Barb's Daily Dose

Losing My Modesty

Our Featured Guest Writer Today is DJ DeProspero

We're delighted that DJ DeProspero, a woman who's just completed chemo and radiation for Anal Cancer, felt comfortable sharing her experience with our readers.  She's an inspiring person for so many reasons including her sense of adventure and her amazing kindness. 

 

And Now For Her Story That She is Willing to Share

From the moment I was diagnosed with anal cancer my modesty, what little I had, came under attack. I realized very quickly that I’d be better off getting over it completely and learn to treat my “private parts” just like I might treat my arms or legs.

My Inspiring Friend Marie

See the Beautiful Woman In the Hat?

That's my friend Marie, who is letting me post her photo on the blog. Marie is one of the most amazing women I know.  She's wearing a hat to cover up the scar from her recent brain surgery that removed a large tumor.  She's undergoing chemo and  sometimes gets a little tired.  But nothing can dampen that 1000 watt smile.  It's the same smile she used to charm people in the hospital gift shop, where she was a volunteer.  Marie has been through a lot in her life, her brain tumor is just one more in a long list of challenges, and yet, she inspires me to live each day to it's "Fullest".

Crafty Solutions to Chemo Hair Loss

Our Featured Guest Writer Today is: Laurie Andreoni, President, Waking Dream Designs

Alopecia, or hair loss, is a chemotherapy side effect that many of us fear more than any other aspect of treatment. With no hair and the high stress of cancer treatment how can you maintain confidence?

After losing my hair from chemotherapy for breast cancer, I panicked when my skin became too sensitive for wigs.  A scarf tied behind my head reminded me of dusting cobwebs. I wanted something comfortable and poufy - so I wouldn’t look as lousy as I felt.

RIP Farrah Fawcett, Who Wanted Us to Take Her -- And Cancer -- Seriously

Today's Guest Writer Is:  Melanie Haiken, Senior Editor of Caring.com

She may have started her public career as a fluffy pin-up girl, but Farrah Fawcett couldn't have ended it with more dignity in her role as a public figure. Diagnosed three years ago with anal cancer, Fawcett talked openly about her battle with a type of cancer that's particularly embarrassing to talk about.

With her mane of beautiful hair, white teeth, and sun-tinged skin, Farrah was the picture of health and the quintessential California girl (though she hailed from Texas), adorning many a teenage boy's wall in her famous red tank top. Thanks to the gritty documentary "Farrah's Story" that she allowed her friend Alana Stewart to film, we saw her as she finished her life lying in a bed, barely moving, unable to recognize her own son. She brought the horrors of cancer and the infallibility of cancer treatment into our living rooms and got us to talk about really hard topics, like what it would be like to suffer like that, and how far we'd be willing to go to stay alive.

To further continue reading this informative article click here

Questions to Ask the Oncologist About Breast Cancer

20 Essential Questions About the Diagnosis and Suggested Treatment
Written by Featured Guest Writer

Melanie Haiken, Caring.com, Senior Editor

Quick Summary

A breast cancer diagnosis can be so shocking that it may be hard to know where to begin when talking to the doctor. It's common to feel completely tongue-tied, wondering if it's okay to even let the things you're thinking about cross your lips. For example, the first question on your mind may be "Is it curable?" The doctor may not be able to give you a definitive answer, but asking the question allows you to begin planning for the future and start a conversation about what's to come.

20 Essential Questions

For all medical appointments, it's a good idea to bring a pen and paper to take notes, or ask the doctor's staff to provide writing materials. Many people find that no matter how hard they listen during appointments, the information becomes a blur as soon as they leave the office. (If you have a tape recorder, you might even want to bring it or another recording device, but ask the doctor before you turn it on.) Start by quickly making a mental list of everything that's unclear. Don't worry if some of your questions seem obvious -- if you don't know the answer, that makes a question absolutely worth asking. And if the answer to one question brings another to mind, ask that as well. You'll find that at each appointment and stage of treatment, more questions will come up. But here are some to get you started.

Continue to Review the 20 Questions

Screening for Ovarian Cancer

About once every 2 months, I receive an email that’s been making the rounds on the internet that urges every woman to get a CA-125 test for Ovarian Ccancer. So many of my friends and patients have questions about this and I thought I’d do a little more research.

As it turns out, there was a recent study confirmed what many health care providers, myself included, have been advising women for years. We don’t recommend the CA-125 test as a good screening test.

Ovarian Cancer & Talcum Powder

A recent report confirmed findings that the use of Talc around the genitals increases the risk of Ovarian Cancer. This is not a new finding, in fact, I remember reading about this over 10 years ago, and counseling patients to avoid talc and talcum powder in the genitals. 

There was a 30% increased likelihood in women who used talc at least once a week or more. There wasn't a problem for women who used talc in other areas or for women who used cornstarch.  It's not known if this is because the talc gets absorbed into the lymph system, or if it's the contaminants such as asbestos and quartz that lead to ovarian cancer in some women. 

One thing is clear, don't use talc or talcum powder around your private girl parts.  For more on Ovarian Cancer see previous posts.

Also here's a great website on Ovarian Cancer

Melanoma

I've been getting many requests today for information on Melanoma. Here's an updated link to a post I did on 9/12/08.

Melanoma

I hope it helps explain the most dangerous type of skin cancer.

Be well

Save The Ta Ta's Team

Yesterday, in San Francisco, I participated in the Susan G. Komen Race for the Cure. I was offering 1 minute Women's Health Consultations at the View From The Bay ABC TV booth.

I met some incredible women, including many breast cancer survivors, some of whom were only a few months from diagnosis. One woman told me that she finally got a good answer about how long it takes before you consider yourself a Breast Cancer Survivor. A friend from a support group told her that you become a survivor the moment that you hear the words, "You have Breast Cancer." After that moment, you are become a Survivor.

Ta Ta's

My mom is a survivor. Many of my friends are survivors. Today, I saw wave after wave of pink T-shirt clad survivors, friends & family on an energetic mission to raise awareness and money for The Cure. I met some members of the Save The TA TA's team, breast cancer survivors from Fremont, California who couldn't stop laughing.

I love the name of their team. They were having so much fun, that I didn't realize that they were also incredible breast cancer advocates and have an incredible non-profit that provides Bras for Body and Soul® Save The Ta Ta's are part of the Hers Breast Cancer Foundation. Check it out.

More lift and support
Women need Bras.

Melanoma

I have a patient who came to see me with a very dark small mole on her neck. She had it for about 3 weeks, and was worried because she had a family history of Melanoma. Her dad had died from advanced melanoma a few years prior. She was in her early 30's and worked as a nurse. She wanted me to take a look because her doctor wasn't concerned and said it was nothing.

For some reason, those words, combined with her family history and how this tiny dark spot had irregular borders gave me chills. I always feel that it's better to be safe than sorry, so I did a punch biopsy on the spot and sent it off to the lab.

As you've probably guessed, the pathologist called me with the news that the tiny, dark, spot with irregular borders was in fact, melanoma. I arranged for her to see a dermatologist, and she had the entire area removed. Luckily for her, it was early enough that she didn't require chemo and is completely cancer free.

Prognosis
If melanoma is caught early, survival rates are in the high 90% range. Unfortunately, if it's an aggressive type of tumor, and not caught early, then it can be fatal. Approximately 75% of skin cancer deaths are from melanoma. Stage 2 for example has a 40% survival rate over 10 years.

Each year, there are about 48,000 deaths worldwide attributed to melanoma. It is more common in males and in caucasians and those who live in sunny areas.

What is it?

Melanoma results from the abnormal and unregulated growth of melanocytes, which are pigment producing cells. The treatment is surgical removal if the thickness is 1mm or less. And that's tiny.

Staging of Melanoma

T = Tumor size. Smaller = better survival

N = lymph Nodes No lymph node involvement = better survival

M = Metastasis, whether it has spread. No metastasis = better survival.

Stage 0: Melanoma in Situ - 100% Survival

Stage I/II: Invasive Melanoma, 85-95% Survival
T1a: Less than 1.00 mm primary, w/o Ulceration
T1b: Less than 1.00 mm primary, w/Ulceration
T2a: 1.00-2.00 mm primary, w/o Ulceration

Stage II: High Risk Melanoma, 40-85% Survival
T2b: 1.00-2.00 mm primary, w/ Ulceration
T3a: 2.00-4.00 mm primary, w/o Ulceration
T3b: 2.00-4.00 mm primary, w/ Ulceration
T4a: 4.00 mm or greater primary w/o Ulceration
T4b: 4.00 mm or greater primary w/ Ulceration

Stage III: Regional Metastasis, 25-60% Survival
N1: Single Positive Lymph Node
N2: 2-3 Positive Lymph Nodes OR Regional Skin/In-Transit Metastasis
N3: 4 Positive Lymph Nodes OR Lymph Node and Regional Skin/In Transit Metastases
Stage IV: Distant Metastasis, 9-15% Survival

M1a: Distant Skin Metastasis, Normal LDH (an enzyme that is elevated with some advanced cancers).
M1b: Lung Metastasis, Normal LDH
M1c: Other Distant Metastasis OR Any Distant Metastasis with Elevated LDH

Based Upon AJCC 5-Year Survival With Proper Treatment

What to look for

• Asymmetrical skin lesion, in other words, it's not the same on both sides.
• Border of the lesion is irregular. The outside looks jagged.
• Color: melanomas usually have many different shades and colors.
• Diameter: moles that measure more than 5 mm are more likely to be melanomas than moles that are smaller.
• Evolution: The evolution (ie change) of a mole or lesion may be a hint that the lesion is becoming malignant
• Elevation: The mole is raised or feels like a bump above the skin.

If you have a suspicious mole get it checked out. If you're worried, keep an eye on your moles and watch for any signs of changes. With melanoma, it usually doesn't look round, instead the outside borders are usually irregularly shaped and kind of jagged.

I've had patients who've lost parents to Melanoma because they were treated too late. Others have had recurrence of their melanoma and required chemotherapy, and I've worked with women who spouses died from melanoma.

Mole Mapping
In any case, melanoma is a serious type of skin cancer. If you have a lot of moles (more than 50) or have a family history, see a dermatologist for mole mapping. For this, full body photos are taken every 6 months to compare the individual moles to evaluate any changes that would require a biopsy.

This is particularly effective for people who are heavily freckled or who have too many moles to remove all of them.

I'll cover Basal and Squamous Cell skin cancer in the coming weeks.