Blog – Sharsheret http://sharsheret.org Jewish Non-Profit Supporting Breast Cancer Survivors Fri, 17 Feb 2017 17:38:16 +0000 en-US hourly 1 https://wordpress.org/?v=4.7.2 http://sharsheret.org/cms/assets/uploads/cache/2016/11/cropped-logo-sharsheret/602533622.png Blog – Sharsheret http://sharsheret.org 32 32 Someone Who Was In My Shoes http://sharsheret.org/someone-who-was-in-my-shoes/ http://sharsheret.org/someone-who-was-in-my-shoes/#respond Thu, 09 Feb 2017 20:29:22 +0000 http://sharsheret.org/?p=104341 When Sharsheret asked me to speak, I jumped at the opportunity. I was happy to be able to give back … Continue reading

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When Sharsheret asked me to speak, I jumped at the opportunity. I was happy to be able to give back to such a wonderful organization. Generally I am a really private person, but I felt if someone who unfortunately is going through cancer could gain from my experience, then somehow my pain wasn’t for naught.

On November 24th 2014, my doctor told me the words that everyone dreads and nobody wants to hear. It was an ordinary Monday and I went for a routine mammogram, but it turned into a day that I will never forget. I was petrified. All I remember saying was that I do not want to lose my hair. I had thick, gorgeous, long, auburn hair. The next few days were a blur. I do not think I was able to stop crying. When the doctors finally confirmed that indeed I did have breast cancer, I just sat there. My husband and siblings cried as well. I do not think a person can ever be prepared to hear the words that they have cancer. I was so young. When did I become so grown up to make such big decisions like a proper treatment plan and which doctors to use? How does a person know that they are making the right decisions? Unfortunately for me, the cancer was too advanced and chemo was a must. I worried about my kids, being that they are so little and need their mom. I also knew that the year would be hard on everyone as I would be unable to be there for them the way that I used to.

The treatment plan was rough. There are not enough words to explain what chemo can do to a person, nor can one understand it unless they have been through it. I think the hardest part for me was not being able to take care of myself, my kids, and my house; not being able to remember things; and not being able to focus on simple tasks. In addition to all of this was the realization of how little control I actually had over my situation. I used to pride myself on doing everything on my own. As most of us know, being sick with cancer unfortunately takes away our strength. But when I was sick, I needed to ask people for help and that was really hard on me.

I made the decision not to tell people that I was sick. I did not want anyone’s pity or to be labelled and looked at differently. I told my siblings, a few close friends, and my work. I did not even tell my children, as I felt they were too young. There were many nights I cried myself to sleep, and I cried that I wanted to give up. The emotional and physical pain was too hard to deal with.

I heard about Sharsheret from a family friend, but didn’t reach out to them until about half way into my treatment plan. But I was really glad I did and, looking back, I wondered why I didn’t reach out sooner. When I finally contacted Sharsheret, they sent me a package with a bunch of useful information and I asked to be signed up for peer support.

At that time, I was preparing for my second surgery. I called Sharsheret and asked to speak to someone who had a similar surgery, and was connected to Sarah. When I reached out to Sarah, I was immediately comforted and I felt at ease. It was really good to speak to someone who was in my shoes, who understood my fears. We each shared our stories and spoke for a while. I asked detailed questions about what to expect and she gave me her honest opinion but, also, she also gave me strength which helped me through my surgery. Sarah called me after my surgery to check up on me. I was so touched, she remembered, reached out and checked up on me.

Sarah and I kept up and I reached out to her for questions many times after that second surgery. She gave me hope when I needed hope and a shoulder to cry on, when I just felt like crying. For me, I put up a front to the outside world, no one really knew I was sick and I somehow had it in my head that I needed to put up a front for my family as well. My outlet with Sarah allowed me to express my feelings to someone I knew who was in the same shoes, who wouldn’t judge me and tell me that everything would be ok. When I spoke to her it was a like a heavy weight was lifted off my chest, we shared some of the same fears and some of the same experiences. Obviously, each one of our experiences is unique and different, but in general I think that we each can share each other’s pain and fears.

A few months later, after I decided to become a peer supporter, I was asked by Sharsheret to be someone’s support, and of course I said yes. To me it was a very healing experience to be able to help someone through their cancer hardships and pain. We spoke for a while and I listened. I was now on the other side and was able to realize what this young mom needed. Just someone to listen, and feel her pain. I thanked her for sharing her story with me and expressed to her what a healing process it was for me to be able to give back. I reached out a few times to check up on her and she reached back and gave me updates.

It has been over 2 years since I was diagnosed, and I am, thank God, finished my treatment. They say God brings the healing before the illness and I can see how true this statement really is. My help and strength came from the most unexpected people. Sharsheret and my peer supporters are on the top of the list. I drew strength from other women who had breast cancer or are currently being treated for breast cancer. They became my heroes and hope. Sharsheret’s Peer Support Network is a great support system for connecting with other women who have been in your shoes. I realized that we cannot take our loved ones for granted and we should never judge people until we really get to know them. People I did not even know shared their stories and gave me courage and strength to fight. I became stronger, and, oddly enough, more comfortable in my own skin.

I pray that g-d will continue to give me strength and good health, and the opportunity to give back to others who are bravely fighting. Sharsheret, thank you for ensuring that no woman going through breast or ovarian cancer goes through it alone.

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What to expect when you are expecting….a mammogram http://sharsheret.org/expect-expecting-mammogram/ http://sharsheret.org/expect-expecting-mammogram/#respond Wed, 08 Feb 2017 19:11:52 +0000 http://sharsheret.org/?p=104295 Your first mammogram can be a daunting experience. Whether it’s concern about the discomfort, fear of the unknown, or nervousness … Continue reading

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Your first mammogram can be a daunting experience. Whether it’s concern about the discomfort, fear of the unknown, or nervousness that develops while awaiting test results, one thing is clear: anxiety is the enemy of the screening mammogram. In fact, anxiety is the leading reason why women delay or even skip their recommended annual screening mammogram.

A small study was published in October 2015 in the Journal of the American College of Radiology which evaluated the impact that public education about screening mammography had on attitudes toward receiving a screening mammogram. The results overwhelmingly demonstrated that understanding the process, reason and results can strongly decrease anxiety and encourage participation in this important health screening program.

The American College of Radiology, American College of Obstetrics and Gynecology, American Medical Association and National Cancer Institute recommend annual screening mammography beginning at age 40. As a physician, my goal here is to try and explain the screening mammography process with the hope of decreasing the anxieties surrounding it.

If you are a woman going for a mammogram, the first thing you should know is that there are two categories of mammograms; screening and diagnostic.

Screening mammograms require an appointment and at certain offices can be hard to get, so call early and schedule the appointment in advance. Upon arrival, you will be met by a technologist and will be asked a series of questions or to fill out a form providing family history and any recent symptoms. The mammogram exam includes 4 pictures- two of each breast. Please note that there are strict guidelines as to what the picture must look like in order for the doctor to interpret it properly, so your technologist may need to take additional pictures. If this happens, take a deep breath – this does not necessarily mean there is something wrong with your breast.

The next step depends on the office you visit. You may receive the results the same day during your visit, via access to an online patient portal, or by mail 7-10 days after the exam.

Approximately 10% of the population will be notified that they need additional imaging, or what’s referred to as a diagnostic mammogram. A positive screening mammogram does not necessarily mean cancer – it simply requires another look at the breast tissue. Further evaluation may be required for various reasons including a change in the appearance from the prior year, a fold in the skin, or poor angle. The majority of the time the problem or suspicion is solved with the additional images or an ultrasound exam.

If you are experiencing breast related symptoms such as a new lump, pain, nipple discharge or skin changes, even if you’ve already had a negative screening mammogram in the past year, it is important to contact your physician as you may need a diagnostic mammogram evaluation.

In summary, it’s important to know that 1 in 8 women in the U.S. will be diagnosed with breast cancer in their lifetime. Screening programs are therefore essential in order to catch the disease at an early treatable stage. Instead of allowing the anxiety surrounding the process to serve as an obstacle in your healthcare, choose to empower yourself with a mammogram.

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Ask the Expert: BRCA Genetics http://sharsheret.org/ask-expert-brca-genetics/ http://sharsheret.org/ask-expert-brca-genetics/#respond Tue, 31 Jan 2017 21:16:35 +0000 http://sharsheret.org/?p=104225 During our webinar, “BRCA Genetic Testing: Understanding the Physical, Emotional, and Financial Challenges,” we received a variety of questions on … Continue reading

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During our webinar, “BRCA Genetic Testing: Understanding the Physical, Emotional, and Financial Challenges,” we received a variety of questions on the topic. Peggy Cottrell, MS, CGC, Genetics Program Coordinator, is pleased to answer your individual questions and concerns below. If you have additional questions, please contact us.

1. If I have a strong family history of ovarian cancer, and already had a prophylactic hysterectomy, should I still consider a prophylactic mastectomy?
If there is no history of breast cancer, only ovarian cancer, then genetic testing would be recommended to help determine whether there is an increased risk for breast cancer as well. If the results are negative, it is unlikely that there is something hereditary causing breast cancer, and you would not meet medical guidelines to recommend bilateral mastectomy. If the results are positive, a prophylactic mastectomy would be an option. If there is a strong history of breast cancer, the genetic test is still a good idea. One way or the other, it would be important to continue careful age appropriate breast cancer screening. If you have genetic counseling, the genetic counselor will help advise you on the best medical management, based on your family history and the results of testing.
2. Where can one go for voluntary BRCA testing?
You can see any genetic counselor; the counselor will take your personal and family medical history. If you have no personal or family history of breast, ovarian, prostate or pancreatic cancer, multisite testing is likely the most appropriate test for you. Multisite testing looks at the three mutations in BRCA1 and BRCA2 that are common in people with Ashkenazi Jewish ancestry. The non-insurance price for this test is a few hundred dollars. There are also discounted testing programs which may be available in your area. You can contact Sharsheret for specific information.
3. If I had BRCA testing done in 2008, and was negative, is there value of getting tested again?
The testing that is done now is different than testing that was done in 2008. Whether or not you need additional testing depends on several factors. First, you need to be able to tell your provider what type of testing was originally done. In 2008, Myriad Genetics was the only commercial laboratory doing genetic testing for BRCA1 and BRCA2. If you no longer have a copy of your result, you can call their customer service (800-469-7423) and get a copy sent to the ordering provider, who can have it sent to you. Second, it depends on your personal and family history of cancer. If you are low risk, you may not need additional testing. Finally, it depends on your insurance. The best way to figure this out is to call a genetic counselor, ideally the one who did your original testing. He or she will take a look at your current family history and previous testing and let you know if you are a good candidate for updated testing.
4. Is there still a benefit of prophylactic surgery if my BRCA gene was passed from my paternal side?
Yes. Mutations inherited from your father are indistinguishable in your body from mutations inherited from your mother. The risk for cancer is the same, whether it was maternally or paternally inherited.
5. Is there any connection between Tay-Sachs and BRCA?
No, except that both mutations are seen more commonly in individuals with Ashkenazi Jewish ancestry.
6. If a woman is tested for BRCA, what are the implications for her children?
If a woman tests positive for BRCA, her children have a 50% chance to inherit the mutation that she carries. If she tests negative, her children cannot inherit a BRCA1 or BRCA2 mutation from her. However, they may have inherited a BRCA1 or BRCA2 mutation from their father.
7. What other gene mutations, besides BRCA, are being researched at this time?
There is a large amount of research going on looking into genes that predispose people to develop cancer. Some studies look for genes that we have not yet identified that can predispose to cancer. Other studies look at the genetic mutations that are present in tumors to try to understand how they lead to cancer and whether their presence gives us any information about treatment. We may also see hints of genes that are hereditary in these types of studies. There are also studies that look at the cancer risks that go along with cancer predisposition genes that we have already discovered but don’t yet understand that well. There are hundreds of genes that have been implicated (some in small ways, some in big ways) in the development of cancer. Finally, we study the uncertain variants that sometimes are identified during testing to see if we can determine their importance.
8. Can Jewish women get nipple tattooing? Is this a conflict with the Jewish law against tattooing?

This issue is very personal and individual, and women who are concerned about this should ask their own rabbi.

9. Ovarian cancer screening methods are often not effective. What ovarian surveillance would you recommend for high risk women?

National guidelines only recommend ovarian cancer screening for women who carry a gene that predisposes them to ovarian cancer. The screening includes a pelvic exam, transvaginal ultrasound, and CA-125 blood test, done every 6 – 12 months. However, ovarian screening has not been shown to improve survival in the cases of ovarian cancer it identifies. Ovarian screening is only a short term measure to be considered until high risk women have prophylactic surgery, which would typically be the removal of their ovaries and fallopian tubes. High risk women should speak to their physician to determine the optimal screening method.

10. Is there risk for colon cancer with BRCA1/2 mutations? What other cancers are associated with the BRCA gene?

Early studies seemed to identify an increased risk for colon cancer, and, rarely, families with mostly colon cancer are found to carry a BRCA1 or BRCA2 mutation. However, most subsequent studies do not find carriers of BRCA mutations are at an increased risk for colon cancer. We recommend that BRCA carriers be careful to have their colonoscopies as indicated by the general population screening guidelines, which suggest a colonoscopy at age 50. Individuals may also consider a colonoscopy at an earlier age than 50 if there is a history of early colon cancer in the family.

BRCA1 and BRCA2 carriers may be at an increased risk for various types of cancer, including the significant risks for breast and ovarian cancer. The other cancers for which there is a small increased risk include pancreatic cancer and prostate cancer. There may also be small increased risk for melanoma, stomach, and papillary serous uterine cancer.

11. Do most BRCA positive breast cancers occur before menopause?

Many, but not all, BRCA1 and BRCA2 positive breast cancers occur before menopause.

12. If BRCA raises the risk of breast cancer so significantly, why are so few people who have breast cancer BRCA+?

BRCA1 and BRCA2 mutations are much rarer than breast cancer itself. Approximately 2% of Ashkenazi Jewish women will carry a BRCA1 or BRCA2 mutation, while 12 – 13% of Ashkenazi women will get breast cancer. Most breast cancer is not hereditary, and happens for reasons we can’t explain.

13. If someone tests negative for a known genetic mutation, but has other risk factors that make them high risk according to breast cancer risk calculators, are they still considered high risk?

They may still be considered high risk; it depends on the other risk factors. It is important to include all of the information in the breast cancer risk calculator, including testing negatively for a known mutation in the family. This is a question which can be addressed by your health care provider.

14. Is it possible to be BRCA+ without any known family history of BRCA or breast cancer in the family?

Yes, we think that approximately 2% of individuals without a personal or family history of breast, ovarian or pancreatic cancer will carry a mutation in BRCA1 or BRCA2.

15. How do you suggest removing the stigma around testing and taking control of the process?

As more people talk about being carriers, the stigma is reduced. As a genetic counselor, I meet and speak with many carriers. I know that most of them, after taking the necessary steps to have screening and/or prophylactic surgery, live long and full lives. It can also help when famous people, like Angelina Jolie, speak out publicly about their own experiences with being a BRCA1 or BRCA2 carrier. Finally, we at Sharsheret can help women take control by helping to educate and support them through this process. It helps to know you are not alone.

16. How can you get insurance to cover CA-125 blood test since it’s typically administered to those who already have cancer?

The reason CA-125 is not covered by insurance is that it has not been proven to be an effective screening test for women who have never had cancer.

17. Do you think it’s essential to work with a genetic counselor during the testing process or is working with an OB-GYN sufficient?

I think it is very beneficial to work with a genetic counselor. Many who call Sharsheret with questions have not had genetic counseling. Sometimes they have received misinformation about genetics from non-genetic providers who ordered their testing. An OB-GYN may not work with enough labs to find the one that will accept your insurance. You may think you are not covered, when in fact you may have either had the wrong test ordered, or the wrong lab utilized. Your OB-GYN does not have the same expertise in genetics as a genetic counselor.

18. If people don’t know if they are Ashkenazi or not, how can they know if they are a carrier or are likely to be a BRCA carrier?

People who are not Ashkenazi can still be BRCA1 and BRCA2 carriers. If you are not sure if you are Ashkenazi, speak to a genetic counselor about your ancestry to be sure you are getting the genetic test that you need.

19. What are the implications of population testing among Ashkenazi Jewish women for long term studies and research for cures and treatments?

I don’t think the main reason for population screening is to increase research. The main goal is to identify women at high risk and offer them high risk screening and prophylactic surgery. Some researchers wonder if families with BRCA1 and BRCA2 mutations who have significantly less cancer have genetic factors that protect them. This may be an area of research for these families to pursue. If population screening for Ashkenazi women is effective, it may be considered for other populations.

20. Do insurance carriers pay for prophylactic surgery and/or reconstructive surgery?

In most cases, insurance pays for these procedures. It is much less expensive to pay for surgery when someone does not have cancer than to pay for the treatment of cancer, as chemotherapy and radiation therapy can be very expensive.

21. If a woman has already had breast cancer, should she have BRCA testing?

The person in the family who has been diagnosed with cancer is almost always the best person to have genetic testing. This is because they are the most likely person in the family to carry the genetic mutation. If no mutation is identified in the person with cancer, other family members may not need the genetic test. Women recently diagnosed with breast cancer may use the result of the genetic testing to decide if they should have a bilateral mastectomy instead of a lumpectomy or single mastectomy. People who have had breast cancer once can unfortunately develop it a second time, so women with a genetic predisposition may be encouraged to have the more extensive surgery. We also want to be sure to remove the ovaries and fallopian tubes of someone who tests positively for BRCA1 or BRCA2 at the proper time. Prophylactic surgery may not be necessary in someone whose testing is negative.

22. How do I find a genetic counselor in my geographic area?

Go to the website of the National Society of Genetic Counselors (www.nsgc.org) and use the “Find a Genetic Counselor” function. You can type in your zip code to see who is available in your area. You can also look at the NSGC pages designed for the public (http://aboutgeneticcounselors.com/).

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Living with Passion http://sharsheret.org/living-with-passion/ http://sharsheret.org/living-with-passion/#respond Tue, 10 Jan 2017 17:05:17 +0000 http://sharsheret.org/?p=103530 Tamera is a registered yoga teacher and focuses on helping individuals who are interested in using yoga to help with … Continue reading

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Tamera is a registered yoga teacher and focuses on helping individuals who are interested in using yoga to help with overall health and wellness.  Tamera teaches at the Miami Jewish Community Center and is running a free survivor yoga and dance program that is open to survivors at Baptist Hospital in January 2017.

I was on my lunch break when I received an incoming call which resulted in learning I had breast cancer in early January of 2015, and I can only say I was in shock. They needed me to see an oncologist as soon as possible. I had two weeks to make a decision about surgery and treatments, my children were my first concern. Who would take care of my children if something happened to me?

I had gone in for a routine mammogram in 2014 which resulted in having to go back for repeat testing and then a biopsy in December of 2014. Little did I know how helpful yoga, meditation, and general mindfulness would be in helping me heal. Sharsheret helped me after surgery and I benefitted from their outreach and Thriving Again Survivorship Kit.

During my diagnosis, I was initially told I would need chemotherapy and radiation, but with yoga and wellness related supports I was arming myself to do anything I could to manage a successful outcome. After my lymph node testing and double mastectomy, I learned I may not need the additional treatments. I feel fortunate to have caught everything early and to have empowered myself with alternative treatments and general wellness.

I did experience lymphedema along the way and had severely lost range of motion in both arms following surgery, but a year and four procedures later I am back to having full range of motion. I continue to eat healthy, exercise, and practice yoga which helps reduce swelling in my right arm. I am grateful to be in recovery and to have met so many supportive women.

I proudly work with the Cancer Support Community of Miami helping adults and children diagnosed with cancer learn to breathe, meditate, and practice yoga or general mindfulness for health, healing, and pain management. I have also proudly become part of the Peer Support Network with Sharsheret.

I hope to do more work to increase awareness of mindfulness based coping and I hope to eventually educate more physicians and support staff on the importance of referring their patients to mindfulness based approaches for healing in coordination with traditional treatments.  The research on yoga and mindfulness is showing positive results in empowering individuals to manage wellness and healing in times of illness. In line with Cognitive Behavioral Therapy, I am aware we can’t change what happens to us in life, but I choose to live with passion and make meaningful choices over how I cope. Maybe along the way I can now help others learn to live a more empowered life.

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Reflections Of An OR Nurse http://sharsheret.org/reflections-of-an-or-nurse/ http://sharsheret.org/reflections-of-an-or-nurse/#respond Tue, 27 Dec 2016 22:05:26 +0000 http://sharsheret.org/?p=103103 Nursing was something I never considered.  When my mother-in-law was diagnosed with breast cancer in the 1970s, I wasn’t a … Continue reading

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Nursing was something I never considered.  When my mother-in-law was diagnosed with breast cancer in the 1970s, I wasn’t a nurse.   I still wasn’t a nurse when my mother was diagnosed with breast cancer in 1980.  I was working in the corporate world—as non-nursing as one could get. By the time my mother’s cancer had metastasized, I was already in nursing school.  I was interested in health care. I thought it was a practical profession with the potential to work flexible hours, raise a family, etc.

In March 1994 it was apparent to all that my mother would not live to see me graduate that May.  She would not live to see me “pinned.”  One of my professors offered to travel to my mother’s hospital room and “pin” me in front of my mother, even though graduation was still two months away. I never forgot the kindness of this teacher. This nurse.

I was fortunate to become an Operating Room nurse. Somewhere along the line, I developed a niche in the area of breast surgery with or without reconstruction. It meant so much to me to be able to speak to these women while they waited to go into the operating room.  To hold their hands.   To answer their questions.  To speak to family members.   To assure them all that I would be at her side while she went to sleep.  That I would make sure she was safe, warm and comfortable.  That I would protect her during the procedure. That I was the eyes and ears for all that was going on in the room.  That everyone on the team was there for HER.

I was so fortunate to work with a team of surgeons and anesthesiologists who shared my passion and my compassion.  We left no stone unturned to ensure a positive outcome for our patients.  These women could be our sisters, our mothers, our daughters.  We all felt such a vested interest in caring for our patients.
I retired in June 2016.  I miss my surgeons.  I miss my patients.  But I continue working with women while they are undergoing mammograms and ultrasounds in my local hospital. I am a volunteer —but I still have that same compassion and passion that I also hope to bring as a volunteer for Sharsheret.

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Healthy Eating and the Holidays http://sharsheret.org/healthy-eating-holidays/ http://sharsheret.org/healthy-eating-holidays/#respond Mon, 19 Dec 2016 20:43:19 +0000 http://sharsheret.org/?p=102864 A healthy diet can greatly reduce your risk for cancer. Sharsheret Medical Advisory Board Member Tanya Zuckerbrot, a Registered Dietitian … Continue reading

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A healthy diet can greatly reduce your risk for cancer. Sharsheret Medical Advisory Board Member Tanya Zuckerbrot, a Registered Dietitian in private practice in New York City and the Founder of the popular F-Factor Diet, shares the following tips to help you keep yourself and your diet in check over the holidays:

PITCH IN, (OR TRY TO) – If you’re not hosting this year, contact whoever is and offer to bring something. Even if the host tells you it is unnecessary to bring anything, simply say “I’d love to participate. What are you planning on serving?” By doing this, you can learn ahead of time what is being served at that gathering, giving yourself the opportunity, and ample time, to think about the food choices you will make there, and leading up to the meal. If the host concedes to letting you bring something, the fork is in your hand to bring a healthy/ healthier version of a dish.

SPOIL YOUR APPETITE – Don’t go into a holiday gathering or festive meal hungry. Instead, have a satisfying snack beforehand that includes both fiber and protein. Fiber and protein are the two nutrients that take the longest to digest, so they keep you feeling full for a longer period of time. By filling up before you go, you safeguard yourself from arriving in a ravenous fury of hunger, tempted to make irresponsible food choices. Good pre-party snack ideas include an apple with a handful of almonds, high fiber crackers with sliced turkey or Greek yogurt and blueberries. Also make sure you drink plenty of water throughout the day as dehydration often mimics the symptoms of hunger, and thus can further cause you to overeat.

PORTION CONTROL – Although the holiday season is full of indulgent celebrations, remember to celebrate the actual HOLIDAY, it’s one day. Be mindful of both what you choose to eat and the amount you consume. Do not go up for seconds or thirds. When making your plate, start with vegetables and salad before going to the entrees and desserts. For a visual cue, imagine your dinner plate as a peace sign, the two side portions are each 35 percent and the bottom is 30 percent. Put lean protein (6 oz for men, 3-4 oz for women) on one side and vegetables on the other. The starchy sides or dessert gets the smaller bottom section.

SAY “NO, THANK YOU” – Remember, you’re invited to the holiday gathering for your charming personality – not your ability to lick all the plates clean. People often feel pressured to eat, and overeat, as to not be rude to the host, and think everyone will notice and judge if they do not try a dish. In reality, there’s little chance anyone will even notice that you didn’t try everything. It’s okay to say “no, thank you”! If you’re still concerned, play it down and say, “everything was delicious. I’m full” or ” try me later.” Then sit back and enjoy the rest of the evening and the food that you decided to eat.

KEEP A FOOD DIARY – Writing down every morsel of food that you eat during this tricky time of year will help keep you accountable and focused on your health and nutrition goals. It is easy to forget about the 5 peanut M&M’s you grabbed off your co-workers desk, or the Santa cookie you grabbed after the meeting, but you will be much less likely to grab for these treats if you know you have to write them down in your journal later.

The importance of healthy eating for cancer prevention:

Research has found that a higher consumption of plant foods can be protective against certain cancers. Fruits and vegetables contain high amounts of antioxidants which help the body protect against oxidative damage DNA. This oxidative damage can lead to mutations and increased risk of cancer.

Plant based foods also contain dietary fiber. Consumption of dietary fiber has also been linked to reduced cancer risk, especially breast and colorectal cancer. As reported in the Journal of Clinical Oncology (July, 2004) researchers found that a diet including 20 to 30 grams of fiber per day can lower blood estrogen levels, which can help reduce risk for breast cancer as estrogen stimulates the early growth and development of breast cancer—the less estrogen you have in your body, the lower your cancer risk. In terms of colon cancer specifically, but true for all cancers (except skin cancers) fiber helps reduce risk by binding to or diluting carcinogens in the gut (from toxins in our food supply and environment) and speeding them through the colon. By getting toxins out of our system before they can cause damage is one of the things we can do to protect ourselves. In addition, regular elimination is, by itself, beneficial to your overall health.

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Breast Cancer Awareness Does Not End on October 31 http://sharsheret.org/breast-cancer-awareness-not-end-october-31/ http://sharsheret.org/breast-cancer-awareness-not-end-october-31/#respond Mon, 05 Dec 2016 20:29:45 +0000 http://sharsheret.org/?p=102707 Time collapses each time I have my annual mammogram. Months and years fold in upon themselves like an accordion. My … Continue reading

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Time collapses each time I have my annual mammogram. Months and years fold in upon themselves like an accordion. My last mammogram was a year ago and yet, as I signed in at the reception desk today, it felt like I had just checked in not a month before. How does the just-been-here-just-done-this feeling surface every year?

Millie Ibarra, our family nanny and dear friend, is a ten-year breast cancer survivor. I made my mammogram appointment today, November 30, to honor her birthday. I know that it has been more than ten years since Millie’s diagnosis, but when I put on the robe before the mammogram, time collapsed for me. It felt like just a moment ago that I was sitting in an office at UMDNJ with her, listening to Dr. Clark tell us that Millie had stage four breast cancer.

My mother and maternal aunt both died of metastasized breast cancer. I bring them with me into the cold, antiseptic room with the spaceship-like imaging machine every year, wishing that they had benefited from all the advances in breast cancer diagnosis and treatment of the past decades. Although my mother’s twentieth yahrzeit is in two weeks, it feels like just a minute ago that she was on the phone, telling me that the cancer had spread and that it was time for me to come home to help her. I packed up Josh, just five months old, left the older three at home with Jon and flew to Maine. Time collapses.

For my mom and my aunt and Millie and my friends, and for the scores of women at the Orangetown Jewish Center who are fighting or have fought breast cancer, I religiously make my annual mammogram appointment. And I go on time. I say a prayer, smile bravely through the test and leave, hearing the precious words, “Looks good! We’ll mail the report.” The Breast Center provides bouquets for every woman and I always choose yellow roses, my mother’s favorite.

One year, the technician could not find any yellow roses amidst the pinks and reds. When I burst into tears, she put her arm around me. “Don’t take any roses this year,” she said. “Next year, take two”. I am one of the lucky ones; the seven in eight, not the one in eight.

With prayers for good health,
Rabbi Paula Mack Drill

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Benefitting from Benefits http://sharsheret.org/benefitting-from-benefits/ http://sharsheret.org/benefitting-from-benefits/#respond Wed, 30 Nov 2016 20:28:04 +0000 http://sharsheret.org/?p=102704 Shanna Lehmann Wolf is a financial representative at Creative Financial Solutions, a full service financial planning firm in Fairfield, New … Continue reading

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Shanna Lehmann Wolf is a financial representative at Creative Financial Solutions, a full service financial planning firm in Fairfield, New Jersey.  She helps individuals and families analyze their employee benefits to coordinate them with their personal needs and circumstances.

Each year, there is one chance to make a benefit election that will affect your costs and medical care for the entire year. Particularly when dealing with a recent diagnosis or a treatment plan, planning is important for the year ahead.  Open enrollment is your annual opportunity to choose health and insurance benefits that reflect what is going on in your family’s life and what you may anticipate for 2017.

The first element to analyze is how you (and your family) have utilized your medical plan and insurance options during 2016.  Then consider what changes have happened over 2016 or you foresee in 2017 that will affect your needs and therefore, elections. During open enrollment, there may be opportunities to purchase life or disability insurance at work.  The enormous advantage to this is you are being considered as part of a group so that your individual health history or status is not analyzed, and you are able to take advantage of group underwriting. This could be a prime opportunity to secure insurance coverage that individually would otherwise be challenging or unaffordable for you to obtain.

The cost of participating in a group benefit is usually favorable to the dollars it would cost for you to obtain a benefit individually. Be sure to analyze the array of benefits available to you so you can maximize on your coverage most efficiently and economically.  As someone facing a cancer diagnosis, it is helpful to have a discussion with a professional who can educate you on your options.

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A New Kind of Family Portrait http://sharsheret.org/new-kind-family-portrait/ http://sharsheret.org/new-kind-family-portrait/#respond Thu, 17 Nov 2016 20:25:20 +0000 http://sharsheret.org/?p=102701 For many families, Thanksgiving is a time to gather together to appreciate the good things that have happened over the … Continue reading

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For many families, Thanksgiving is a time to gather together to appreciate the good things that have happened over the course of the year.  Multiple generations join to share their favorite foods, watch the Thanksgiving parade, or enjoy a football game.  In addition, since 2004, the U.S. Surgeon General has asked Americans to create a new Thanksgiving tradition.  Thanksgiving has been designated as National Family History Day. It is a great opportunity for families that are assembled for dinner to discuss their medical history as a group.

Family history is a very important part of genetic screening or testing.  Knowing about the conditions that affected previous generations can provide information about risks for the current generation.  Knowledge about family history enables individuals to take steps leading to early detection or even prevention of diseases that affected our parents and grandparents.  It is important to discuss conditions like heart disease, strokes, diabetes, osteoporosis, arthritis, Alzheimer’s and cancer.

What are the red flags to alert us to the need for cancer genetic testing in a family? The first thing we look for is cancer at unusually young ages.  Anyone with breast cancer at age 45 or younger meets guidelines for testing.  The second thing is rare cancers.  Ovarian cancer and male breast cancer are rare; anyone diagnosed with these at any age meets guidelines for testing.  The third thing we look for is multiple cases of the same or related cancers.  A family meets guidelines for testing if there are three or more people on the same side of the family with breast cancer, regardless of age of onset. Finally, ancestry is important.  Any Ashkenazi Jewish woman with breast or pancreatic cancer meets guidelines for testing.

While discussing family history is important, it is not unusual for family members to be secretive about their medical conditions.  They may feel partly responsible for what has happened to them. They may be afraid of being subjected to unsolicited advice about how to manage their illness. They may not want to burden other family members with upsetting news.

What is the best way to open up communication about family history?  In many families, it may be easy enough to bring up the topic while everyone sits around the Thanksgiving table.  However, a more gradual approach may be necessary if affected family members are resistant to sharing information.  A more private encounter may be more effective.  It is important to emphasize how the information about family history can be helpful, avoiding any comments that can be perceived as blame.  No one can be considered “at fault” for passing on an inherited mutation.

So, this Thanksgiving, reach out to your family members to find out about any cancer history in previous generations.  Educate your family about what you discover. And, finally, speak with your doctor or genetic counselor about your concerns.  You are not alone. If you are considering genetic counseling or testing, call Sharsheret and speak privately with our genetic counselor and our clinical team at no cost to you or your family.  We can schedule a family conference call, to help you facilitate the genetics conversation with your family and answer critical questions.  Together, we will help you understand the genetic testing process and assist you in making informed decisions.

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What You Should Look For When Hiring a Trainer After Breast Cancer http://sharsheret.org/look-hiring-trainer-breast-cancer/ http://sharsheret.org/look-hiring-trainer-breast-cancer/#respond Wed, 16 Nov 2016 20:22:31 +0000 http://sharsheret.org/?p=102698 Many of us know that exercise is important after undergoing breast cancer surgery and treatment, but there are still many … Continue reading

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Many of us know that exercise is important after undergoing breast cancer surgery and treatment, but there are still many questions that linger. If you are thinking of hiring a personal trainer, what are the important considerations? What questions should you ask a potential trainer? Here are some suggestions.

  1. Do you have any type of fitness certification? Trainers are not licensed, so make sure that they minimally have a certification from one of the industry leaders including ACE or ACSM.
  2. Have you taken any courses on cancer fitness or do you have any specialty certifications such as the ACSM Cancer Exercise Trainer? They should have education in cancer and the implications of cancer treatment on mind, body and spirit.
  3. What type of experience do they have with cancer survivors? Have they worked with clients with breast cancer? Ideally, they should be educated and know how to proceed with clients who may have lymphedema, fatigue, weight gain, peripheral neuropathy, breast reconstruction, and Chemotherapy Related Cognitive Dysfunction or chemo-brain.
  4. If working in your home, do they have liability insurance?
  5. What will your initial assessment include? A thorough assessment is often comprised of flexibility, strength, balance, and cardiovascular status.
  6. Do you require a doctor’s clearance for exercise and are any special precautions advised?
  7. Do they ask about the type and timing of surgery, treatment and breast reconstruction that were performed and if you have any other medical conditions? This will determine when to start strength training to the affected arm and core as well as cardiovascular conditioning recommendations. Knowing about other conditions may necessitate modifications in your program.
  8. Do they recommend a DEXA? If you have undergone chemotherapy or are on aromatase inhibitors you are at risk for osteoporosis. A baseline should be performed to know what types of exercises are appropriate.
  9. What type of exercise do they include in their program? A good program should include a warm up, flexibility training, strength training, and cardiovascular recommendations within your capabilities and goals.
  10. If you have lymphedema, make sure that you consult with your lymphedema specialist to see if you should wear a sleeve and glove while exercising.

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