Over the last couple of months I've been doing a little informal polling on various networking sites such as Facebook, LinkedIn, and Twitter. I (and a few other fitness professionals) have been asking questions about why people exercise, or don't, what they do to exercise, and what are their perceived roadblocks to exercising. I must stress, this is completely unscientific - just a few people anwering a few questions. But the answers are enlightening.
As you might expect, the biggest problem is time. Everyone feels they don't have time, that exercise gets crowded out by the demands of job, family, commuting, cleaning, house upkeep, etc. Another problem is some serious resentment of the barrage of information of the latest exercise or diet/nutrition fad. And lastly, a feeling of helplessness: if they can't do all of whatever the latest recommendations are, why bother.
I've been wondering if we (the fitness & health professionals) can't do better. I think we can simplify the message and it will still be effective. We need to stick to science-based information, not the latest fitness fads. Fads come and go, and are sometimes contradictory. The public sees this and assumes that all the recommendations are as fleeting. But the basic fitness recommendations are based on strong scientific evidence, not a passing fad. Solid evidence may not be as sexy or exciting as the latest fad, but will serve our clients better in the long run.
We can do better about teaching people that fitness is what matters, not necessarily a particular exercise. What I mean by that is that there are many ways to exercise a particular muscle and many places it can be done. It's actually OK if someone can't get to the gym for an hour 5 days a week if they have real alternatives. With clients and in my workshops, I always try to show ways of building some exercise into daily life. (lift the groceries five times before putting them away, do tummy tucks while sitting at a traffic light, WALK) No, they're not going to look "ripped" or train for a marathon that way, but they can actually improve their overall fitness.
And doing something is better than nothing! We know the recommendations: 30 mins. of moderate-intensity exercise, 5 days or more per week. We also know that is a difficult thing for many people. Unfortunately, many people realize they can't do that and just think "why bother". Often overlooked in the recommendations is that the benefits of exercise can still be obtained if the exercise is broken into shorter segments. If someone can't manage 30 minutes at a time, for whatever reason, they will still get the benefit from the cummulative time - three 10-minute bouts, for instance. And if that's too much, getting some exercise is still better than none. At Life-Cise, we always stress starting at an appropriate level, even if it's not much. This is only the starting point, a place from which to grow.
But you (the non-fitness professionals, the public) have some responsibility, too. You've got to get rid of this all-or-nothing idea. Of course you're busy, of course you're stressed and have too many obligations. Sorry, there's nothing special about that; it doesn't give you a free pass. If you can't do the recommended levels of exercise because of your current fitness level or time constraints, do what you can. It is totally in your power. You can choose to walk instead of ride; you can choose to do some isometric exercises while commuting on the train; you can choose to lift the sugar bag 8 times before putting it on the shelf. So you can't get to the gym for a hour - who cares? You can still choose to lead a healthier life. It is entirely in your control. And if you choose an excuse, choose to do nothing, take responsibility for your choice! Don't be suddenly surprised when you fall ill (heart disease, diabetes, some cancers, even the common cold) or suffer an injury. Yes, disease and injury happen to everyone (I'm a perfect example of that), but we know that many illnesses and injuries are strongly tied to lack of exercise. It is your life; it is your responsibility; it is your choice.
Julie
Wednesday, April 29, 2009
Monday, April 27, 2009
Static Stretching
Researchers at University of Limerick have found that static stretching is more effective at improving hamstring flexibility than dynamic stretching, involving gentle swinging. The study looked at athletes with lingering hamstring stiffness after otherwise recovering fro
m an injury. The static stretching involved three sets of gently leaning the upper body forward over an extended leg, and holding for 30 seconds. The dynamic stretches involved three sets of slow leg swings, forward and back.
While this study looked specifically at athletes recovering from injuries, it is sound advice for all of us. Generally, stretching should be done using the static method. Dynamic stretching is often less effective and can lead to injury. When stretching, stretch just to the point of slight pull or discomfort, hold for 10 - 30 seconds, and release. Always remember to keep breathing while you stretch. Holding your breath creates tension in your body - the opposite of what you're going for in a stretch.
Proper stretching is essential for full recovery from many surgeries. Surgery causes scar tissue at the incision and often tightness in the surrounding muscles. In addition, radiation frequently causes increased tightness as well. If left unaddressed, this tightness can, over time, cause some serious and painful problems (back & neck pain, shoulder weakness, weakness & pain of other joints).
This is true for many surgeries and cancers, but is especially true for breast cancer. Surgery for breast cancer is often more extensive and can be more debilitating than many surgeries. Many people suffer from limited range of motion after breast cancer surgery. The first step, once you've been cleared by your doctor, is to begin an effective stretching routine to regain range of motion. Here are some basic stretches for regaining range of motion after breast surgery. I repeat this information periodically in this blog because it is so important.
A few chest stretches: always remember to stretch just to the point of slight stretch, hold for 10-30 seconds and release.
Wall crawl: Best thing to start with! Stretches pectoralis major & minor. Stand facing the wall, about six inches away. Place your hand on the wall and begin slowly walking your fingers up the wall. Go only until you feel a slight stretch. Do not stretch to the point of pain! Slowly walk your arm back down. As this movement gets easier you can modify the stretch to continue increasing your range of motion. Begin turning your body away from the wall to increase the stretch. Eventually you should be able to get your body to perpendicular to the wall and crawl your arm up to the side.
Open shoulder stretch: This is nice - you can do it anywhere, anytime. Gently stretches chest (pectorals) and front of shoulder (anterior deltoids). Place the hand of the side of your surgery on your shoulder of the same side. Let your elbow hang down by your side. Gently squeeze your shoulder blade while you draw your elbow toward the back. At the same time, turn your head gently toward the opposite shoulder.
Chest stretch – arms outstretched: Stretches and opens the chest. Sit or stand with your arms outstretched to the side at a height that is comfortable. Gently squeeze your shoulder blades together and pull your arms toward the back. If you have limited range of motion in your shoulder, you can begin with your arms down at a comfortable angle. As your range of motion improves, raise your arms out to the side for the stretch, eventually getting them up to shoulder-height.
Shoulder stretch: Stretches back of the shoulders and shoulder blades. Bend your right elbow and raise your arm to shoulder-height, so your arm is parallel to the floor. Place your right hand on your left shoulder. Grab your elbow with your left hand and pull it gently across your chest until you feel a slight stretch across the back of your shoulder. Hold for at least 10 seconds and repeat on left side.
Butterfly stretch: Stretches chest muscles. Sit or stand. Place your hands behind your head with your elbows pointing forward. Slowly open your elbows out to the side until you feel a slight stretch. Hold for at least 10 seconds, and return to the starting position.
These are just a few. They're really important - the more extensive your surgery, the more important it is to stretch. And make sure you've regained good range of motion before you begin any strengthening exercises.
Julie
m an injury. The static stretching involved three sets of gently leaning the upper body forward over an extended leg, and holding for 30 seconds. The dynamic stretches involved three sets of slow leg swings, forward and back.While this study looked specifically at athletes recovering from injuries, it is sound advice for all of us. Generally, stretching should be done using the static method. Dynamic stretching is often less effective and can lead to injury. When stretching, stretch just to the point of slight pull or discomfort, hold for 10 - 30 seconds, and release. Always remember to keep breathing while you stretch. Holding your breath creates tension in your body - the opposite of what you're going for in a stretch.
Proper stretching is essential for full recovery from many surgeries. Surgery causes scar tissue at the incision and often tightness in the surrounding muscles. In addition, radiation frequently causes increased tightness as well. If left unaddressed, this tightness can, over time, cause some serious and painful problems (back & neck pain, shoulder weakness, weakness & pain of other joints).
This is true for many surgeries and cancers, but is especially true for breast cancer. Surgery for breast cancer is often more extensive and can be more debilitating than many surgeries. Many people suffer from limited range of motion after breast cancer surgery. The first step, once you've been cleared by your doctor, is to begin an effective stretching routine to regain range of motion. Here are some basic stretches for regaining range of motion after breast surgery. I repeat this information periodically in this blog because it is so important.
A few chest stretches: always remember to stretch just to the point of slight stretch, hold for 10-30 seconds and release.
Wall crawl: Best thing to start with! Stretches pectoralis major & minor. Stand facing the wall, about six inches away. Place your hand on the wall and begin slowly walking your fingers up the wall. Go only until you feel a slight stretch. Do not stretch to the point of pain! Slowly walk your arm back down. As this movement gets easier you can modify the stretch to continue increasing your range of motion. Begin turning your body away from the wall to increase the stretch. Eventually you should be able to get your body to perpendicular to the wall and crawl your arm up to the side.
Open shoulder stretch: This is nice - you can do it anywhere, anytime. Gently stretches chest (pectorals) and front of shoulder (anterior deltoids). Place the hand of the side of your surgery on your shoulder of the same side. Let your elbow hang down by your side. Gently squeeze your shoulder blade while you draw your elbow toward the back. At the same time, turn your head gently toward the opposite shoulder.
Chest stretch – arms outstretched: Stretches and opens the chest. Sit or stand with your arms outstretched to the side at a height that is comfortable. Gently squeeze your shoulder blades together and pull your arms toward the back. If you have limited range of motion in your shoulder, you can begin with your arms down at a comfortable angle. As your range of motion improves, raise your arms out to the side for the stretch, eventually getting them up to shoulder-height.
Shoulder stretch: Stretches back of the shoulders and shoulder blades. Bend your right elbow and raise your arm to shoulder-height, so your arm is parallel to the floor. Place your right hand on your left shoulder. Grab your elbow with your left hand and pull it gently across your chest until you feel a slight stretch across the back of your shoulder. Hold for at least 10 seconds and repeat on left side.
Butterfly stretch: Stretches chest muscles. Sit or stand. Place your hands behind your head with your elbows pointing forward. Slowly open your elbows out to the side until you feel a slight stretch. Hold for at least 10 seconds, and return to the starting position.
These are just a few. They're really important - the more extensive your surgery, the more important it is to stretch. And make sure you've regained good range of motion before you begin any strengthening exercises.
Julie
Saturday, April 25, 2009
Lymphedema Tips
I came in from a hike about an hour ago - getting out to enjoy this beautiful spring weather before I go to work. I'm having a bit of mild swelling in my hand since then. I do occasionally have minor bouts of swelling because of my compromised lymph system. Lymphedema is a risk many cancer survivors live with. I'm not really sure what triggered it; it could be the heat (it's suddenly much warmer today), or I may be slightly dehydrated, or it could be an infection. It's hard to know precisely what triggers it, and everyone's bodies react differently. It's important for us to pay attention and figure out what works and doesn't work for our bodies.
This is pretty mild, so I'm not going to worry too much about it. But I will keep an eye on it, and see my doctor if it gets worse. In the mean time, there are a number of exercises I can do (and plan to, many times) to help stimulate my lymph system.
First, I've been doing a lot of shoulder rolls (I like rolling them to the back). I also do a lot of wing pinches: With your arms at your sides, bend your elbows to 90 degrees. Hold your hands, palms up, slightly wider than your body, keeping elbows at your side. Draw your elbows back and squeeze your shoulder blades together. Arm circles are good, as well: Extend your arms, straight, out to the side at shoulder height. Turn your palms up and make small circles to the back with your arms. And finally, I'll be doing a lot of deep breathing, which helps to pump the lymph system; and my favorite, jiggling my raised arm (like I'm waving to my loyal subjects).
All of these simple movements help to stimulate the lymph system. I expect, based on past experience, that within a couple of days my hand and arm will be back to normal. Because of my extensive surgery and treatments, I know that I am at a higher risk for lymphedema. And it's an ongoing risk; it doesn't go away - ever. But there is a great deal I can do to help my body function in it's compromised state so that I can live a perfectly normal life.
Julie
This is pretty mild, so I'm not going to worry too much about it. But I will keep an eye on it, and see my doctor if it gets worse. In the mean time, there are a number of exercises I can do (and plan to, many times) to help stimulate my lymph system.
First, I've been doing a lot of shoulder rolls (I like rolling them to the back). I also do a lot of wing pinches: With your arms at your sides, bend your elbows to 90 degrees. Hold your hands, palms up, slightly wider than your body, keeping elbows at your side. Draw your elbows back and squeeze your shoulder blades together. Arm circles are good, as well: Extend your arms, straight, out to the side at shoulder height. Turn your palms up and make small circles to the back with your arms. And finally, I'll be doing a lot of deep breathing, which helps to pump the lymph system; and my favorite, jiggling my raised arm (like I'm waving to my loyal subjects).
All of these simple movements help to stimulate the lymph system. I expect, based on past experience, that within a couple of days my hand and arm will be back to normal. Because of my extensive surgery and treatments, I know that I am at a higher risk for lymphedema. And it's an ongoing risk; it doesn't go away - ever. But there is a great deal I can do to help my body function in it's compromised state so that I can live a perfectly normal life.
Julie
Wednesday, April 22, 2009
Happy Earth Day
To celebrate Earth Day today, choose to do something that's good for you and the planet. Walk or ride a bike to the store or to work instead of driving. Take the stairs instead of the elevator. Walk to lunch rather than grab a taxi. If you have to drive, organize your trips so you make one trip instead of five. - You get the idea.
Healthier living, both for the planet and for us, is not about making a big decision one time; it's about small, daily choices. Greener living is not just buying some fancy "green" appliance. Of course, if you need to buy a new refrigerator (like I will soon), choose the most energy efficient model rather than just the one that looks good. But what's equally (maybe more) important are the choices we make every day. Choose to take shorter showers, choose to turn off the lights, choose to draw the curtains at night to help keep in the heat. And many of your choices can turn out to be healthier for your body, too.
In our society we are accustomed to wanting big, quick results. Healthier living is not like that - healthier living is not "Biggest Loser". It's about making small choices every day. Over time those small choices get easier, seem more natural; and then making bigger choices begin to seem possible. Healthier living is a lifestyle, and it begins with one healthier choice today. And to celebrate Earth Day, make that choice one that's good for the planet, too.
Julie
Monday, April 13, 2009
Mammogram Folowup
Given the emails I received about my April 1 post on the mammogram debate in Britain, I feel a followup is warranted. Several news outlets had reported that the health service in Britain was reconsidering their informational leaflets about mammograms in response to protests that they didn't give enough information about negative aspects of the scans.
Over the years I have heard similar arguments against mammograms here. I have heard about the stress that the scans cause, and about the unnecessary procedures caused by misleading or misinterpreted readings. I have heard that we would all be better off without the extra stress and radiation because some breast cancers would never develop into a life-threatening condition anyway. I have heard these arguments and I want to respond. This is only my opinion, based on my experience - not medical advice.
In my experience, these arguments often come from women who have never actually faced a diagnosis of cancer. Yes, there is some truth to these arguments, and yes, there have been women who have needlessly suffered. I do not minimize their pain. However, cases of true misdiagnosis are few. There are sometimes confusing or unclear readings that require further tests to determine whether or not cancer is present. The uncertainty and fear that go along with further procedures is indeed stressful, but that stress pales in comparison to the stress of facing a cancer that has already spread! The truth is that regular mammograms increase your chance of discovering a cancer early. And the key to successful treatment is early detection - it it so much easier to treat a small, localized cancer than it is to treat it once it has spread throughout the body. Yes, it's true that some cancers would never develop into a life-threatening condition, but they're only a small percentage of all breast cancers. Estimates are that only about 10% of breast cancers are that harmless type.
I am such a firm believer in mammograms because I know that I am alive today because of a scan! And I know that, no matter how stressful the scans may be, it is so much less than facing a cancer that's spread. I made a decision when I was first diagnosed to be completely open about my cancer. I didn't try to hide my disease from anyone, answered people's questions, and proudly walked around bald during chemo. In part, it was just the way I needed to fight - to face it head on. But, in part, I wanted to be a wake-up call. It was such a shock that I, at my age, with no family history, in great health, would develop breast cancer. I wanted everyone to be shocked! I wanted them to pay attention: it's not just our mothers or our aunties or someone else - it's us, it's all of us! I had heard my older friends talk about how they hated going for their mammos and would often put it off. I wanted them to be shocked into realizing that those mammos they hate really do matter.
So stop putting it off. Go get your mammograms. It matters; it saves lives. And when your friends say they don't want to be bothered, tell them to give me a call.
Julie
Over the years I have heard similar arguments against mammograms here. I have heard about the stress that the scans cause, and about the unnecessary procedures caused by misleading or misinterpreted readings. I have heard that we would all be better off without the extra stress and radiation because some breast cancers would never develop into a life-threatening condition anyway. I have heard these arguments and I want to respond. This is only my opinion, based on my experience - not medical advice.
In my experience, these arguments often come from women who have never actually faced a diagnosis of cancer. Yes, there is some truth to these arguments, and yes, there have been women who have needlessly suffered. I do not minimize their pain. However, cases of true misdiagnosis are few. There are sometimes confusing or unclear readings that require further tests to determine whether or not cancer is present. The uncertainty and fear that go along with further procedures is indeed stressful, but that stress pales in comparison to the stress of facing a cancer that has already spread! The truth is that regular mammograms increase your chance of discovering a cancer early. And the key to successful treatment is early detection - it it so much easier to treat a small, localized cancer than it is to treat it once it has spread throughout the body. Yes, it's true that some cancers would never develop into a life-threatening condition, but they're only a small percentage of all breast cancers. Estimates are that only about 10% of breast cancers are that harmless type.
I am such a firm believer in mammograms because I know that I am alive today because of a scan! And I know that, no matter how stressful the scans may be, it is so much less than facing a cancer that's spread. I made a decision when I was first diagnosed to be completely open about my cancer. I didn't try to hide my disease from anyone, answered people's questions, and proudly walked around bald during chemo. In part, it was just the way I needed to fight - to face it head on. But, in part, I wanted to be a wake-up call. It was such a shock that I, at my age, with no family history, in great health, would develop breast cancer. I wanted everyone to be shocked! I wanted them to pay attention: it's not just our mothers or our aunties or someone else - it's us, it's all of us! I had heard my older friends talk about how they hated going for their mammos and would often put it off. I wanted them to be shocked into realizing that those mammos they hate really do matter.
So stop putting it off. Go get your mammograms. It matters; it saves lives. And when your friends say they don't want to be bothered, tell them to give me a call.
Julie
Tuesday, April 7, 2009
Survivorship
Continuing on the survivorship theme of my last post.... As I said before, in the beginning I was not at all comfortable with the word "survivor". I developed a strong circle of support around me, but somehow I didn't connect to the "survivor" brand. Maybe it was because I was still so definitely fighting my fight, and the word survivor seemed like it was past tense.
Similarly, I was not a big fan of cancer support groups in the beginning. I did go to a few breast cancer support meetings, but it just wasn't for me. I didn't feel much of a connection with my cancer sisters. I was more aware of our differences than our similarities. That's not to say I didn't have support. I had an important circle of friends who had all had cancer - we just didn't get together for meetings.
As time has passed, I've grown into my place in this community. In a recent interview, I was asked how long it took before I didn't think about cancer every day. I haven't reached that point - maybe never will. That might be because I made a conscious choice to stay active in the cancer community, starting this new career. I believe that I have something of value to offer, and in the process of fighting my fight, found my voice. So, between fitness clients with cancer, and writing or speaking, I do think about cancer every single day. But it's not necessarily a negative thing. I don't think about it in a panicked, what-if-it-comes-back kind of way. I do have those moments (not sure if they will ever really go away), but more often I think of the transformational aspects of cancer.
I've recently started attending the support group (whenever I can make it) at my local American Cancer Society. Eight years later, far from being done with cancer, I feel more connected. The differences that bothered me in the beginning with groups now draw me in. We all go through cancer in our own way, but we are united in the fact that we all have this to go through. (sorry, that's not so well written, but I struggle with how to express this). Support groups are not for everyone, but they can be an important aid to coping with cancer. They are a place where people can feel comfortable saying all the things they can't admit to friends and family; and to realize that whatever they are thinking or feeling, they are not alone. And they are a place to see that our differences only enhance our shared experiences.
I've also made my peace with the word "survivor" now. There is no real definition of the word (maybe that's why I've made peace) - we each make our own personal definition. Through support groups or the online community, we can see that there is no one way to have cancer, no right or wrong way. We are all writing our own survivor stories.
My definition? I think it's about looking squarely at our darkest moments - those-middle-of-the-night-all-alone moments - and choosing to move ahead, even when all the choices suck. And in doing so, it is possible to find great strength and great joy.
Julie
Similarly, I was not a big fan of cancer support groups in the beginning. I did go to a few breast cancer support meetings, but it just wasn't for me. I didn't feel much of a connection with my cancer sisters. I was more aware of our differences than our similarities. That's not to say I didn't have support. I had an important circle of friends who had all had cancer - we just didn't get together for meetings.
As time has passed, I've grown into my place in this community. In a recent interview, I was asked how long it took before I didn't think about cancer every day. I haven't reached that point - maybe never will. That might be because I made a conscious choice to stay active in the cancer community, starting this new career. I believe that I have something of value to offer, and in the process of fighting my fight, found my voice. So, between fitness clients with cancer, and writing or speaking, I do think about cancer every single day. But it's not necessarily a negative thing. I don't think about it in a panicked, what-if-it-comes-back kind of way. I do have those moments (not sure if they will ever really go away), but more often I think of the transformational aspects of cancer.
I've recently started attending the support group (whenever I can make it) at my local American Cancer Society. Eight years later, far from being done with cancer, I feel more connected. The differences that bothered me in the beginning with groups now draw me in. We all go through cancer in our own way, but we are united in the fact that we all have this to go through. (sorry, that's not so well written, but I struggle with how to express this). Support groups are not for everyone, but they can be an important aid to coping with cancer. They are a place where people can feel comfortable saying all the things they can't admit to friends and family; and to realize that whatever they are thinking or feeling, they are not alone. And they are a place to see that our differences only enhance our shared experiences.
I've also made my peace with the word "survivor" now. There is no real definition of the word (maybe that's why I've made peace) - we each make our own personal definition. Through support groups or the online community, we can see that there is no one way to have cancer, no right or wrong way. We are all writing our own survivor stories.
My definition? I think it's about looking squarely at our darkest moments - those-middle-of-the-night-all-alone moments - and choosing to move ahead, even when all the choices suck. And in doing so, it is possible to find great strength and great joy.
Julie
Friday, April 3, 2009
Voices of Survivors
The word "survivor" is one of those words that is tossed around rather indiscriminately, and whose definition is decidedly fuzzy (a lot like "love"). When I was first diagnosed, and for several years after, I resisted using the word. I mean, we've got survivors on TV that have nothing to do with anything real, people after even a normal winter who have "survived" the season, mothers of teenage kids who "survive" parenting...so many people surviving ordinary life. What did my cancer experience have to do with any of that? For a long time I refused to think of myself as a survivor; I just didn't know what that means. I simply thought of myself as someone who happened to have cancer.
In recent years my attitude toward the word has changed - maybe because I chose to direct my career in a new direction, toward helping others facing cancer; maybe I just couldn't come up with a better word. But I've begun to embrace the word and the whole concept of survivorship. I'm still not sure what it means, but there is something to it.
There is an organization, Voices of Survivors, which is exploring "survivorship". Founded by documentary filmmaker and survivor, Lynn Lane, Voices of Survivors is an ongoing online documentary of what being a survivor means to individuals. Through a variety of forms, including video and the written and spoken word, Lynn is trying to show the human face of "survivors".
As I continue to embrace and explore the meaning of survivorship, I will follow Lynn's project with great interest.
Julie
In recent years my attitude toward the word has changed - maybe because I chose to direct my career in a new direction, toward helping others facing cancer; maybe I just couldn't come up with a better word. But I've begun to embrace the word and the whole concept of survivorship. I'm still not sure what it means, but there is something to it.
There is an organization, Voices of Survivors, which is exploring "survivorship". Founded by documentary filmmaker and survivor, Lynn Lane, Voices of Survivors is an ongoing online documentary of what being a survivor means to individuals. Through a variety of forms, including video and the written and spoken word, Lynn is trying to show the human face of "survivors".
As I continue to embrace and explore the meaning of survivorship, I will follow Lynn's project with great interest.
Julie
Wednesday, April 1, 2009
Mammograms - To Scan or Not To Scan
Yesterday's New York Times had an article about a debate going on in Britain about mammogram recommendations. Britain's current recommendations for mammos. are every three years starting at age 50. Health officials have agreed to reconsider informational fliers about mammograms that are given to patients after a group of advocates complained that the fliers overstate the benefits of screening. Advocates wrote a letter to The Times of London saying that the handouts don't provide information about possible harm from screening. These advocates cite research by the Nordic Cochrane Center in Copenhagen. In 2006, their research found that for every 2,000 women (aged 50 - 70) screened for 10 years, only one woman's life would be saved, verses 10 who's lives would be unnecessarily disrupted by excessive or unwarrented treatment. However, British health officials point out that other studies have shown the ratio of saved lives to unnecessary treatment to be closer to 1 to 1. You can read the full NY Times article by clicking here.
This is an issue that comes up periodically, as it did recently for prostate cancer screening. Unfortunately there's no easy answer for this. Medical screening is imperfect, as is the medical community's understanding of cancer. There are false positive readings that lead to other procedures and cause great anxiety. Then there is the issue of finding and treating cancers that are unlikely to ever cause harm. Certain cancers, so called "indolent" cancers, if left alone, are very slow-growing and would not likely be life-threatening. The problem is that scientists can't identify those cancers yet; under the microscope they look the same as other cancers. Robert Smith, of the American Cancer Society, estimates that only about 10% of breast cancers are that harmless type, however.
This is a tricky issue for me. Certainly, anyone whose life has been upended unnecessarily would be skeptical of the benefits of scans. And in these days of cost-cutting, there may be an element of cost analysis in the issue. However, as someone whose life was saved by a scan, I find it hard to be totally objective. I felt the same way a couple of years ago when there was debate about self exams. I admit that my thoughts on issues of screening are totally clouded by my own experience.
I found my cancer by a self exam - no lump, just a very slight change in texture. My doctor believed it was nothing, just age-related texture changes, but had me go for a mammo just to be sure. I was in my mid-30s, so would not have had a mammogram for several years. When it turned out to be cancer, each of the surgeons I saw for opinions applauded my doctor for sending me for a scan. The change in feel of the breast was so subtle and I was still quite young; very many doctors would have ignored my concerns. It turned out that my cancer was quite aggressive and had already spread; most of my lymph nodes were positive. Without my self exam and without a prompt scan, I would most certainly be dead now.
I know that there are false positives and unnecessary treatments, and that those people truly suffer. But I also know about saved lives. I don't know what is the right answer. What I do hope for is the ability to determine which cancers could be left alone and which must be treated. Scientists are studying this issue, for breast cancer as well as other cancers. They have some clues and are making progress. My hope is for increased funding and progress in this very important area of cancer research.
Julie
This is an issue that comes up periodically, as it did recently for prostate cancer screening. Unfortunately there's no easy answer for this. Medical screening is imperfect, as is the medical community's understanding of cancer. There are false positive readings that lead to other procedures and cause great anxiety. Then there is the issue of finding and treating cancers that are unlikely to ever cause harm. Certain cancers, so called "indolent" cancers, if left alone, are very slow-growing and would not likely be life-threatening. The problem is that scientists can't identify those cancers yet; under the microscope they look the same as other cancers. Robert Smith, of the American Cancer Society, estimates that only about 10% of breast cancers are that harmless type, however.
This is a tricky issue for me. Certainly, anyone whose life has been upended unnecessarily would be skeptical of the benefits of scans. And in these days of cost-cutting, there may be an element of cost analysis in the issue. However, as someone whose life was saved by a scan, I find it hard to be totally objective. I felt the same way a couple of years ago when there was debate about self exams. I admit that my thoughts on issues of screening are totally clouded by my own experience.
I found my cancer by a self exam - no lump, just a very slight change in texture. My doctor believed it was nothing, just age-related texture changes, but had me go for a mammo just to be sure. I was in my mid-30s, so would not have had a mammogram for several years. When it turned out to be cancer, each of the surgeons I saw for opinions applauded my doctor for sending me for a scan. The change in feel of the breast was so subtle and I was still quite young; very many doctors would have ignored my concerns. It turned out that my cancer was quite aggressive and had already spread; most of my lymph nodes were positive. Without my self exam and without a prompt scan, I would most certainly be dead now.
I know that there are false positives and unnecessary treatments, and that those people truly suffer. But I also know about saved lives. I don't know what is the right answer. What I do hope for is the ability to determine which cancers could be left alone and which must be treated. Scientists are studying this issue, for breast cancer as well as other cancers. They have some clues and are making progress. My hope is for increased funding and progress in this very important area of cancer research.
Julie
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