Some scientists believe that surgery to remove a breast tumor may actually help the cancer spread and have recently reported that this same belief may be the exact reason black women are more likely to die of breast cancer.

There is apparently a widespread belief in parts of Africa and the United States that removing a tumor hastens death.

"I must say that I am sure there is more to this than just a myth," said Michael Retsky of Children's Hospital and Harvard Medical School in Boston, who shares his opinions in the International Journal of Surgery.

Retsky still urges any woman with breast cancer to have her tumor removed. And he says chemotherapy is such standard practice for any cancer threatening to spread. It's a safety net of sorts to catch the cells that get away. So if surgery causes cancer to spread, then in theory, chemotherapy should stop the spread.

Retsky, who is not suggesting any change in clinical practice, thinks the subject needs far more research. American Cancer Society experts, who tend to question this theory, agree.

"Whether or not the theory is correct, I have difficulty with the logic that they employed to get there," said oncologist Dr. Len Lichtenfeld of the American Cancer Society who says women should never delay treatment for breast cancer.

Retsky believes that perhaps surgery, by wounding the body, causes it to produce growth factors that fuel the growth of other, tiny tumors. Or maybe a primary tumor secretes some sort of factor that holds the other tumors in check. When the main tumor is removed, the smaller tumors grow.

But it could be that surgery does not cause a spread at all – and that any belief of this nature has no connection with breast cancer tendencies in black women. It may be that black women just have a genetic predisposition for more aggressive forms of the disease.

As evidence mounts, it's becoming more and more clear that chemo brain, a mental fogginess that can result from chemotherapy, is a real concern and not just a convenient excuse cancer patients use to explain away their flighty and forgetful tendencies. It seems the brain really can suffer cognitive damage from the poisonous drugs that fight off deadly cancer cells. And sometimes, this damage is present years after treatment.

Add to chemo brain the normal aging process as well as brain conditions such as mild cognitive impairment and even schizophrenia and the brain might not stand a chance of ever remembering anything. Unless we buy into the new concept of mental training -- somewhat like physical fitness training -- in which case we may be able to bring back a level of sharpness to our lives.

Research suggests this type of training may delay mental decline. And Betty Hall, 85, who is taking a brain fitness class at her senior living complex in Illinois, says brain-enhancing activities are definitely helping her.

Hall is participating in an eight-week program where she spends one hour per day, five days per week using a computer to match words and listen for details in stories. She says it's helping her remember where she places her keys and her grocery lists -- and it's even helping her in her bridge club.

"I've won four times out of the last five at bridge club, and I think the players are going to shoot me because I keep remembering the cards people have," she said. "It's much easier for me to concentrate . . . and I brag about it everywhere I go."

One clinical professor of neurology says brain health programs will explode over the next few years because of the stunning findings on this front. One study shows relatively short training regimens, lasting just five or six weeks, improve functioning for as long as five years. And booster sessions help advance these gains. Study participants says their everyday tasks, like managing finances, are much easier after mental workouts. Another study of the computer software Hall uses shows the program shaves an average 10 years off the mental age of users.

Not all mental training is alike, and different cognitive difficulties may call for different training protocols. But the simple fact that I can work out my brain like I can work out my body gives me hope that I can possibly reverse the effects of chemotherapy on my own foggy brain, that I can one day not worry anymore that I might find my check book in the refrigerator and my cell phone in my sock drawer. Bring on the workouts!

Thanks to Bev, my brainy friend, for this story tip!

The combination of breast cancer drugs Tykerb and Xeloda are effective at slowing the progression of metastatic breast cancer after the drug Herceptin fails -- but the drug duo is only effective at extending the lives of patients for a few months, according to the results of a recent international clinical trial.

The trial, led by Charles E. Geyer, M.D., of Allegheny General Hospital, Pittsburgh and published in the December 28 issue of The New England Journal of Medicine, focused on 324 women whose breast cancer had spread to other organs. The women had already been treated with Herceptin for a median of 42-44 weeks -- and then half received Xeloda chemotherapy and half received both Xeloda and Tykerb.

Women who received the drug combination had more than a 50 percent delay in disease progression. Their cancer spread after a median 8.4 months, compared to 4.4 months for women who received only Xeloda.

Targeted drugs Herceptin and Tykerb are major advances in the fight against breast cancer -- for the 20 percent of diagnosed women with the aggressive HER2 positive disease -- and they are also quite expensive. While some say they are worth every penny if they offer a cure, others question the cost if they only delay the disease progression for a few months. Such was the case in this study.

Perhaps the greatest potential for these agents is for use before breast cancer spreads, when they may improve the chance for a cure.

I know that after my surgery for breast cancer I wanted to start chemotherapy immediately, so much so that I had my first dose of Adriamycin and Cytoxan before my port was put in. I didn't want to have to wait for another surgery and more healing time before getting started with fighting the cancer that may be in my body.

A new study shows that it is safe to wait up until twelve weeks after surgery to start chemotherapy. This is important because it can give the patient time to recuperate after surgery and also can help them to have more time to make decisions about treatment options.

The women in the study received chemotherapy after surgery for Stage I and Stage II disease. The study showed that among the women who started chemotherapy within four to twelve weeks after surgery had an average survival rate of 86 percent at five years. It also showed however that waiting longer than the twelve weeks to receive chemotherapy can cause the patient to have a higher risk of recurrence and also lower survival rates.

"Our findings can reassure women with early-stage breast cancer that it is okay to take time before they start chemotherapy to gather information and be actively involved in treatment decision making. These steps have been shown to reduce anxiety and depression associated with breast cancer. However, to achieve the full benefit of chemotherapy, patients should not delay further, and should ensure that they start treatment within three months of surgery." said the lead author of the study, Dr. Caroline Lohrisch, a medical oncologist with the BC cancer agency.

I was in the emergency room the other night with my three-year-old who was experiencing a mysterious leg pain that resulted from a bad case of strep throat. It wasn't serious enough to warrant swift movement from the waiting room to an actual room and we sat in a holding pattern with a crowd of other patients, some of whom were still waiting after Danny had been treated and released. I was told patients are served in the order in which they arrive but also according to the seriousness of their complaints -- which takes me back to the night I was in the ER with a fever, headache, sore throat, and sore gums. The night I was given a mask and was immediately escorted from the waiting room to a private room where doctors and nurses treated me for neutropenia -- a condition caused by chemotherapy and marked by a drop in neutrophil levels, a condition that puts chemotherapy patients at great risk for infection. This was the second time I went to the hospital for neutropenia. Both times I was admitted and treated for five days.

And so sitting in the ER reminded me about how serious chemotherapy side effects can be. And it makes me want to caution all chemotherapy patients to never dismiss the signs that the body is suffering -- to never tough it out with the hope that a good night's sleep or a few days rest will straighten everything out. Because it may not -- and the end result may be tragic.

All chemotherapy patients should be briefed by their medical teams about when to call for medical assistance. For me, a temperature of 100.4 was the magic call-for-help signal. And twice, I called for help -- once in the middle of the night. But any symptoms , and definitely a combination of symptoms, are cause enough for a simple phone call. So don't delay. Don't excuse warning signs that your body is struggling. Don't second-guess your decision to notify a medical professional about your symptoms. Just call. It could save your life.

In January 2002, a young woman in her 30s Cynthia Storm went to see the doctor after she discovered a lump in her breast. When a mammogram and ultrasound failed to detect a tumor, the doctor did not order a biopsy, and because of this, Storm's breast cancer diagnosis was not made as soon as it could have been.

When the breast lump was eventually biopsied in October of that year, the cancer had spread.

Experts testified that the delay in diagnosis led to surgery and chemotherapy that might not have been necessary had the breast cancer been diagnosed earlier in the year. The jury awarded Storm $770,000, including $250,000 for pain and suffering, $150,000 for loss of life's pleasures, $100,000 for disfigurement, $50,000 for embarrassment, $20,000 for unpaid medical expenses and $200,000 for loss of earnings. Her husband, Christopher, was awarded $125,000 for loss of consortium.

There has been a great increase during the past 10 years in the number of women receiving mammograms in Florida. But shockingly, almost one million Florida women over the age of 40 have still not ever received mammograms. So the American Cancer Society has teamed with the Medical Quality Assurance Inc. -- and they have co-published a guide to help these women locate a mammography center that meets their needs. This guide is sorted by city and is available on the American Cancer Society website for quick and easy access.

I can only imagine how the numbers stack up in consideration of all states -- and not just Florida. I can only imagine why these one million women in my state alone have not reported for this critical test --perhaps reasons stem from lack of awareness, lack of access, lack of financial resources, lack of concern. I can only imagine that not everyone -- due to life circumstances -- can be a recipient of this potentially life-saving test. Like I was -- at the age of 34 with a small but aggressive cancerous tumor living in my left breast. My referral for a mammogram saved my life. And I can only imagine how many more women might be saved from the horror of breast cancer because a mammogram assisted in early detection. I can only imagine that the day will somehow arrive when all women -- of all ages -- are afforded the opportunity for this test. And that those who have the opportunity -- and the means -- decide to delay no further.

Someone once told me to think of cancer as a chronic condition -- an illness like diabetes or asthma that may linger for life and may require continual treatment. And while battling cancer, perhaps for life, I should just hope that medical advances occur and new treatments become available. And maybe, just maybe, the science of medicine will decrease by leaps and bounds the number of people who die from cancer.

During my own battle with cancer -- which has been 18 months long -- two new breast cancer drugs have hit the scene with rave reviews from researchers and medical professionals. This is good news for me because my type of breast cancer makes me a candidate for both drugs. Herceptin is one of these drugs -- given to women who are HER-2/neu positive -- that's me -- and over express a protein that makes the tumor aggressive. Herceptin is received over 52 weeks -- and I go every three weeks for a 90-minute infusion of this clear liquid that causes me really no side effects at all. It can be toxic to the heart but monitoring tests have revealed that my heart is not suffering at this time. And with just three more infusions to go -- one this Wednesday -- I will likely encounter no adverse reactions to this potentially life-saving drug.

And now Tykerb is making headlines. Tykerb, suggested for use with advanced breast cancer and manufactured by British-based GlaxoSmithKline PLC, is an experimental drug that delays the growth of tumors nearly twice as long as standard chemotherapy in patients who no longer respond to Herceptin. This finding, reported this past Saturday at a meeting in Atlanta of the American Society of Clinical Oncology, confirms initial findings about the promise of this drug -- that like Herceptin, made by Genentech, precisely targets tumors without killing lots of healthy cells. The difference between the two drugs is that Herceptin blocks the protein on the cell's surface and Tykerb does it inside the cell -- blocking a second abnormal protein too. And while Herceptin is given intravenously, Tykerb is given in pill form -- which may make it cheaper and easier to use.

While now part of an international study, Tykerb may be available to women in the United States later this year. And it perhaps will be offered in conjunction with Herceptin or instead of Herceptin for women with advanced breast cancer.

I hope I do not ever need Tykerb -- and that Herceptin alone will be enough for me -- but it is comforting to know that there is something else out there. Something that if necessary, just might help me live with this potentially chronic condition called cancer.