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Lumpectomy technique saves patients from repeat surgery

On Sunday, for the very first time, I read a magazine article about the hospital where I received treatment for breast cancer. I had never before seen mention of my hospital, my doctors, my city in anything other than local and regional newspapers and on area television stations. I figured news about Shands Hospital at The University of Florida was out there -- in more areas than my own -- because it's a well-known facility. People travel from all over to receive treatment here. So I know it's a good place. But to see in the October 2006 issue of Good Housekeeping an actual blurb about a new kind of lumpectomy -- pioneered right here in Gainesville, Florida -- is exciting.

I am the happy recipient of this new kind of lumpectomy -- which really is not new at all. It was developed 20 years ago by the surgeon who performed my own lumpectomy, and it allows women who undergo lumpectomy the chance to avoid return trips to the operating room.

The method is called frozen section analysis, and it was first used by Dr. Edward Copland III, first director of the UF Shands Cancer Center, who was tired of waiting for pathology reports and tired of operating on patients two and three times to ensure clear tumor margins.

It all happens like this -- a surgeon removes the breast cancer tumor, takes tissue samples, freezes them in an embedding compound, and sends them to a pathologist for immediate analysis. In a typical case, this frozen section process adds just 15 minutes to the operating time. If pathology reveals more tissue must be removed, the surgeon returns to the patient, still under anesthesia, and continues surgery. The patient does not need to return for more surgery.

Surgeons at most institutions rely on a method called permanent section analysis to determine whether or not cancerous cells remain along the margins of a tumor. The technique is labor-intensive, takes days to complete, and requires patients to return for additional surgery if margins are not clear. Surgeons using the frozen section method still consult permanent sections to confirm margins are clear -- but they are mostly certain of their findings during frozen section.

Studies show frozen section analysis to be safe and effective -- and it adds just $851 to the cost of surgery, a savings considering the cost of returning for surgery as a result of permanent analysis.

There are many advantages -- but the procedure is tricky and on occasion can fail to detect some cancerous margins, indicating frozen section should continue to be used in conjunction with permanent section. Opponents of the practice say false positives could result in unnecessary mastectomy. But Copeland says this has never happened at UF -- and he would never remove a woman's breasts until permanent section confirmed it was necessary.

Despite the promise of this method, only a handful of institutions make practice of this surgery-sparing technique. Shands at UF is the only hospital in North Florida where breast surgeons perform frozen section analysis on a regular basis.

The procedure -- which is not risky, is not harmful, and clearly saves patients from returning for surgery -- is the exact procedure I received almost two years ago. Dr. Copeland removed my tumor, froze tissue samples, sent them to pathology, and 15 minutes later knew my tumor had clear margins and had not spread to my lymph nodes. He visited my family in the hospital waiting room just after surgery and told them the good news -- clear margins, no spread, a 1.1 cm. tumor, stage I. And while other tumor criteria, such as ER/PR status and HER2 status, did not come my way immediately, I at least knew the basics when I woke from surgery. No waiting. No worrying. No complaints.

Magical food media reports misleading consumers

Writer Richard Morris of www.breadandmoney.com coins the word nutritainment in a recent article about foods that are hyped to magically make us healthy -- foods that can cancel out cancer and wipe out heart disease. Nutritainment is nutritional news delivered in entertainment-like fashion, designed to urge consumers to buy into the latest, greatest super foods. Yet making small changes in diet -- what most consumers will do -- to incorporate these so-called powerful products is unlikely to do much good, Morris says. And he offers some thoughts on why the media continues to force this news down our throats and why we continue falling for their tactics.

Morris says human nature and marketplace economics motivate those engaged in nutritional sciences to strive for media attention and exposure. As a result, bits and pieces of nutritional studies make their way to medical journals and then land in media's lap through press releases. Some will even ghostwrite nutrition articles to promote products. These articles end up in the hands of the media and spread like wildfire to the public, in as-is format. Consumers may be left with the notion that these bits and pieces are important, relevant, non-biased research -- when this is not the case.

Morris says knowledgeable health experts who have the time to accurately report on important nutrition news are scarce. And when they do have time to share words of wisdom that really do matter, the packaging of the news is often technical and not so sensational. A headline that reads, Pomegranate juice packs power to prevent cancer will bury a scientific -- yet more accurate -- headline. Catchy headlines grab readers, and readers buy products. But headlines can be misleading -- and pomegranate juice alone is not likely to have many health benefits.

There are also issues with advertising and editorial content, according to Morris, who compares overall good nutrition to car maintenance. "Just like changing the air freshener in your car won't prevent a breakdown if the car desperately needs a tune-up, adding one item of magical food to your diet won't protect you from a breakdown either," he says and shares that a complete dietary makeover is what's necessary for good health -- that and stress reduction, physical activity, emotional balance, and life fulfillment. A quick dose of pomegranate juice may not do the trick. But a steady, consistent dose of these items will.

Sunday Seven: Seven steps for securing a sane schedule

Cancer has helped me slow down -- a little. I am more patient in the moment without racing to the next task I think is waiting for me. I can better manage my priorities and can offer the most important things the majority of my time. I am better at passing on opportunities that are low on my wish list. And I can typically say "no" if I don't have the time or energy to devote to a request. I know that I have to be healthy and happy and fulfilled in order to operate effectively and joyfully in this world. So I try to enjoy peaceful moments and put priorities first and not overextend myself and slow down. I'm not completely there -- yet. But I plan to keep practicing. And I'm going to try these seven strategies -- offered by a freelance writer, wife, mother of two, and reformed over-committer -- in an article I stumbled across in a local family magazine I picked up this week.

Continue reading Sunday Seven: Seven steps for securing a sane schedule

Crossing the street may be more dangerous than coloring hair

Hair colorist Jason Backe hopes hair dye does not cause cancer -- because he is covered in it every day in the Manhattan hair salon where he works. But the topic of hair dye and cancer has been on his mind lately -- because he has been fielding questions from clients about the possible link between the two ever since an American Journal of Epidemiology study was released and caused nationwide panic about hair dye upping the odds that women might contract lymphoma -- a cancer of the lymphatic system. But on Thursday, a New York Times article summed up opinions from both experts and hair stylists, revealing that most everyone believes this panic is not necessary.

Recent studies found that those who had ever used hair dye were 1.19 times more likely to get lymphoma than those who had never used it. Those who colored their hair before 1980 -- before then-questionable chemicals were removed from hair dyes -- were 1.39 more times likely to get the disease. Ann Curry on the Today Show said, "These are scary numbers," but Dr. Barnett Kramer, associate director for disease prevention at the National Institute of Health said, "Compared to risk factors for other diseases, those numbers are very small." Smoking makes people 10 to 60 more times likely to get lung cancer. According to Dr. Joseph K. McLaughlin, president of the International Epidemiology institute, if these numbers are true -- and that's a big if -- it would mean that using hair dye may present a remote risk to your health. But it would still be less risky than crossing a street, driving a car, not wearing a seat belt, or drunk driving.

I am not exactly in a panic about this whole issue. But before I heard the news about hair dye and cancer, I did dye my hair -- once. And I don't think I will do it again -- even though the risk may be small -- because I have already had cancer. And any amount of risk associated with any type of cancer is just something I don't want to mess with.

Witnessing death both heart breaking, soul strengthening

I was present for death only one time in my 36 years of life. I consider this both a bad and a good thing. It's bad because I did not want my grandmother to die -- and watching it happen made it so real, so vivid, so painful. I don't think I would have ever chosen to watch my grandma die -- to watch her slip from consciousness to coma, to observe her altered body once death arrived, to witness the movement of her body on a stretcher as it was wheeled out of the house from the bedroom I still see every time I visit my mom's house. But I think I am lucky really -- and this is the good part -- because I got to be with her during her final moments. I got to watch her body as it lay still, peaceful and calm and still breathing. I got to talk to her and although she could not respond, I believe she could hear my words. And it makes me happy to know my grandma may have known I was with just prior to her flight to heaven. And after her flight, I got to touch her cool hands. I got to feel the power of the passing of one life -- a long life -- and I got to feel the comfort of a death that was not ugly or painful or difficult. It was sad -- it's still sad -- that my grandma died three years ago. But what a privilege it was to be part of the day she left this world.

Susan DeWilde left this world in much the same way -- with loved ones by her side. She was a fighter and had conquered several rounds of breast cancer, a tumor in her spinal cord, uterine cancer, lymphatic cancer, and then leukemia, which took her life at the age of 53. I don't know this from Susan herself but from her friend, Christy Mack -- who helped her accept her death and guided her into her own final moments so that she could escape her pain and die peacefully. Christy writes about her beautiful friend and her empowering death in an article that appears in the August 2006 Oprah Magazine. Titled Friends to the End, Christy's story details how she soothed her friend, cradled her hand, and talked her through her last breaths. She helped her on her way during a time her friend feared most. Christy writes, "What she and I shared the night she died was a precious gift of friendship, emotionally profound and sacred in its perfection. It broke my heart. It strengthened my soul."

This I understand.

Buddy program helps promote early breast cancer detection

A friend of mine told me last year about her friend who was featured in a newspaper article about a program called Buddy Check 12. I read the article online and cataloged the gist of the story in my head. But I didn't do much with the information as I was in the midst of treatment for breast cancer and thought perhaps at a later date, I could better sort through the abundance of resources that were sent my way.

Continue reading Buddy program helps promote early breast cancer detection

A friend because of breast cancer

My friend Amy is done with chemo. Her hair is growing back.  Her spirits are lifting.  She is coming back to life after a diagnosis that sent her world into a tailspin.  I know this from e-mails and phone chats and a series of articles written about Amy in the Akron Beacon Journal.  Yet I have never seen Amy, have never reached for her hand or given her a hug or supported her in the way I would have liked to -- but our relationship is still solid and strong because of our connection.  We are both breast cancer survivors -- diagnosed not too far apart from each other and at an age that seemed much too young for what we now know is a much too common disease.  We were both 34.

Amy and I became friends because of a common friend.  Amy's high school friend was my college roommate who linked us when she realized we were both fighting a similar battle.  I am thankful for this match-up because my bond with Amy is priceless.  She is always on my mind and will always be my companion on this journey that we both agree has been both devastating and positively meaningful.  Read on and you too can get to know my friend Amy.

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