’re talking about thousands of dollars out of pocket.  

Bashe:

Insurance is a little bit like the law of averages. They think, “We’re not going to cover this because the chances of her having breast cancer are pretty slim, and if we cover it for her, we’ll set a precedent, and we’ll have to cover it for everyone. Let’s pretend we’re going through the motion of doing breast cancer screening.” 

Then boom, something happens.  There is something suspicious when you call up. I imagine your doctor said, “Well, come on in, and we’ll talk about it.”

Heathman:

Something you said reminded me of something I think is essential to share. And then, I’ll get to how I found my cancer. The other thing that’s recommended is that women do self-exams.

First of all, I breastfed both my kids, and I always had trouble in my left breast with clogged milk ducts and all kinds of lumpiness, nothing hard, nothing like they always used to say. If you’re feeling anything that feels like a pea or a pebble, that’s alarming. You need to be checked out. But if everything feels like it always has, you’re probably fine.

It always felt normal. My left breast was lumpy because it had been lumpy ever since I breastfed my kids. Nothing felt odd, and I never did have that hard stone or pea-shaped shot that they always say it feels like.

Bashe: How did this surprising discovery unfold?  How was this discovered?

Heathman:

How I found my breast cancer was a stroke of luck, which doesn’t sound like a stroke of luck when I tell you this story. My partner Tom and I went mountain biking. We were on a camping trip up near McCall, Idaho, mountain biking almost every day. One day, we decided to take the mountain bikes up to this lake – there was supposed to be great fishing up there. It’s five miles on the single track. There was one place near the lake where you had to cross a creek on a little bridge, and I fell off the bridge into the water! Fortunately, it was September, so the water level was relatively low, but the bike fell on top of me and pushed me into a tree trunk. I dislocated my shoulder.

When I got back to Portland, I told my doctor what had happened, and we decided that I should do a course of physical therapy because it was still painful. The physical therapist and I worked on this for about a month. Instead of getting better, the symptoms got worse. My physical therapist said I should get an MRI.

I had to see the doctor for an MRI, and he said: “It’s been a year since I’ve seen you, so you might as well just come in.”

That was the luckiest thing ever because when I went in 10 days later, he did the usual check of the lymph nodes. He was doing the examination and said, “How long have you had this lump under your left arm?” I said I didn’t know I had a lump under my left arm. I can hardly reach it right now because my right shoulder was so screwed up from the accident. He said, “I feel a lump under your left arm, and we need to get you in for an ultrasound.” That was the beginning of the odyssey of finding out I had breast cancer; it was just a stroke of luck.

Bashe:  I don’t know if it’s a stroke of luck, but it’s like, “How I dislocated my shoulder and saved my life.”  From the moment your doctor said, “What’s this lump underneath there?” What went through your mind?

Heathman: 

Honestly, I was not terribly concerned, and I’ll tell you why. I’ve always been very active and very healthy, and nothing traumatic or awful health-wise has ever happened to me. I first talked to my physician sister, and she said, “Well, it could be many different things. Let’s not get too worried.”

So I wasn’t upset. I was like, I’m sure it’s nothing, I’m sure it’s nothing, but it wasn’t nothing. I went in for the ultrasound. I was lying on the table, and it was quiet. I remember thinking I was tired. I could almost take a nap. She went away after she was done and was gone for a long time. I thought, well, that’s odd. Then the doctor came in, sat down, and asked me all these questions. “Have you been feeling okay? Are you losing any weight?” All of a sudden, I began to perspire profusely. Suddenly, I thought nervously, “Oh goodness, oh gosh. What is happening here?” My stomach was immediately nervous. “Uh oh. This is not nothing.”

All of a sudden, I was very, very afraid. I had never had cause from a health standpoint to be so scared. I was terrified, like we were not talking about a nothing thing here at all. He sent me then for a biopsy, I believe.

Bashe:

Did he say at any point you might be looking at cancer?

Heathman:

He did. That was the root of all those questions: are you feeling okay? Have you been losing any weight? I feel fine. And no, I have not lost weight. But I was just terrified. Suddenly, it was like it was real. I went in for the biopsy next, and it came back positive for cancer. I then had an MRI, where they could first visualize it. That was the first time anyone had seen that there was a tumor in my breast. It appeared pretty good-sized and had probably been growing there long.

Bashe:

The challenge with the diagnostic system, particularly the mammogram, is that we get into a “check the box” mindset, as opposed to the need for your doctor, other doctors, to say that if someone has dense breasts, we have to reject the mammogram approach, have a diagnostic procedure, and ensure coverage. At least reimburse women for the scan every other year.

Heathman:

You could alternate. Over the years, I’ve often thought, you know, it would have been great if every other year I had a mammogram one year and an ultrasound another year, and they could have alternated. Ultrasounds are not expensive; they’re standard.

Bashe:

A part of it is that the payor contracts with the radiology center to have mammograms done at a base price. Let’s say the insurance company will tell you to go to one of three radiology labs in your area. They’ve created a volume discount price. That discount takes precedence over your specific physiological or biological needs. That’s the challenge we face in the payor system: health for everyone, but not necessarily health for you.

Heathman:

Health for the average baseline. I learned from the Pink Lemonade Project that in the Northwest, one in seven women will be diagnosed with breast cancer at some time in their lives. Nationally, it’s one in eight. That’s many women.

Bashe:

How did you get involved with the Pink Lemonade Project?

Heathman:

That’s an interesting story. When I was first diagnosed, one thing that seemed right was to join a support group, so I did.

It was through my hospital, and I hadn’t even lost my hair yet. I was super early in the process. I think I lost my hair after my second or third chemotherapy round, but I was in the support group even before that –  just diagnosed. I remember my first support group meeting, which was not a Pink Lemonade support group meeting. It was just through the hospital.  It wasn’t completely satisfying, but of the eight women, one woman, Susan (Susan Stearns), well, we hit it off and became friends.

Susan got the job of CEO of the Pink Lemonade Project. I was introduced to Pink Lemonade through her and her fortune in working with this amazing organization, which drove the conversation and possibility.

Bashe:

The personal connection was very important here.

Heathman:

There’s a silver lining in this cloud, and that silver lining was Susan and the Pink Lemonade Project. They’re based in Vancouver, Washington. I live across the river in Portland, Oregon, and Susan Komen is a well-known breast cancer charity in Portland. What a lot of people don’t realize is that Susan Komen is no longer providing local support. They are only a national nonprofit now. The local programming in almost every community had to be pulled.

It is up to local organizations like the Pink Lemonade Project to pick up the slack and provide those programs locally that Susan Komen could no longer fulfill. Organizations like the Pink Lemonade Project must create opportunities and support for women seeking local support.

Bashe:

You had some difficult decisions to make then. You’re diagnosed with breast cancer. It sounds like chemo and radiation were part of the decision-making process, maybe more. Tell me a little bit – not about the medical stuff; I understand that, but the sense of how you felt at that moment and what role the Pink Lemonade Project played in getting your perspective. It sounds like you’re very self-aware and in touch with other people, but you’re now in what I’ll call an “extreme situation.”

You enjoy bicycle riding, fishing, hiking, skiing, and the great outdoors. Your sister is also an official hand-holder. You have a medical guide at your beck and call. Tell me what role the Pink Lemonade Project played in your life and what role you played in their life.

Heathman:

From the standpoint of an organization like the Pink Lemonade Project, I was very fortunate that I didn’t need to take advantage of some of the programs that Pink Lemonade delivers to women or people with breast cancer — because men get breast cancer, too, as you know.

Pink Lemonade provides practical support, transportation to appointments, treatment options, care for lymphedema and swelling after the lymph nodes have been removed, support groups, and valuable information, such as whether a woman needs a wig because she’s lost all her hair. I took advantage of some of the things that the Pink Lemonade Project provides.

I do have a good employer, a car, and good insurance. I had all those things covered. I have a really good support system. You could argue there wasn’t much I needed. What I found that I took advantage of was the support groups. They have a metastatic breast cancer support group. It’s geared mainly toward women who have a stage 4 cancer diagnosis, such as me. They are women who are in many ways in the same boat that I am in, and their questions are the same questions that I have, and the kinds of experiences they have are the same kinds of experiences I have.

Many women are older, have retired, and are no longer working. But not all of them – many of them are young women who are raising families. Many of them are younger women who are still working, trying to have a career while they’re going through treatment. That was important to me because I am still working, and I continue to work through treatment, but it hasn’t always been easy.

Having other women to bounce ideas off and get good advice was unbelievably important. The other important thing about being involved with an organization like the Pink Lemonade Project is that you are surrounded by women and people who hear what’s on the cutting edge of treatment. When you have a stage four diagnosis, your doctors, you, as the patient, and your family must understand that the breast cancer community, the medical community, is constantly coming to the table with new treatment ideas and new treatment options.

In time, treatments may stop working for a person, and they may need to go to whatever the next treatment is. And that’s incredibly important for someone with a stage four diagnosis because the treatment that I’m on may not always work. So that’s important, too.

Bashe:

As we spoke, I remember the first time you had a very reflective way of looking at this. You know you have a philosophical strength about life and being present. I also sensed you were quizzical about the future. There’s an authentic presentation when you speak. I’m curious if that mindset is present in your conversations with other members of the Pink Lemonade community and if the conversation is equally sharp.

Heathman:

That’s why there’s such a striking difference between the people I’m now talking to within support groups and that first experience, which was very negative and unsupportive.

The women in the support groups are very practical. It’s odd, but you rarely encounter a person in these support groups saying “Woe is me” or wringing their hands. By and large, they have been the most positive, gracious, giving, extraordinary women, people, but mainly women, and that’s what I needed in a support group. I needed to be surrounded by other people going through the same situation but meeting it with this: “We’re going to get through this.”

One of my favorite movies is The Shawshank Redemption, and Tim Robbins, one of the main characters, says a line that goes something like, “Get busy living or get busy dying.” I think about that all the time – here I am, and this is what I’ve got to get through today or this week, or this surgery or that treatment; I’m going to get busy living because it’s the only choice I have.

I’ve been surrounded by people making that same choice, which I needed in a support group. There’s no Pollyanna; not many women say this is not a big deal. It’s a huge deal. But they’re practical about it; maybe we’re all good at compartmentalizing it. This is a bucket that’s over here. This is another bucket that’s today. This is another bucket that’s tomorrow. I am still determining what the future will bring, but worrying about it doesn’t change it.

Bashe:

The sharpened sense of mortality creates a vibrancy about life. You might not have taken special vacations beforehand, saying, “Oh, I don’t know if I want to spend the money right now.” Now you say, “I think we will take that vacation. I want to go there and see that. I want to do that with you.” Does that play out from time to time? I don’t know about 20 years from now, but I do know right now.

Heathman:

It’s an excellent question. My version of vacation is being able to get outdoors and do the things I love, whether skiing, biking, hiking, or fishing. You’re right—I find it easier to say yes to those things because I don’t tend to talk myself out of them like, “Oh, you shouldn’t” or “It’s too expensive.” Life is short.

Those kinds of things are things that I need to experience, things that I need to do. This sharpened sense of mortality goes beyond just thinking about time away or vacations. It just factors into my overall decision-making. Are we going to build that addition on the house? My car was eight years old. Am I thinking maybe it’s time to get a new car? And it’d be easy to say I might not need that new car. Does that make sense? But if I decide that I don’t need that new car, I’ll not be getting busy living.

Bashe:

That line you shared about the Shawshank Redemption is true – “Start living.” You can think about the clock stopping, running out of line, the click, click, click. The clock is still working, and I don’t want to break down on the side of the highway. Why not enjoy the new car now?

Heathman:

Exactly. Why not do it now? Because you may not have forever. And to your point, Gil, we all imagine ourselves immortal until we have a significant health crisis. It’s too terrifying to think of the alternative, and most of us don’t until we have to. But in no way has it consumed me. I’m not going to say I never think about it. I think about it. I’ve even explored some things that are specific to that. But it isn’t as though I’m consumed by it. I don’t live my life like that.

Bashe:

“I’m here, and I need just to enjoy the fact that I know I could be elsewhere, so to speak, but I have a certain sense of strength and understanding that lean into the here and now.”

Heathman:

Some days are hard. There are things about being in treatment that are hard, and sometimes challenging things happen that are work-related or what have you. Then, I’ll join a support group, and I’ll be able to talk about what is happening. Someone will have had a similar experience, and someone else will have a funny thing to say about it.

Before long, I found that I was happy I was here and that they were here. There have been times when someone was not there. In particular, one woman is no longer a part of our support group because her cancer came back, and it came back with a fury, and she died. I still miss her. She was such an incredibly kind, caring, altruistic person. In support groups, you meet people who may show you something you didn’t see, something that feels like someone making your day better.

Bashe:

Well, they say you’re exceptional, and those that do are beyond spot on. The reality is that you’re in the midst of an adventure in which the ending has not been written, and you are very present about where you are and what you’re feeling, but you’re very much in harmony with other people. The support group, I think, the Pink Lemonade Project community, has brought out something that was always within you: the understanding that we need each other.

Heathman:

Absolutely. If there is a silver lining in all of this—and some days, it’s hard to find one—I have a much different understanding of others and what others want and need. It’s changed me. There’s no getting around the fact that cancer has changed me, and I think that cancer has changed me for the good as well.

I cannot say enough about my experience. Again, it is not always pleasant, and it’s not fun, but I feel so supported. I think back to that woman that night who I met who had nothing good to say about her employer, and I think, Oh, honey, I wish you’d had a very different experience, like I’ve had, of what real support feels like because I think she was bitter.

Bashe:

You know, it’s a two-way street. You’re an incredibly inspiring, uplifting person who understands and speaks about the importance of patient support groups like the Pink Lemonade Project.

Your experience is distinctly unique. You are an incredibly inspiring person, and the fact that you welcomed this special community into your life speaks volumes about your ability to recognize this level of life challenge is difficult enough – but going it alone adds another complexity to the health struggle. I think many people need people like you, Lisa; they need to read about people like you because it gives them a sense of hope for this day and tomorrow. Thank you for this time.

We often read about people confronting cancer diagnoses and their worries about therapy and survival. We read about varied patient advocacy and support communities. Lisa Heathman and the Pink Lemonade Project offer another perspective—how friendship forged through this difficult journey leads to better medical and emotional care. A key lesson is that people with dense breast tissue should take advantage—advocate for advanced screening!

You can connect with the Pink Lemonade Project, which offers support to men and women, through its website and follow its updates on social media.

The post A Cycling Accident Saved My Life appeared first on Medika Life.

In general, breast cancer in young women has a less favorable prognosis compared with older women.

Researchers recently evaluated breast cancer incidence among women ages 20 to 49 in the United States. They examined 20 years of data from the Surveillance, Epidemiology, and End Results program.

We’ll look at the findings in more detail, but here is the bottom line:

There were increases in breast cancer incidence rates among young U.S. women.

Background

I have the privilege of being involved in the medical care of hundreds of patients with breast cancer each year.

In the United States, breast cancer is the leading cause of cancer death among women aged 20 to 49.

That’s according to the American Cancer Society.

Young

Young women tend to develop more breast cancers that are biologically aggressive compared to older women.

What do I mean by “aggressive?” Young folks’ tumors tend to be larger and more advanced in stage.

Moreover, the cancers are less likely to have positive hormone receptor status (estrogen and progesterone receptors) and more likely to have overexpression of HER2, a growth factor receptor.

All of these factors can contribute to a poorer prognosis in young women with breast cancer.

Oh, there is also this: Breast cancer screening programs are not available for women under 40 who are not at very high risk.

Study

While we know that breast cancer has been rising among young women, there is not a lot of data about trend patterns based on cancer stage, race, and cancer biology.

Researchers analyzed data from the U.S. Surveillance, Epidemiology, and End Results registries. SEER is a public database from the National Cancer Institute with coverage of 27% of the U.S. population

They included women ages 20 to 49 who had been diagnosed with invasive breast cancer. The final analytic set included 217,815 women.

The investigators formatted age as five-year age groups (20–24, 25–29, 20–34, 35–39, 40–44, and 45–49 years).

Trends

What are the long-term trends in breast cancer incidence among women aged 20 to 49 years?

The graph comes from this paper, “Breast Cancer Incidence Among U.S. Women Aged 20 to 49 Years by Race, Stage, and Hormone Receptor Status,” appearing in JAMA Network Open.

Look at the recent upward trend line (in blue). Disturbing, to say the least.

Why?

Let’s try to tease out this uptrend in young breast cancer diagnoses.

Period effects

Could it be that breast cancer rates are rising among all age groups, with the younger population riding the incidence wave?

Cohort effects

Or is there something different about the younger population? Could it be environmental exposures or changes in other breast cancer risk factors?

It turns out it is both. The rising incidence of breast cancer among young cancer is due to two effects:

• a general increase in incidence over time
• the special risk of being born in the late 1970s to early 1980s.

Stage

The stage is the extent of breast cancer at presentation. The study offers a fascinating finding:

The rising cancer rates among young women are mostly due to more stage I and IV (metastatic, with spread to distant sites) disease. The increases are not because of stages II or III breast cancer.

The higher cancer rates are due primarily to stage I and stage IV cancers, not stage II and stage III cancers.

The higher rates of stage I are perplexing to me. I don’t think it is because of early detection; women with normal risk levels would not be candidates for screening studies (such as mammograms).

Maybe I am wrong, and women are more aware of being at high risk. More genetic testing might lead them to get early screening.

Estrogen receptor-positive

Much of the reported breast cancer increase among young women is a type known as estrogen receptor-positive (ER +).

The cells of this breast cancer type have receptors that allow them to use the hormone estrogen to grow.

Treatment with “anti-estrogen” (endocrine) therapy can block the growth of such cancer cells.

Why might we see a rise in estrogen receptor-positive breast cancer among young women?

This rise in incidence may reflect women tending to have fewer children and children later in life.

Stage IV (advanced)

The report also showed a rise in young women presenting with later-stage breast cancer.

Why?

This finding does not surprise me.

If breast cancer is rising in all age groups, including among young women, we will see greater numbers of women with advanced breast cancer.

Younger women generally should not have screening mammograms. If a woman presents with a palpable lump in her breast, she is more likely to have an advanced stage.

But why the recent change? The study authors suggest that an increase in overweight and obese women in the U.S. might play a role.

Historical studies associated higher body mass index (BMI) with higher breast cancer stage at presentation.

My take

I don’t know why breast cancer is rising among young women.

But, I am disturbed.

We may need to adjust our screening approaches as the contours of breast cancer epidemiology evolve.

We may need to address weight and other lifestyle factors, environmental toxins, and other potential risk factors.

The post Startling Statistic: Growing Trend of Breast Cancer in Younger Females appeared first on Medika Life.

I am a breast cancer survivor, a medical professional, and a fierce advocate for ongoing post-treatment diagnostics for the prevention and timely detection of recurrence.

During the active phases of my treatment for breast cancer (ILC right) and DCIS left) and now in my recovery, my nursing experience led me to compare and contrast, through research, the contradicting information given by my medical providers regarding my diagnosis and treatment options, clinically proven alternatives, and managing my health to subsequently prevent recurrence.

Unfortunately, my oncology team provided no information on the latter subject and very little else otherwise that would lead me to restoring my energy, health, cognitive function and more.

My goal forward is to make exceptionally educated, not fear-based, decisions and choices for my life and health. I want to live to at least 100 years old and do so with strength, style, grace and confidence.

And cancer-free.

Understanding The True Risk Of Recurrence

A breast cancer survivor needs adequate, regimented post-treatment diagnostics throughout their life to monitor for recurrence.

This does save lives, and otherwise, substantial length of days.

In my research, I discovered a very intriguing and concerning characteristic of cancer cells observed both during and after chemotherapy and radiation which is not routinely discussed with breast cancer patients: that is that fragmented lingering DNA particles from (treated) and dying cancer cells move into the bloodstream and lymphatic system and lie dormant in the body, with great potential to become activated anytime later from diverse sources of persistent and excess inflammation such as stress, dehydration, cell starvation (not enough nutrients), lack of oxygen to organs and organ systems, and other internal states that hinder or halt the body in regenerating and restoring itself. I do not address external factors in this article.

This information alone begs the need for drastic changes in the current standard of care for recurrence prevention for breast cancer survivors.

The Main Deterrence To Cancer-Free Recovery

The National Cancer Care Network, (NCCN) which steers current oncology guidelines, recommends against routine and continuous monitoring for breast cancer recurrence. Under the influence of this entity’s stance on women’s health, many lives globally have been and continue to be lost.

This is a major failure of the oncological community treating breast cancer.

Conversely, NCCN propagates the idea that “the stress of undergoing ‘unnecessary scans’ and (other diagnostics)” for post-treatment breast cancer patients outweighs the benefit of recurrence-detection focused testing and promotes the idea that “surveillance does not increase survival time.” I disagree. Read here.

If this were actually the case, why are we inundated with the idea that a recurrence is inevitable and expected, but not then followed up on to judiciously detect? (this mindset guides the primary diagnosis and our care plans). Again, if so, why are we led to believe that such aggressive treatments such as chemotherapy, radiation, and aromatase inhibitors are actually as widely clinically successful as touted, if we are left with possible residual disease that will not be monitored until it has progressed significantly, despite treatments?

2023 NCCN Guidelines for Breast Cancer (pg. 23)
On screening for metastases:
“In the absence of clinical signs and symptoms suggestive of recurrent disease, there is no indication for laboratory or imaging studies for metastases screening.”

See this podcast giving NCCN guideline recommendation reasoning for not monitoring most survivors for recurrence. Please note that the statement “there is no clinical evidence for” means that little to no purposeful actions have been taken by NCCN, ASCO or other major oncological entities to aggressively pilot widespread clinical trials in which large, diverse groups of survivors are monitored for recurrence through systematic, long-term monitoring using diagnostic imaging and labs.

This is the problem. The medical community focuses primarily on using clinical data to create treatment plans, but if there is not enough stable and trustworthy clinical data (obtained through extensive research/trials and unbiased, non profit-minded clinicians who are not associated with Big Pharma), then a solid “recommendation” to not routinely follow clinically after treatment periods cannot be made.

This action was first necessary beginning in the early 1970’s (investigate further to see the 1950’s time period where cases began to markedly increase) when breast cancer cases began to substantially rise, according to researched data. Large scale global trials must be commissioned today, to make real strides in saving women’s lives.

The result would unequivocally catapult change, but inevitably also come with the pervasive argument of cost and loss of revenue from halting and preventing the mass cases of metastases we are seeing in most of the world. More on the issue of cost here.

Here are two statements (my third article on recurrence prevention will relay more) from a 2015 PubMed article addressing the concerns for the need for post-treatment diagnostics to catch early metastasis: (the first paragraph states the current standard).

“Current post-treatment surveillance guidelines for patients with treated breast cancer do not recommend intensive surveillance, such as routine chest radiography, bone scans, or laboratory tests, to evaluate distant recurrence or metastatic diseases.”

“Because isolated recurrences are associated with distant metastasis and/or poor outcome, early detection and targeted treatment for recurrences are critical to improve patient outcome.”

This article written in 2004 published in The Journal Of the National Cancer Institute, (focusing for that piece on mammograms) notes even then that the “absence of screening was associated with a markedly increased risk of late-stage disease among women with invasive breast cancer” and that “problems in detection account for 40% of the late-stage cases.”

This information sounds very scary and elicits a feeling of powerlessness in our ability to take control of our health and the quality and length of our lives, however, we can take charge of our lives and health through consciously employing even just a few tools available to us.

Effective, Natural Ways To Prevent Recurrence

Breast cancer post-treatment plans and teaching are almost non-existent. Survivors are left to investigate the realities of and alternatives for their diagnoses independent of clinical guidance. We need concrete information that will help us advocate for ourselves and know our options in preventing recurrence.

Powerful supplements are available, healing mindsets (new conscious way of living and thinking which actually produce hormone functions and neurotransmitter synapses that heal disease states in the body), and many other potent, successful ways of living and being that achieve renewed health and wellness. More importantly, that work to prevent (breast) cancer recurrence.

A first priority, and the most profound route to wellness and healing (which also create an marked absence of disease) is obtaining adequate sleep and rest. Read my associated article here on this topic.

Below is an easy to read list of simple tools to employ highlighting most of the options available in post-treatment scans and labs to ensure the following:

• a) that the treatment(s) you endured show drastic reduction or eradication of disease.
• b) you are educated on your alternatives to prevention and prevention of recurrence.
• c) that your providers continue to order everything available and appropriate for you (3D mammogram, MRI, PET should be a yearly standard) in your years of recovery to monitor your progressive healing and early detection of any regrowth.

Arm Yourself Against Breast Cancer Recurrence

1. Vital diagnostics available

• Thorough hands on exam (clinical breast exam). Every follow up visit. Educate yourself on the expected thorough details of this exam.
• 3D Mammogram (if you did not receive a bilateral mastectomy) every 6 months first year after treatment ends, at least yearly, thereafter. Read here on the newest 3D/4D mammograms.
• Metabolic PET/CT-fdg (yearly) (see here) or
• MRI with contrast (detects cancerous tissue vs. normal tissue, but overall results, in most cases, inferior to PET) or
• CT with contrast (particularly highlights bone structure/changes and some soft tissue but, overall results, in most cases, inferior to PET, alone. MPET/CT is most-efficient.)
• liquid biopsies (ct-dna) yearly or upon the presence of new symptoms. (Because this is just emerging as a (soundly proven) diagnostic tool, few clinical studies recommending timeline protocols (how often to test) are available, but given the nature of discreet cancer cells, it is prudent to request yearly. See here to learn how to pay out of pocket for this test. This company is now contracted with MD Anderson for clinical trials for this powerful diagnostic tool.
• tumor markers and hormone levels (estradiol, FSH/LH etc.) best is every 3–4 months after treatment ends (and in some cases, some labs will be required during chemotherapy). These likely will migrate to every 6 months in the second to third year after treatment ends.
• Bone density (every 2 years)
• Bone scan with contrast (yearly is best preventative, but this is not standard, nor encouraged at all, without symptoms that confirm metastasis, even prior to scan.)

A “wait and see” attitude is fatal to many women. Allowing late symptoms to occur before scheduling diagnostics to confirm extensive or uncontrollable regrowth is never prudent or conducive to preservation of life. In reality, not judiciously monitoring the body and care with scans and labs in the recovery years can inevitably result in any regrowth of cancer taking control.

Breast cancer survivors must stay vehemently pro-active in reporting every new symptom or pain that cannot be explained by short term illness (viruses, colds, the flu etc.) or injury. Even in the presence of these incidents, any persistent pain or symptom needs to be addressed and investigated with thorough and effective diagnostics.

Be tenacious about your survival.

Supplements (in high levels) that act as aromatase inhibitors or have potent anti-cancer properties

2. Each of the following supplements has extensive research supporting their individual powerful anti-tumor functions.

• Melatonin; and read here.
• CoQ10; and read here and here
• Tumeric and read here
• Ashwaganda and read here
• DIM and read here and here
• Vitamin C and here
• Vitamin D and here
• Vitamin E and here
• Whole plant CBD: media has taken over in avidly suppressing the truth of the miraculous effects of taking CBD, and especially with CBG, and using RSO (contains THC). Researching this phenomenal plant is well worth your time. See Charlotte’s Web.
• European mistletoe and here; this article shows how to obtain it in supplements.

3. Mindsets (redirected thought patterns) that establish healing

You are created to live a long, healthy, life.

• No weapon formed against you will prosper. You have armour at your disposal.
• Your body is capable of healing itself and can be spoken to do so, each organ and organ system
• You can think yourself well, whole and fulfilled. Life begins and ends with the mind.
• Expect healing, because it is yours to begin with. We must take this action of expectation with utmost seriousness and implement ferociously.
• Keep a vibrant, open mind. This is the beginning step to changing your cells and disease processes in the body. See podcasts such as this one to acclimate to a new way of thinking about living to old age, despite your diagnosis.
• Deuteronomy 30:19 I call heaven and earth to witness against you today, that I have set before you life and death, blessing and curse. Therefore choose life, that you and your offspring may live.

4. Deep breathing exercises: adequate oxygen causes cancer cell death. This topic needs more research on the writer’s part and in clinical studies, but it’s also common sense to note that increased regular oxygenation in the body increases health and healing.

5. Fasting either weekly or just from dinner to breakfast shows a significant improvement in insulin levels, which increases the body’s resistance to disease. It is linked strongly to preventing cancer, both primary and secondary (recurrence).

Grounding: This is a simple, profound way of promoting healing and preventing (breast) cancer recurrence. Note, that to receive best advantage of this technique, 30–60 minutes daily is recommended. It is also a wonderful way to renew peace to the mind and the body.

To summarize, the majority of breast cancer survivors are not adequately educated by their oncology team of the real risks for recurrence and are not informed of what tests can and should be ordered routinely to monitor for recurrence, which ultimately would save many lives. The oncology field’s gross neglect and resistance toward monitoring breast cancer recurrence has been and continues to be fundamental in creating an environment of that recurrence through neglecting to prioritize our lives with necessary preventative diagnostics.

In closing, I suggest that breast cancer patients be prepared to face strong resistance from their oncology team in introducing any demand for post-treatment diagnostics and especially alternative (non-Western medicine) treatment choices. The cancer care system is not set up to efficiently observe, monitor and track disease recurrence. We must be be our own advocates in obtaining and implementing safer, Big Pharma-free alternatives to our health and especially in standing firm in our right to have thorough, routine scans and labs that will preserve our health and lives.

We need more answers and follow through if we are to effectively fight against recurrence-related deaths.

If this information is helpful to you, please see my first article on preventing breast cancer recurrence.

The post Preventing Breast Cancer Recurrence appeared first on Medika Life.

As a 20 plus year veteran nurse, I understand the body’s processes and potential to truly heal and fully restore optimal health, and I employ the following information myself to help with insomnia, but foremost to prevent recurrence.

Preventing Breast Cancer Recurrence is Achievable

My observations and medical and personal experience lead me to propose that it can take up to five years after treatment ends for restoration of health after breast cancer (due to the intense stress of physical, mental and emotional turmoil associated with a cancer diagnosis and treatment) provided there is no recurrence in that interval. Even if there is, sufficient sleep and rest will combat cancer growth as a primary defense.

Breast cancer patients can absolutely achieve a greater level of health that is above pre-diagnosis and combat /prevent recurrence with simple, intentional life changes.

Two foundationally important interventions which are dynamic inhibitors of disease (cancer, particularly) and deterrences to breast cancer recurrence are full nocturnal sleep and mindful daily rest.

Medical interventions such as surgery, chemotherapy and radiation result in the primordial need for eight or more hours of sleep to effectively heal from the results of those interventions. Daily rest periods in our ongoing recovery are equally crucial.

Breast cancer treatment follow up in most cases is primarily a series of appointments, over the subsequent 5 years past treatment, dotted with some labs and scans, usually sparse in comparison with what feels safe or comfortable to the recovering breast cancer patient.

Most cancer patients will relay that they received no information in their post treatment plans that include either the teaching of the preventative power of full sleep cycles to prevention of recurrence, nor any other clinically proven (natural) actions to take which arm them against recurrence.

Rather, these plans universally focus on highlighting the fear of the “likely possibility” of recurrence. The patient is left looking over their shoulder (as my oncologist advised was my expectation) for the rest of their life and are unsure at best what to do to live confidant and cancer-free.

Most often, we are offered only the option of taking brutal medications that seriously inhibit our quality of life and mental health.

Refusing to live in hopelessness, I have researched many natural defenses which can tangibly be employed to combat insidious cancer regrowth, the most important of which is sleep.

How Does Lack of Sleep Cause a Risk Of Recurrence?

Most women do not get enough sleep to begin with, which predisposes the body to disease states and especially breast cancer, as it is commonly linked to adverse, imbalanced hormonal states, which occur with lack of REM sleeps.

The few studies done since 1976 on the results of poor sleep vs long sleep in post treatment breast cancer survivors reveal a correlation between recurrence and long sleep times (nine or more hours consistently, which is suspected to include fragmented, interrupted sleep), but document that the inconsistency across the board is whether or not these women had undiagnosed underlying conditions (such as depression, sleep apnea or heart disease) predisposing them to excess cancer-friendly cytokines caused by (disease-related) increased stress states. It is important to note that “long sleep times” did not necessarily mean actual uninterrupted sleep of nine hours duration, but rather, nine hours of being in bed attempting to sleep. What was confirmed was that persistently interrupted sleep, fragmented sleep, and short sleep times correlate positively with breast cancer recurrence.

Hormone restoration and distribution occur during sleep, but do not occur adequately in less than 8 hours of sleep. Aldosterone (regulates sodium and potassium) and renin (manages blood pressure) are two important renal (kidney) hormones necessary to help distribute cortisol (the fat and fluid retention stress hormone) and remove excess fat, toxins and fluid from the body, among other important anti-inflammatory and immune functions.

Reduced sleep and inconsistent sleep patterns distort the circadian rhythm of the body, altering the ways these and other hormones perform within the body’s natural defense against inflammation and disease. The end result is altered cell function, which produces disease states, profoundly, cancer.

A little known fact rarely discussed with breast cancer patients is that lingering DNA particles from (treated) and dying cancer cells move into the bloodstream and can lie dormant in the body. They become activated anytime later from diverse sources of persistent and excess inflammation such as stress, dehydration, cell starvation (not enough nutrients), lack of oxygen to organs and organ systems, and other internal states that hinder or halt the body in regenerating and restoring itself. (See this company’s information on ctDNA and end of article for more information. Ask your oncologist or PCP to order this for you. To pay out of pocket, if your insurance will not cover it requires just the doctor’s order and costs in the range of $80)

Chronic stress can cause insomnia and vice versa. In turn, vulnerable internal body regions (ex: mastectomy sites and lymph node(s) (function) restricted by excess, blocked lymphatic fluid) become rich environments for tumor growth. The lymphatic system is how displaced DNA from cancer cells get from one place to another in the body; in addition, body systems that are not consistently restored and regenerated during adequate sleep times are also highly vulnerable to altered cell division, which ultimately leads to abnormal cell growth. This abnormal cell growth if not checked or caught has a strong potential to become cancerous.This is what can cause a secondary or separate cancer state in the body.

What Happens During Sleep That Works To Prevent Recurrence?

The regeneration and restoration of cells and organ systems which occur during optimal sleep duration are imperative to health and especially in preventing cancer in the first place, as well as recurrence.

During sleep, the brain sends signals to the entire body, calling for a slowdown in most functions, elicits the release of necessary hormones that cause growth and repair to skin, muscles and tissues and more. Blood flow is increased to problematic areas for healing.

The brain also regenerates new brain cells, forms myelin (which protects the neural pathways) processes problems and thoughts through dreams and chemical reactions. These reactions reduce a constant of the negative stress-related “fight or flight response” states during the day as the body and mind has been “worked on” to create a more calm state. A body that stays in this FOF mode predominantly or frequently is incredibly strained and at risk for illness and overall system-wide decreased function.

Daily rest breaks, even in 5 minute intervals during the day, allow the body to stop demanding of itself to perform for a bit, giving itself a momentary reboot. This is necessary for mental and physical health.

Real Solutions To Insomnia and Jagged Sleep Patterns:

The insomnia related to (breast) cancer can be long-lasting, induced by several factors both inside and outside our control.

Our mental health is adversely affected by a diagnosis of cancer, the fear of dying, treatment modalities, (processes, techniques) the fear of the unknown, and many other deeply individual idiosyncrasies that, many times, breast cancer patients have no words to verbalize.

So, how in the world do we obtain enough adequate sleep to benefit from it?

1. Obtain Trauma Therapy. Getting professional help as soon as, but preferably before, you notice any changes in your mental and emotional health after diagnosis will go a long way in creating a calmer self and more peaceful life perspective. This will do wonders in restoring rest and sleep, especially if your mental and emotional health were compromised to begin with. This decision is a catalyst to our healing.

Therapy teaches us to reframe our thoughts (which are paramount to our health and healing) and experiences and arms us with new thought processes that highlight the importance of being compassionate to ourselves and focusing on the fact that “we are doing the best we can” in any given life situation. We must learn to stop living in guilt-producing self-condemnation. That will keep you up at night, by itself.

Effective therapy guides us to creating a peaceful mind, and teaches us positive times to focus on problems and form effectual solutions, rather than at bedtime, which we all naturally do. These changes positively produce optimal functions in the brain’s synapses causing less inflammation, irritation and unpleasant feelings, which inhibit falling and/or staying asleep.

2. Get a prescription. When lack of sleep is fostered or caused by menopause, chemotherapy effects, or the formidable radiation process, medicinal approaches appear to be imperative to successfully achieving restful sleep. I am 18 months post treatment and must take both Ambien and low dose Trazodone to sleep. I am not addicted. I need to sleep.

Here are some options: (Read this article about medications in the aforementioned link on sleep.)

• Ambien
• Wellamoon (this is new to me, but as a nurse, I see no problem with it and am going to try it!) Read the positives on the product, but also read the reviews on distribution.
• Trazodone
• Lunesta
• CBD, full spectrum hemp, and here (Important hint: for breast cancer treatment and prevention of recurrence, you will need higher, concentrated doses, including CBG and ThC. Yes, you can get an actual prescription or do your own rogue research to purchase.
• Restoril

3. Reboot your mind after a no sleep jag (and to prevent a long one). I realized recently during one of the 1–2 week episodes of (absolutely) no sleep I experience sometimes, that I was stressing so much at night to fall asleep, that I was actually keeping myself awake trying (I am sure you can relate). I expected to stay awake, so I did. Here are the simple things I do that help me break that cycle and begin returning to regular sleep:

• Move my pillow to the opposite end of the bed. (Why? I don’t know. It works a lot of the time.)
• Sleep in another bed (my child’s. I move him.)
• Not being the last one to go to bed. ( I am weirded out being the only one awake in the house after my diagnosis.)
• Invest at least $40 in a sound machine. Both my mother and I swear by them.
• Journal writing: getting feelings, frustrations and fears out on paper restores my inner center and I sleep every time.
• Purposely change my thought process each day after I experience no sleep, from a helpless outlook to one that reminds me I can still accomplish things and have a good day. This entails checking my feelings about the lack of sleep the night before (or the previous 5) which are usually a regalia of fearful responses (what if I never sleep?, what if brain metastasis is causing this?, I must have done something wrong and my conscience is pressing on me?, I’m so frustrated, I can’t do anything I want or need to after no sleep. This is hopeless.) Just a few pages into this book helped me dramatically change my perspective in dealing with bouts of insomnia.

Cancer cells thrive on strain and stress, so reducing daily stress and inflammation that occur from the hectic nature of life is an attainable goal we all have the power to work toward through rest and sleep.

Breast cancer patients do have many tangible options to create a hostile environment for breast cancer recurrence. We can survive and live out our lives healthy and confident in our ability to do so. Knowledge and education on our options always better our outcomes.

It’s difficult as a female many times to stand firm in self-care when we spend most of our waking time planning and executing the care of so many others in our lives. However, prioritizing our rest and sleep, is not debatable and cannot be compromised. We literally need it to survive our diagnosis.

Further Reading

See my other associated on Prevention of Recurrence:

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I am sad to report that the medical community lost a compassionate and visionary leader with the passing of Dr. Susan Love. The cause was a leukemia recurrence, according to Allie Cormier, the chief marketing officer at the Dr. Susan Love Foundation for Breast Cancer Research.

I am grateful to have known her. Here is a picture of us from several years ago:

Patient-Centered Care

Dr. Love’s tireless efforts, empathy, and dedication to women’s health have left an indelible mark on the field of medicine, transforming the lives of countless individuals and inspiring future generations.

My tribute seeks to celebrate her remarkable contributions and honor her enduring legacy.

First, I want to share her words from Dr. Susan Love’s Breast Book:

“When I was in medical school, I embarrassed myself horribly when I found a ‘lump’ in my breast and frantically ran to one of the older doctors to find out if I had cancer. I found out I had a rib.”

A Passion for Patient-Centered Care

Dr. Love was a staunch advocate for patient-centered care, recognizing that each person’s journey through illness is unique and deeply personal.

She emphasized the importance of understanding patients’ experiences, concerns, and desires, empowering them to participate in their healthcare management decisions actively.

Dr. Love’s groundbreaking work laid the foundation for a paradigm shift towards personalized medicine, ultimately improving breast cancer patients’ outcomes and quality of life worldwide.

The Revolution of Her Research Foundation

In 1990, Dr. Love founded the Dr. Susan Love Research Foundation, a groundbreaking organization dedicated to eradicating breast cancer through innovative research, education, and advocacy.

The foundation pioneered novel approaches to breast cancer research, emphasizing collaboration, data sharing, and patient engagement.

Dr. Love’s vision of creating a global network of scientists, patients, and advocates fueled the transformation of breast cancer research into a collaborative effort.

Her foundation was pivotal in accelerating scientific discoveries, fostering breakthroughs, and bringing us closer to a world without breast cancer.

Revitalizing Breast Cancer Screening and Prevention

Dr. Love’s work challenged traditional breast cancer screening and prevention notions. She recognized the limitations of mammography and the urgent need for more effective methods.

Her research focused on understanding the underlying causes of breast cancer, exploring risk factors, and developing innovative screening techniques. Dr. Love’s commitment to prevention led her to advocate for increased awareness of environmental factors, lifestyle modifications, and genetic testing.

Love’s holistic approach redefined the field, shaping a new era of prevention strategies tailored to individual needs.

Empowering Women Through Education & Support

Beyond her groundbreaking research, Dr. Love dedicated herself to educating and supporting women affected by breast cancer.

She authored the bestselling book “Dr. Susan Love’s Breast Book,” a comprehensive guide that demystified the disease, empowered patients, and provided them with the knowledge necessary to make informed decisions.

Her writing inspired me to write books for individuals with cancer.

Dr. Michael Hunter’s Breast Cancer Book

www.amazon.com

Dr. Love’s genuine concern for women’s well-being resonated with countless individuals facing breast cancer, offering them hope, comfort, and a sense of empowerment.

Legacy of Collaboration and Inspiration

Dr. Susan Love’s legacy extends far beyond her research and advocacy. She was a bridge-builder, fostering collaboration among researchers, clinicians, patients, and advocates worldwide.

Her belief in the power of collective effort and knowledge-sharing revolutionized the approach to breast cancer research. Dr. Love’s infectious enthusiasm, empathy, and ability to inspire others led to a new generation of researchers and advocates who continue to carry her torch.

Her unwavering dedication to making a difference in the lives of women affected by breast cancer inspired countless individuals to join the fight against this devastating disease.

Through her compassion, determination, and unwavering belief in collaboration, she reshaped the landscape of breast cancer treatment and prevention.

Dr. Love will continue to inspire me, reminding me of the importance of empathy, empowerment, and the relentless pursuit of progress.

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The breast cancer death rate dropped by nearly half (43 percent) from 1989 to 2020, according to findings published in CA: A Cancer Journal for Clinicians. Unfortunately, racial disparities persist.

This decline in breast cancer death rates is significant and may be attributed to earlier detection through awareness and screening plus management advances. While I welcome the improvements in breast cancer mortality, I want to focus on some key ways you may reduce your risk of being diagnosed with breast cancer.

Let’s get to the top ways to significantly reduce your chances of getting (or dying from) breast cancer.

1. Don’t smoke.

If you currently smoke cigarettes (and have for more than ten years), you have a higher risk of developing breast cancer. This finding is not particularly surprising, nor is the fact that the duration of smoking matters: Those smoking for 40 years have a 1.6-times greater risk of breast cancer than non-smokers.

Moreover, the number of years smoked before a first full-term pregnancy appeared to be associated with a higher risk of breast cancer than comparative years smoked after pregnancy. Cigarettes are linked to breast cancer development, and the timing of the smoking exposure matters.

Whether women who previously smoked have a higher risk of breast cancer remains under investigation.

2. Breastfeed

Breastfeeding is associated with slightly lower breast cancer risk, especially for those who opt to nurse for a year or more.

Breastfeeding is associated with only a modest risk reduction; a large pooled analysis that included individual data from 47 studies (including about 50,000 women with invasive breast cancer and 97,000 controls) estimated that for every year of breastfeeding, there appeared to be a 4.3 percent reduction in the relative risk of breast cancer. If your risk had been 15 percent, breastfeeding might drop by slightly less than one percent.

3. Postmenopausal weight loss

Some, but not all, studies show that weight loss in postmenopausal women may reduce breast cancer risk. For example, a meta-analysis that included 237,000 women with breast cancer (and four million controls) discovered weight loss associated with nearly one-fifth (18 percent) lower breast cancer risk.

The Nurse’s Health Study prospectively assessed weight change since menopause among approximately 50,000 women followed up to 24 years. Here are the results:

Women with no prior hormone therapy use who maintained a weight loss of at least 10 kilograms (22 pounds) had more than a halving of breast cancer risk than women who did not.

4. Child-bearing

A full-term pregnancy affects breast cancer, but this influence hinges upon the age of the first full-term birth. Women bearing children later in life have an increase in breast cancer risk.

The Nurses’ Health Study looked at women who never delivered a baby compared with child-bearing women. The cumulative incidence of breast cancer by age 70, compared with a woman bearing no children, was as follows:

• For women delivering a first child at age 20, the risk dropped by one-fifth (for a woman with a one in eight baseline risk in the USA or many parts of northern Europe, a decrease by about two to three percent).
• For women delivering a first child at age 25, the breast cancer risk dropped by one-tenth or just over one percent for a woman at average risk in the United States.
• For women delivering a first child at 35, the breast cancer risk rose by one-twentieth. This risk is comparable to a woman who never had a full-term pregnancy.

Breast cells fully differentiate during and after pregnancy, which may protect the breast from cancer. On the other hand, having a first birth at a later age may increase the risk by giving additional stimulation to breast cells that are more likely to develop (and more likely to be damaged).

5. Move

The available research suggests that physical activity is associated with a lower risk of breast cancer. A meta-analysis of 139 studies discovered:

Higher physical activity levels appeared to lower breast cancer risk by nearly one-quarter (a drop by 22 percent in relative risk). This risk reduction appeared similar in pre- and postmenopausal women and for high- versus light-intensity movement.

Because higher weight in premenopausal women is associated with a lower breast cancer risk (higher weight raises the risk in postmenopausal women), the drop in risk is not because of weight loss associated with physical activity.

Blood levels of hormones (such as estrogen), insulin, and insulin growth factor-1 (IGF-1) may impact risk.

6. Watch the alcohol

Alcohol consumption is associated with a higher risk of breast cancer driven by estrogen or progesterone hormones. For example, a study of nearly 52,000 postmenopausal Swedish women discovered this:

Increased alcohol intake appeared associated with estrogen receptor-positive breast cancer, with a 1.35-fold increase (if you have a baseline risk of 12 percent, it will rise by about four percent).

Could folic acid intake decrease the alcohol-associated increase in breast cancer risk? Observational studies hint that those who consume alcohol should take a multivitamin with folic acid, but our grain has supplemental folate in the USA.

7. Get appropriate screening

Women between the ages of 40 and 44 should consider beginning annual mammograms. Women ages 44 to 54 years should have annual screening, and those 55 and older have the option to test every one or two years. Breast cancers discovered by annual mammograms are usually smaller and less advanced than those discovered during mammograms every two years.

8. Get to know your genes

Modern medicine has made assessing one’s risk of developing various forms of cancer much simpler. This understanding of risk can be especially helpful for women with inherited gene mutations that make them particularly vulnerable to breast cancer. The American Cancer Society explains, “When it comes to breast cancer risk, the most important inherited gene changes are in the BRCA1 and BRCA2 genes. Women (and men) with one of these gene changes are said to have Hereditary Breast and Ovarian Cancer (HBOC) syndrome.”

9. Risk-reducing surgery or medicines

Some medicines may significantly reduce the chances of developing the disease for women with a higher-than-average breast cancer risk. Because risk-reducing drugs such as tamoxifen, raloxifene, or aromatase inhibitors have potential side effects, you will need to balance the pros and cons of the medicine.

This approach of using medicines to help reduce disease risk is chemoprevention. If you are considering this approach, first have a health care provider help determine your breast cancer risk.

The American Cancer Society explains that some important breast cancer risk factors include:

• Older age
• Having close relatives with a breast cancer history
• Having more menstrual cycles
• Having a history of invasive breast cancer or ductal carcinoma in situ (DCIS)
• A history of breast lobular carcinoma in situ (LCIS, atypical ductal hyperplasia (ADH), or atypical lobular hyperplasia (ALH)
• Having a gene mutation associated with a family cancer syndrome (such as a BRCA mutation)

10. Eat well

A limited number of studies suggest that there may be a connection between eating fruits and vegetables regularly and a lower risk of developing some aggressive forms of breast cancer.

I hope this article helps you understand how lifestyle influences breast cancer risk. Thank you for joining me today.

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We’ll come back to that awful statistic, but we need to keep such findings in context: Randomized clinical trials show that screening mammograms save lives.

Today, I look forward to exploring breast cancer screening, including the pros and cons of the various imaging approaches.

Mammograms

Mammograms remain central to screening for breast cancer. Systematic reviews of randomized clinical studies for women ages 40 to 69 years show a long-term drop by up to one-fifth in the risk of dying from breast cancer.

Unfortunately, these are primarily historical; most screening mammograms studies began before 1990. Since then, there have been changes in imaging, and there have also been tremendous treatment advances.

Full-field digital mammography

Today, many patients have full-field digital mammograms. These images are similar to traditional film-screen mammograms, except now the image is captured by an electronic detector stored on a computer.

In the United States today, virtually all of the mammography units accredited by the Food and Drug Administration are full-field digital units. Are these newer digital mammograms better than the old film ones?

The most extensive study, the Digital Mammographic Imaging Screening Trial (DMIST), discovered that while the overall diagnostic accuracy of the film and digital mammograms appear similar, digital mammography is more accurate for women less than 50 years of age, for premenopausal and perimenopausal women, and women with dense breasts.

Tomosynthesis

This digital approach produces three-dimensional (3D) images using a moving X-ray source with a digital detector. Multiple studies suggest that tomosynthesis mammograms increase cancer detection rates modestly compared with historical 2D digital mammograms.

A 2018 analysis of a collection of studies showed a gain of 1.6 cancers (per one thousand screening studies) detected with the addition of tomosynthesis, compared with traditional mammograms alone. The tomosynthesis rates also appeared lower.

Alas, no studies have examined whether tomosynthesis cuts breast cancer mortality chances.

Mammograms — Still the gold standard

Mammograms continue to be the primary imaging modality for screening women at average risk of getting breast cancer.

Ultrasound sometimes supplements mammogram screening for those with dense breasts, even though we don’t have high-level evidence to show improved outcomes.

Magnetic resonance imaging (MRI), in combination with mammograms, is being increasingly used for those at high risk of getting breast cancer. However, we have some data that incorporating MRI for those with extremely dense breasts (and normal results on mammograms) results in fewer interval (between studies) cancers than mammograms alone.

Mammograms — New findings

A University of California, Davis-led study, published 25 March 2022 in the Journal of the American Medical Association Network Open, reports these findings:

Half of women will experience a false-positive mammogram after ten years of annual breast cancer screening with 3D mammograms. The risk appears lower for women who have mammograms every other year.

The 3D mammogram approach modestly dropped the odds of having a false-positive result compared with standard digital 2D mammograms.

These groups had a lower false-positive risk:

• Women with non-dense breasts
• Older women
• Those who screened every other year

Writing in sciencedaily.com, the first author Dr. Michael Bissell writes that the “screening technology did not have the largest impact on reducing false positives.”

Dr. Bissell adds that the findings from our study highlight the importance of patient-provider discussions around personalized health. It is essential to consider a patient’s preferences and risk factors when deciding on screening interval and modality.

The researchers analyzed data collected by the Breast Cancer Surveillance Consortium on 3 million screening mammograms for over 900,000 women aged 40–79 years.

I am surprised that the innovative 3D mammogram approach for breast cancer screening did not lower the chances of having a false positive after ten years of screening. Still, mammograms save lives.

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