She's the guru on breast cancer, the woman who writes the continually updated breast cancer bible. She's Dr. Susan Love, author of Dr. Susan Love's Breast Book, and in the May/June 2007 issue of MAMM magazine, she shares some of her latest thoughts.

On milk ducts

Dr. Love says all breast cancer begins in the milk ducts. If we want to get rid of breast cancer, she says, we need to understand where it starts. Until recently, we weren't able to do that. Now, doctors can numb the nipple, thread a catheter into a milk duct and sample the fluid, cells, carcinogens, and hormones. By looking at the location where cancer develops, there's the potential to find out how it started and how to prevent it. In March, Dr. Love's Research Foundation sponsored a conference on this topic.

On MRI

Dr. Love is not a big fan of MRI. It's overly sensitive and finds everything -- most of which is not cancer, she says. MRI leads women on wild goose chases so Dr. Love likes to reserve this test for women at high-risk.

Here's an opportunity for you to share your personal breast cancer experiences, and help further research too.

Molly, a college student at BYU, has launched a national research project aimed at examining the relationship between couple leisure satisfaction and marital satisfaction of couples in which one spouse has breast cancer. Molly and her study partner Dr. Ramon Zabriskie hope to identify new avenues for cost effective intervention targeted at improving the quality of life for adult cancer patients and their spouses.

Both the cancer patient and spouse/partner will be asked to complete a short online questionnaire. No identifying information is required, and all responses will be kept confidential.

An Oxford skin cancer expert is weighing in on the recent advice that we would all be wise to sport our denim, polyester, and wool when we head into the sun's harmful rays.

It's an extreme approach, says dermatologist Dr. Robert Turner who believes this skin cancer prevention guidance could push sun seekers to do just the opposite.

Think about this:

"I just don't think this is practical," says Dr. Turner. "People will think it's ridiculous and just go out anyway. If you advise people to do something that is extreme, they're more likely to go the other way completely."

Dr. Turner agrees that clothing is better protection than sunscreen -- especially for children -- but he thinks expecting people to take such drastic cover is unrealistic. He'd much rather urge people to stay out of the sun completely during the middle of the day, when the sun's rays are scorching hot.

The skin cancer we so desperately try to avoid may be caused, in part, by the very thing we use to prevent the disease -- sunscreen.

Scientists at the University of California report in the journal Free Radical Biology & Medicine that some of the chemicals found in sunscreen products can become cancer-causing agents once they are absorbed into the skin.
And perhaps this is why more and more people are developing skin cancer, despite the increasing use of sun lotions.

"Sunscreens may be doing more harm than good," says lead researcher Dr. Kerry Hanson.

May is the important word here. Sunscreens may contribute in some way to the incidence of skin cancer. But the jury is still out. And experts are not sure right now how significant this research will be in the long run.

Merck, maker of the cervical cancer vaccine Gardasil, is backing off its lobbying campaign following pressure from medical groups and parents who believe the vaccine should not be mandated as a school attendance requirement for adolescent girls.

The public outcry that caused Merck to announce its stop order on Tuesday stems from the fact that the vaccine protects against the sexually transmitted human papilloma virus (HPV), which causes cervical cancer. School-mandated vaccines are typically for diseases spread through casual contact, such as measles and mumps.

Merck's medical director for vaccines, Dr. Richard M. Haupt says, "We're concerned that our role in supporting school requirements is a distraction from that goal, and as such have suspended our lobbying efforts," adding that the company will continue providing information about the vaccine upon request.

Gardasil, launched in June and the first vaccine to prevent cervical cancer, has inspired controversy since day one. There's the cost -- $360 for three required shots -- and all sorts of insurance concerns and conservative groups who worry the vaccine encourages premarital sex and interferes with parental rights. Even those in support of the vaccine -- like the American Academy of Pediatrics and the American Academy of Family Practitioners -- question Merck's quick push to market this drug, especially in light of the company's withdrawn painkiller Vioxx.

"I believe that their timing was a little bit premature so soon after (Gardasil's) release, before we have a picture of whether there are going to be any untoward side effects," says Dr. Anne Francis, who chairs an American Academy of Pediatrics committee.

Legislatures in 20 states have taken steps to mandate the vaccine for young girls. And with the exception of Texas governor Rick Perry's February 2 executive order requiring Texas girls entering the sixth grade in 2008 get vaccinated, nothing has been made official so far.

Besides preventing birth defects in the brain and spine and other congenital abnormalities, the folic acid found in prenatal multivitamins has now been shown to prevent cancer in children whose mothers take the vitamins during pregnancy.

A new Canadian study, appearing online in the journal Clinical Pharmacology & Therapeutics, estimates prenatal multivitamin supplements can save hundreds of children each year in Canada -- where only 40 to 50 percent of women take prenatal vitamins -- from developing leukemia, brain tumors, or neuroblastoma. And the vitamins may prevent 900 cases of pediatric leukemia and more than 300 brain tumor cases annually in the United States.

It's not clear which vitamins or minerals, and in what amounts, could be protecting babies from cancer, but it's possible folic acid -- critical for cellular function -- may be acting alone.

One thing is certain, says lead investigator Dr. Gideon Koren -- this is one inexpensive way to prevent cancer.

Blogger Kristina Collins wrote on February 11 about three great steps for reducing the risk of cancer. Her suggestions -- eat well, get fit, and stop smoking -- are such good tips and could certainly account for major health changes in those who heed this advice.

Each one of these recommended lifestyle alterations is a major undertaking. And if you're like me and find big, swift, sweeping changes a sure recipe for defeat, then this short to-do list may seem a bit intimidating. So I'd like to offer a bit of my own advice for accomplishing these health feats -- take baby steps.

Kristina has taken baby steps. She first quit smoking -- I'm not sure there's anything small about this success, however -- and now she's taking on membership at a gym. Cutting down on red wine comes next, she says, as she pursues a life driven by health.

I have just recently taken a baby step myself. I stopped drinking soda -- or pop as I called it before relocating from Ohio to Florida. I'd known for some time I wanted to rid myself of the sugar that comes packaged in my favorite drinks -- Dr. Pepper and root beer -- but for some reason, I was dragging my feet when it came to giving up this vice. Yet I did it. I stopped drinking soda, replaced it with water, and now have no desire for sugary drinks of any kind.

I am a creature of habit. I know this because I spent years drinking only water. But when cancer struck, I turned to the carbonation of soft drinks to settle my upset stomach. With time, my stomach stopped bothering me. But I didn't stop drinking soda. I kept drinking it for no other reason than pure habit. And when I convinced myself this practice was not necessary in my life, I cut it out.

Perhaps I'll tackle chocolate next. Or exercising more. Who knows. I'm just happy I accomplished one small task. And I hope you'll consider taking baby steps in your pursuits for better health. Just remember, we didn't hop up one day and start sprinting in infancy. It took years to fine-tune our ability to run on our own. And it may take years to carve out a healthful way of living.

If the experimental breast cancer drug Tykerb continues to prove successful in study participants, it could be headed for FDA approval.

Tykerb, now in international study, showed in early studies to be even more effective and to have fewer side effects than similar breast cancer drug Herceptin. Both drugs are part of a cluster of targeted therapies that attack cancer cells while sparing healthy cells. Designed for use on women whose breast cancer is HER2 positive -- meaning it contains too much of an aggressive protein -- Tykerb may be a wonder drug, with the capability of effectively keeping breast cancer at bay.

Dr. Paul Goss of MA General Hospital says, "We're seeing Tykerb, which is a pill, which is easier to take, has a broader attack and gets inside cells. It's like an electrical circuit that's turned on, and Tykerb can pull the lever, the circuit breaker, and switch it off."

A U.K. researcher confirms what many dog lovers already know -- dogs are good for your health.

Apparently, dog owners are generally healthier than non-pet-owners. They have lower blood pressure and cholesterol, suffer fewer minor ailments, and stray from serious medical problems too. Dogs can prevent their owners from getting sick, help them recover more quickly when they do fall ill, and they can even warn of cancer, heart attack, epileptic seizures, and hypoglycemia, says Dr. Deborah Wells from the Canine Behaviour Centre of Queens University in Northern Ireland.

Wells, whose study is published in the British Journal of Health Psychology, says dogs buffer us from stress -- a well-known cause of illness -- and promote general well-being. Owning a dog leads to increased physical activity and increases development of social interactions -- both of which minimize stress and contribute to human health.

While Wells found those who own both dogs and cats benefit from their pets, dog owners enjoy improved health for much longer than cat owners.

The American Cancer Society has happily announced that cancer deaths have declined for the second straight year. This is big news -- mostly because our population is growing and aging and it's entirely possible this could have led to an increase in cancer deaths. Not only is this not true, but the drop in deaths for this second year is eight times greater than the drop during the first year. Amazing.

It's hard to imagine in light of this great news that there are still less hopeful statistics out there on the cancer front. But there are so many dimensions to this disease -- prevention, detection, diagnosis, treatment, survival -- that the numbers can vary tremendously depending on perspective.

From the perspective of diagnosis, one in two men and one in three women in America today will develop cancer during their lifetimes. These staggering statistics, based on data collected during 2001 through 2003, are detailed in a pivotal paper appearing in The Oncologist -- a monthly peer-reviewed journal for doctors devoted to cancer patient care.

Dr. Matthew Hayat and colleagues, who worked on this paper for the National Cancer Institute, reveal other worrisome numbers and facts.

It seems the number of new cancer patients is expected to more than double from the current 1.36 million in 2000 to almost 3 million in 2050. Five-year survival for all cancer stages combined ranges from as low as 16 percent for lung cancer patients to 100 percent for prostate cancer patients. And black Americans are reported to have the highest cancer incidence and mortality rates for men and women for all cancers combined.

So while less people are dying from cancer, diagnosis of the disease seems to be on the rise. Not exactly a perfect scenario -- but if science and research can keep up, perhaps those diagnosed with cancer will need to prepare not for death, but for the management of a chronic condition.

Dr. Len Lichtenfeld, MD, is the deputy chief medical officer for the American Cancer Society. He is also a blogger and authors his very own blog -- called Dr. Len's Cancer Blog.

Dr. Len writes on his blog about all sorts of topics related to cancer. He shares his opinion on the recent drop in breast cancer cases (December 15, 2006), he promotes the Great American Smokeout (November 14, 2006), he sounds off on lung cancer screenings (October 25, 2006), and he urges parents to always slather sunscreen on their children (October 5, 2006). He has so much more to say -- and his blog is a great stop for those wishing for more information on hot cancer topics.

As this year comes to a close, Dr. Len offers a review of what he believes were the hottest cancer topics of 2006.

Dr. Len reflects in his blog about decreased cancer death rates that represent real progress in the fight against cancer. He calls the HPV vaccine a breakthrough and he recaps the STAR trial -- a comparison of raloxifene to tamoxifen to reduce the risk of recurrent breast cancer in post-menopausal women -- with emphasis on how raloxifene proved just as effective as tamoxifen, but with a better safety profile. He calls new targeted therapies a dream -- with a hefty price tag -- sure to garner debate and discussion in 2007.

Dr. Len reviews the Surgeon General's report on second-hand smoke -- it's harmful to non-smokers, the report says -- and he marvels at the capability of science to approach an understanding of what makes a cancer cell a cancer cell. He also remarks on how remarkable it is that chronic myelogenous leukemia is in fact chronic and no longer fatal, thanks to the drug Gleevec.

Of course, there is ample attention given to the declining incidence of breast cancer, reportedly due to less women using hormone replacement therapy, and the risks weighing on those who are overweight and obese, and survivors and supporters who gathered for Celebration on the Hill -- the site of one incredible American Cancer Society event.

Dr. Len closes his review of 2006 with recognition of three celebrities who lost their lives this year to cancer -- Dana Reeve, Ann Richards, and Ed Bradley. And while he recognizes there are other lives and other stories that deserve mention, there is simply not enough time or space for him to do justice to every noteworthy item.

"What we have seen over the past year is an incredible leap forward in cancer research, diagnosis and treatment, and I suspect there are going to be even more exciting developments in the coming year," says Dr. Len who looks forward to 2007 -- a year that is sure to deliver more hope and more progress in the fight against cancer.

If you have ever been diagnosed with breast cancer, it is quite likely that one of the first books, if not the only book, recommended to you was Dr. Susan Love's Breast Book. The New York Times rightly refers to her book as "the bible for women with breast cancer." Her second book, Dr. Susan Love's Menopause and Hormone Book, was one of the first to question the widespread use of postmenopausal hormones. Dr. Love is a genuinely trusted presence and clear voice in the world of women's breast health.

An eminent pioneer in the field of breast cancer for 30 years, and considered one of the founding mothers of the breast cancer advocacy movement, her mission, and the mission of the Dr. Susan Love Research Foundation, is to eradicate breast cancer within our lifetime and better the lives of women by generating resources and innovation for education, research, and advocacy on women's health issues.

Part of the recently redesigned Dr. Susan Love Research Foundation website is the addition of a blog. Dr. Love is blogging the San Antonio for the San Antonio Breast Cancer Symposium where she joins more than 8000 physicians, scientists, and breast cancer advocates in what is considered one of the most important conferences held each year regarding cancer.

On the first day, Dr. Love blogs both clinical and big picture highlights, including her take on two newsworthy study findings we posted here earlier today. The first concerns the common house mouse virus link to breast cancer and the second one regarding the dramatic decrease in breast cancer cases and the corresponding decrease in women using hormone replacement therapy (HRT).

Dr. Love posted, "There was a sudden dramatic (7 percent) decrease in breast cancer in 2003 corresponding with the equally dramatic decrease in women who stopped taking HRT after the WHI study found it appeared to do more harm than good. The study found 14,000 less breast cancers in one year! In my mind this is the final proof we need that taking hormonal therapy after menopause for the prevention of the diseases of aging makes no sense."

For a trusted analysis of the conference, you can find Dr. Love blogging the San Antonio Breast Cancer Symposium here.

I really like the book I've recently been writing about -- The Journey Through Cancer: Healing and Transforming the Whole Person. And I plan to read more. And I plan to write more. But I'm at a standstill.

I haven't been reading lately. And I haven't been writing lately. Because life is getting in the way. And in my book, that's a good thing.

There was a time when it would have caused me great stress to have committed myself to something -- like reading a book and writing about it -- and to have somehow fallen short on completing the task. Stress would have caused me to make time for my commitment, to push other important tasks aside, to fulfill my self-imposed deadlines.

But ever since cancer arrived in my life and jolted me into the realization that I only have the pleasure of one day at a time, I am better at capitalizing on what's most important in my world -- my family.

I have been busy playing beauty shop with my son. The boy who once shaved my head prior to my chemotherapy fallout is now twisting my dark brown curls into one-of-a-kind styles. I have been hanging Christmas lights with my sister who really has done all the work for me. I have been watching my two boys play in the yard and skateboard down the driveway and create concoctions of dirt, water, and weeds on the front porch. I have been shopping for holiday gifts and finding all sorts of great buys for myself too. I have been playing with my niece and dining out with my husband and writing posts and sitting by a fire at night. I have not been reading.

I am perfectly content with my hiatus from reading and writing. Because enjoying my moments, on my preferred terms, is surely part of recovering from a illness that threatened to take all my moments away.

I'm not sure when I'll get back to Dr. Jeremy Geffen's book, when I will continue reading about his Seven Levels of Healing. Because at the moment, I am too busy healing myself.

To read previous posts on the same topic, visit:
The Journey Through Cancer: State-Of-The-Art-Medical Care
The Journey Through Cancer: Beverly Is Every One of Us
The Journey Through Cancer: What Is The Purpose Of Medicine
The Journey Through Cancer: Introduction
Sunday Seven: Seven Levels of Healing on Cancer Journey

Stay tuned for an eventual post about:
The Journey Through Cancer: Level One -- Education and Information

I never got a chance to call for the results of my breast biopsy the day after it was performed -- because my phone rang hours before I was told to inquire about the pathology of my lump. That one phone call changed everything. Forever.

November 2004

The next day, November 24 and the day before Thanksgiving, my phone rang at 10:00 AM and the doctor who did the biopsy said the pathology report was back already. He said that unfortunately, cancer cells were found. He said I would need a lumpectomy (surgery to remove the lump), radiation, and possibly chemotherapy. He told me to buy a book called Dr. Susan Love's Breast Book. I got the book that day.

Somehow, I made it though the Thanksgiving weekend, with my thoughts jumping from the hope that this would turn out okay to the fear that I would not see my boys grow up. My mind wandered and worried about surgery and what treatments I would have. I wondered if I could have more kids and whether or not I would lose my hair. I cried and lost sleep and was hopeful too.

I learned a lot from reading my new book. I learned that many women do go on to have kids after cancer but I also learned that chemotherapy in young women can cause early menopause. I learned that I have an 85 percent survival rate and also that I will get tiny little tattoos surrounding my breast to aid in the proper delivery of radiation. These permanent tattoos will also alert any future doctors that my breast has had radiation because I can never have it again in that same area. The book helped me feel positive about this journey but it also helped me face reality.

I have since faced reality. And now I am surviving the reality of breast cancer. Following my diagnosis, I endured a lumpectomy, four rounds of dose-dense chemotherapy, more than six weeks of radiation, and one year of Herceptin treatment. Through it all, I learned that I am okay, that I will likely see my boys grow up, that my early menopause was only temporary, that I am physically able to have more children, that I did in fact lose my hair, that my 10 tiny tattoos are so small I can barely see them, that my survival rate is much higher than 85 percent.

I knew I had breast cancer the day I detected a lump in my breast. It just took eight days to confirm my suspicion. And now it's been two years. I have survived for two years.

Every cancer patient should receive state-of-the-art medical care, says Dr. Jeremy Geffen in his book The Journey Through Cancer: Healing and Transforming the Whole Person. This medical care -- the foundation of every cancer treatment program -- should be administered by highly trained and qualified caregivers, under the meticulous supervision of an experienced oncologist.

Some don't believe this is the necessary foundation and consider the triad of surgery, chemotherapy, and radiation both poisonous and barbaric. There is no doubt that people encounter pain, frustration, and toxicity with these therapies, according to Dr. Geffen. But he believes it's almost always a serious mistake to forgo these remedies in exchange for unproven alternative therapies.

There are demonstrated benefits of conventional medicine. And it is clear that with each day, treatments become safer, less toxic, and more effective than ever before. Some cancers -- like Hodgkin's disease, testicular cancer, and childhood leukemia -- were once considered deadly. Now, they can be cured. The anatomy and function of the eye, breast, larynx, esophagus, anus, rectum, and prostate can now be preserved, despite surgery and treatment. Advances in pain control have delivered considerable relief to patients experiencing discomfort with treatment. And there is reason to believe future progress against cancer will be even more dramatic -- with the advent of molecular and genetic technology, immunotherapy, targeted therapies, better diagnostic technologies, and more effective control of side effects.

Dr. Geffen stresses this -- conventional medicine is a must in the fight against cancer. But alternative and complementary therapies also have a place. And throughout his book, he details the Seven Levels of Healing that encompass both approaches.

He begins with Level One -- Education and Information. The starting place. The place common to all of us who receive diagnoses that are troubling and confusing and require a little investigation, a little research, a little explanation. The place I will describe in my next Journey Through Cancer post.

To read previous posts on the same topic, visit:
The Journey Through Cancer: Beverly Is Every One of Us
The Journey Through Cancer: What Is The Purpose Of Medicine
The Journey Through Cancer: Introduction
Sunday Seven: Seven Levels of Healing on Cancer Journey

Stay tuned for:
The Journey Through Cancer: Level One -- Education and Information