Women sixty five and over with early stage breast cancer who do not have radiation after surgery may have an increased risk of a local recurrence or development of a new primary breast tumor.

Half of the women diagnosed with breast cancer are sixty five and over. Past studies have shown that older women are less likely to be offered chemotherapy, hormonal treatments or radiation. Young women are more likely to receive aggressive treatment for their breast cancer.

This study showed some important things:

1. Women in the study who had a lumpectomy without radiation were found to have an greater risk of a local recurrence.
2. Women in the study who received hormonal therapy and stayed on their treatment for the full five years had less of a recurrence rate than those who prematurely stopped the medication.

If you are over the age of sixty five and have been diagnosed with early-stage breast cancer, talk to your doctor about the risks and benefits of receiving radiation after surgery.

1600 years ago, about 400AD, an inherited form of melanoma began from a genetic mutation that occurred in a single ancestor, according to Glasgow University researchers who traced the genetic mutation back 88 generations. Upon further investigation, a number of Scottish families, presently living in Scotland, as well as Australia, Canada and America, were found to carry the specific genetic mutation that puts them at an increased risk for a certain type of melanoma.

According to the researchers, one in ten patients diagnosed with melanoma have a strong family history of the disease and between 20 to 40 percent of those patients carry a high-risk faulty gene known as CDKN2A. The Scottish mutation in this gene is known as M53I. With these genetic discoveries, there is hope that gene therapy can be developed to repair damaged genes in cancer cells.

Leroy Sievers is a journalist who has spent a long career covering dozens of wars. He is accustomed to seeing other people die. But now, he is witnessing his own death. And on a recent NPR podcast, Sievers talks about how his doctors are trying to kill him by pumping poisonous chemotherapy drugs into his body. They haven't succeeded in killing him yet -- but they haven't cured him of cancer yet either.

Blogger Dalene Entenmann wrote about Sievers on July 3, 2006, pointing readers in the direction of his NPR blog My Cancer. Since her posting, Sievers has continued to reflect on his battle and on October 3, he shared an essay about chemotherapy -- the same essay he reads on the NPR poscast. He tells readers and listeners that nowadays he reports for chemotherapy every three weeks and sits for five or six hours while drugs sail through his veins. The drugs just keep coming -- and a vacation from this drug treatment is nowhere in sight. It's become a way of life for a man who is simply buying time. It is a changed life -- one he would happily live without.

Sievers, who thought he won the war against colon cancer and is now fighting brain and lung cancer, wakes each morning and feels pretty good -- as long as he stays in bed. When he gets up, the nausea begins and the tingling in his hands and feet begins. It takes him hours to get going, and eating is the last thing on his mind. But he takes pills that require food so giving up food is not an option. Sievers fights through debilitating fatigue each day, and no longer schedules anything in the morning. Mid-day -- when he feels pretty good -- is when he packs in appointments and meetings. But it all wipes him out and by the end of the day, the nausea and fatigue is back. One-quarter of one day, and Sievers is totally spent. And then each evening is a repeat of each morning.

Sievers is trying a new drug and hopes it will shrink his tumor. He doesn't want to get his hopes up though, and he fears disappointment. Mostly, though, he wants his old life back. Even if just for a few days.

I don't take for granted that I am alive. I am fully aware of it, consciously grateful for it, continually amazed by it. Before I was confronted with breast cancer, I still knew I could die -- in a car accident maybe -- but I thought chances were pretty good that I would make it to a ripe old age. Death was never at the forefront of my mind. I had no reason to believe that life could be snatched from me. And because of this, I am sure some pretty important moments slipped by me, virtually unnoticed. But now -- after a breast cancer diagnosis, surgery, chemotherapy, radiation therapy, and then more therapy, I realize life is not a guarantee for anyone. Me included. Even at age 36, I am not safe. I feel confident about my future -- and I believe cancer has left my body -- but my life has been threatened like never before. And that makes me wake up and take notice -- really notice -- the moments that are too important to take for granted.

My first baby boy starts kindergarten today. Before cancer, this still would have been a monumental day for us both. But now, after cancer, it's even bigger. Because I know of several moms who did not survive cancer long enough to see their children walk through their first classroom doors -- moms who thought, like me, that they would surely beat cancer and would see their kids off for every first day of school. So I am lucky to have made it to this day -- to witness the wonder of my sweet, shy, sensitive, challenging, demanding, loving boy as he leaves the comfort of home for the real world.

Two days ago, my littlest guy said, "Mommy, I love you and want to keep you forever." Joey -- the boy whose wisdom should guide him right through his first day of school -- said, "Danny, you can't have mommy forever. One day she will die, and you will never see her again." Fortunately, his harsh meaning was lost on three-year-old Danny who kept playing with whatever toy was occupying him at the time. But his meaning was not lost on me. He spoke the truth. And so I plan to soak up the kindergarten moment this morning -- and photograph it and write about it and cherish it for my days to come. And in two years, I hope to do it again with Danny as he starts off on the same path. With me by his side.

Kids can be so positive and encouraging, even in the face of sickness. Now today my kids have just a simple sickness -- nothing life-threatening -- that I'm sure will pass in a day or so. They are throwing up every content of their little tummies -- even sips of water -- and they are pale and lethargic and run-down. But still, they have hope for a brighter tomorrow. This morning, five-year-old Joey said to me while resting in my bed and just after he threw up , "this is just the good getting rid of the bad." He went on to explain how the good in our bodies knows when to push the bad out. And this is what is happening to him today, he said. He is throwing up the bad so the good can take over. Simple. Easy. Makes sense.

I never saw my own sickness like this. Instead of visualizing chemotherapy as a good agent that kills bad cells, I was repulsed by the horrific liquids that poisoned my body. I knew of people who were able to turn chemotherapy into a Pac-Man game -- with Pac Man chomping away at the cancer cells and leaving nothing but healthy cells to thrive. And I knew people who were relieved to feel sick because it meant the chemotherapy was working. I never saw it like this -- although I do know that chemotherapy may have saved me from a life with cancer. I was discouraged by chemotherapy. I had a negative attitude about it, and I had to really gear up for all of my infusions. I still -- more than one year later -- cannot eat anything I ate on my chemo days. The mere thought of these foods makes me feel ill.

A pediatrician friend of mine told me that kids with cancer tend to be positive. There are a few old souls, she said, but for the most part, they continue to tackle life with spirit and adventure and simplicity. Like my boys today who are peacefully napping at the moment so everything good in their bodies can come back with a vengeance.

Several boxes containing injections of Neulasta have lined the bottom of my refrigerator for more than a year. They are left-overs from chemotherapy -- from a time when one needle pierced the skin on my arm after each chemo treatment to keep my blood counts in a safe range. I've looked at them day after day after day, and I've allowed them to sit in the same exact spot for all this time. But today, they are in the trash -- not because I made a conscious choice to throw them away but because water spilled all over the inside of my refrigerator and left them soggy and damaged. Surely I would not have used them in this condition, I thought -- so I tossed them. But really, I would not have used them anyway. They were old -- probably past their expiration date -- and I am not receiving chemotherapy anymore. I had absolutely no use for them. But I kept them for safety or comfort or some other impractical reason -- for the same reason I keep a basket full of old medication in my kitchen cupboard. It's all cancer-related -- most of it never touched because I don't really like taking medication, even when necessary. So this stock-piling tendency defies all logic for me. Until today -- when part of my past sits in a white trash bag, ready for the curb, and the rest of it is soon to be trashed. So I can continue moving forward. Away from cancer. For good.

Apple CEO Steve Jobs delivered a commencement speech at Stanford University on June 12, 2005. It was about following curiosity and intuition, about looking back and connecting the dots in life, about beginnings and endings, about death. Jobs, a survivor of pancreatic cancer, knows a thing or two about facing death. And the words he chose to relate his life-threatening experience to a crowd full of hopeful graduates are powerful and inspiring. I could paraphrase his message -- but surely something would be lost in my translation. So here is a bit of what he said -- word for word.

I told my little guy Danny today that he and his big brother would be going to their Nana's house so I could go to the doctor -- for an echo-cardiogram to test for possible heart damage due to Herceptin therapy for breast cancer. Danny -- age three -- asked me, Why you keep doing that? This is the same question he keeps asking -- because he wants to know why I keep going to the doctor. I give him the same answer each time -- that I need to keeping seeing doctors so I can stay healthy. He always seems satisfied with this response, although he continues to ask the same question. He either forgets that he's already asked or he forgets my response or he finds comfort in my routine answer -- or perhaps he is completely aware of his repeat question and just wants me to provide a better explanation. Which is hard to do -- in a three-year-old kind of way -- when my response is the best I've got. I keep going to the doctor in search of health. It's simple. And fortunately, so is Danny -- simple in a young and innocent and pure way. And Joey is too.

Right after my exchange with Danny, Joey -- age five -- said to me, Won't you be glad when you don't need to go to the doctor and you can be healthy all by yourself? Yep, I told him and then realized that these boys have a definite pulse on my cancer journey -- almost two years after it started. They wonder about it and try to figure it out and predict how I must feel. And through it all, I am happy they are involved with me in this intricate adventure. And I am concerned at the same time that what they do know may cause them some stress, some worry, some uncertainty about our future together. My hope is that this experience in their young lives strengthens them, humbles them, prepares them for a future that is not always as simple as the responses I give them about an illness that is so complex. But when it comes down to really simple terms -- that we all can appreciate -- I have my boys and they have me and for today, that is all that matters. Well, that and the fact that my echo-cardiogram today revealed that my heart is just fine.