Self Breast Exam

Dear Dr. Bone,

I am a good patient who goes for annual mammograms, but I do not do breast self exam.I am afraid that I won’t know what I am feeling or that I will find something. I feel guilty about it but have heard various things about how important it is to do regularly. What do you think?

M.M.

Dear M.M.

If only I had a nickel for the number of times that I’ve heard those comments! You are not alone. There are many studies pointing stressing the importance of self exam to find cancers, especially ones that do not show up on mammogram and come up between mammograms (called interval cancers). Other studies show that breast self exam does not necessarily improve survival from breast cancer or long term outcomes. My feeling is that you should try to do them, but not beat yourself up about it if you do not do them regularly. There are now kits available to improve your technique by using silicone or other liquids between to layers to improve your skill. While these may be helpful, if you can just start with soap and water in the shower and try to cover all areas of the breast and armpit it is a good start. Remember, almost every woman has some lumps and bumps. Anything hard, stuck, and painless may be important. Try to examine during the week after your period is over when the breasts tend to be less sensitive. If you are postmenopausal, just pick the first of the month or your birthday number. I liken breast self exam to moving to a new city. In the first few months you don’t know your way around, but eventually, you know the streets well and would notice if there is a traffic detour. Once you make breast self exam a habit, any changes, even small ones, will probably stand out without a conscious effort.

Having said all that, don’t cancel your mammogram! Do them both.

Dr. Bone

Please take advantage of the following videos of Dr. Melanie Bone explaining both a stand up and laying down breast self exam.

Weirdest Cancer Ever

Dear Dr. Bone,

My cousin and I were trying to figure out what type of cancer is the weirdest. Is there really cancer of the fingernail? The hair?

J&J

Cousins

Dear J&J,

Yes, you can get cancer of the fingernail. While it is rare, it does happen. Fungal infections of the nail are very common and cause deformities that have been misdiagnosed as cancer. Traumatic injuries to the nail also cause a discoloration that can be confused with cancer. The most common cancer of the nail is melanoma. It looks like a change in the color of the nail, usually tan to black. Unfortunately it can be misdiagnosed as a nail injury and overlooked. A good rule of thumb (get it!) is to wait until the nail grows. If the lesion does not go away with the nail growth, get it checked out. I suggest seeing a dermatologist.

Hair does not get cancer, but the hair follicle from which the hair grows is susceptible to cancer. Remember, in order to get cancer, there needs to be live cells that divide and a blood supply to the area. Hair has neither of these.

Keep sending more questions.

Dr. Bone

No Scary Hairy: 100% profits donated to Cancer Schmancer

Hey Everyone!


Today is the last day to purchase Naturally Fresh Deodorant for 100% of profits to go back to Fran Drescher's Cancer Schmancer Movement. 

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No Scary Hairy is one of Cancer Shop USA's FAVORITE products! This 100% natural serum that is phthalates free, paraben free, and carcinogen free is meant for ANYONE who feels their hair and scalp are stressed, for dry fragile hair due to intense treatments, and need some extra special attention and gentle enough if you have or are currently undergoing cancer treatment.


Also for finger nails and toe nails, because it heals skin cracks which can become a significant health issue especially for people undergoing cancer treatment.


Learn more about No Scary Hairy and purchase this product between 3/15-3/28 for 100% of profits to be donated to The Cancer Schmancer Movement.


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Lean On Lavender, The Color Of All Cancers,
Cancer Shop USA Team

Paps and Cancer

Dear Dr. Bone,

My gynecologist wants me to have a pap smear. I had a partial hysterectomy 3 years ago and no longer have a cervix. Do I really need a Pap smear to screen for cervical cancer if I don’t have a cervix?

A.M.

Dear  A.M.,

What a smart patient you are! The pap does screen for cervical cancer. If you don’t have a cervix, you probably do not need a pap smear. If your hysterectomy was done for pre-cancer or cancer of the cervix, then I would continue to screen you with pap smears. In my residency many years ago, we were taught to do yearly paps on everyone without a cervix to find vaginal cancer. I have never seen a case. We now know that the HPV virus is the cause of cervix cancer and warts. If you are in a stable, monogamous sexual relationship or are not sexually active, then I would no longer do a pap smear. On the other hand, if you have a new partner or there is a question about your spouse’s fidelity, then I would screen you with a pap and HPV every three years (unless one or the other are abnormal). I refer you to the American College of Obstetricians and Gynecologists website for more information (www.acog.org).

~Dr. Bone.

Plastic Bottles and Cancer

Dear Dr. Bone,

 I drink a lot of water everyday and got nervous when I was sent a message on-line that drinking water out of plastic disposable bottles, especially if they are hot after being left in the car, poses a risk for developing breast cancer. I even read that Sheryl Crowe thinks this might be why she got breast cancer. Is there any truth to this?

Heavy on H20

Delray Beach

Dear Heavy,

First let me remind you that although water is healthy to drink, Americans (and many of my patients!) think that they need to drink large amounts of water each day to cleanse and “detoxify” their systems. The truth is that the human body does not need quite as much water as one would think and those people that drink water only when they are thirsty are no less healthy. I do see women who are depleted of electrolytes because they drink too much water and urinate so much that they lose potassium and sodium along the way, so be careful.

As for the association between plastic water bottles and cancer, the answer is a bit complicated.  There are different plastic bottles. The pliable ones that are designed to be disposable are made of PET (polyethylene teraphthalate), or a #1. This type of plastic is used in many different products and appears to be safe. The hard plastic bottles (like Nalgene or Lexan) are made out of BPA (bisphenol A). There is controversy about this compound. Some scientists believe that BPA acts biologically like estrogen and could promote estrogen-related cancers.

Until more definitive studies are done, it is best not to take any chances. The “green” advice is to use glass, or an old-fashioned thermos (lined with glass). It is better for the earth and, to my knowledge, glass has not been associated with any particular health hazards.

Dr. Bone

Prevention

Dear Dr. Bone,

With all the time, money and effort spent on finding cures and treatments for cancer, why is there not the same done to prevent? If we never got cancer in the first place, we wouldn’t have to cure it! You really don’t need to reply.

Reader

Dear Reader,

That is the million-dollar question. I hope to devote an entire column to it soon. Suffice to say that cancer is not just one disease. The causes are numerous. Each person’s body deals with cancer cells differently so each person would probably require a different prevention strategy. Lastly, there are already a lot of medical and charitable dollars spent on prevention. Open the paper and you will read about the dangers of excess alcohol consumption and cancer. Still, a large percentage of the population drinks too much. I don’t even need to discuss the risks of smoking. Yet we are not a smoke-free nation. The challenge for public health experts is to get America to adopt more healthy lifestyles that would not only decrease cancer, but heart disease, lung disease, diabetes and a host of life-threatening ailments.

Dr. Bone

Life After Cancer

A guest blog by: Sue Bock

Walking down the dim hallway, I have a light bulb moment; "I don’t need any more answers, I no longer need to research about my breast cancer." At that moment in time my roller coaster of feelings came to a close. Before that, I was always stressed, never comfortable with the uncertainty waiting for the next shoe to drop. I was scared and of course, clinical (since I am an RN after all), researching and searching for answers. Self-care was a big focus for me. I used exercise, yoga, acupressure, and retail therapy with friends to keep me sane. Love was abundant from family and friends. After 3 lumpectomies (because no one ever expected to find any cancer), the specimens were sent for gene testing. All the while, I was hoping, for a positive outcome. After a university tumor board reviewed my results, they agreed unanimously that treatment only by radiation was the best course of action. After I completed my last radiation treatment in January 2011, I celebrated with the therapy team. Then my husband and I drove away to spend a very silly day at the Santa Cruz Beach Boardwalk playing games. No worries. No thoughts of cancer. 

During treatment one of my radiotherapy technicians told me her own breast cancer story; how she finished 9 months of chemo & radiation and was forced to decide what was next for her. Her increased risk of injury with subsequent increased risk of infection & lymphedema prevented her return to her career as a jewelry designer. This inspired me to take my life coaching in a different direction. Now it is my mission and pleasure to help women after breast cancer to live a life they deserve. It’s about living your best life possible with or without disease. Let me help you find where you fit, maximize your strengths, your impact, and your contentment.

Breast cancer doesn’t define you; it frees you to arrive at different choices.

Sue Bock

Coach Sue

“Inspiring women with courage to dream, change, and live life’s adventure

http://bestlifeafterbreastcancer.com

Deodorant and Cancer

Dear Dr. Bone,

I read that underarm deodorant can cause breast cancer. Is this true?

~Sweaty

Dear Sweaty,

I remember getting an email many years ago about the hazards of deodorant. Actually, it was about antiperspirants, not deodorants.  What is the difference? Deodorants prevent or control odor related to perspiration, whereas antiperspirants work to prevent perspiration in the first place. A major concern about antiperspirants surrounded the aluminum content found in these products. Aluminum was thought to be linked to Alzheimer’s disease. The relationship between aluminum and breast cancer came later and still is hotly debated. Aluminum deposits are found in greater concentration in the areas of the breast where most cancers are diagnosed, and aluminum, like cadmium, has estrogenic-like activity on breast cancer cells.  A further risk involves the ingredients called parabens, which are used throughout the cosmetic industry. When absorbed through the skin sometimes from underarm shaving cuts, these parabens might conceivably accumulate in the fat cells of the breast or in the lymph nodes near the breast.

Despite these associations, there is no definitive study proving that deodorant or antiperspirants cause cancer. However, it makes sense that you should avoid unnecessary exposures that might be related to cancer, even if remotely. I advocate using only deodorants, not antiperspirants. Sweating is a natural mechanism to help us rid our bodies of toxins. Instead of trying to prevent sweating, I prefer to use a deodorant that eliminates odor naturally. The crystals in Naturally Fresh Deodorant products are pure, aluminum-free and paraben-free, and are hypoallergenic.  They are perfect for people working to prevent cancer, for cancer patients, and for cancer survivors.

And, in addition to their original fragrance-free line, Naturally Fresh now has lovely scented products, including lavender, papaya fusion, ocean breeze, and tropical breeze to appeal to men and women everywhere.

~Dr. Bone

Cancer Quiz

Quiz/statistics/ poverty

Cancer Quiz

1.      What is the most common kind of cancer worldwide?

2.      Which cancer is considered the most curable? 

3.      Which causes more deaths in the United States: cancer or heart attack and stroke?

4.      Which cancers are most preventable?

5.      What percentage of cancer is probably preventable?

6.      What is the biggest risk factor for cancer?

Answers

1.      The most common cancer worldwide is lung cancer, causing over 1.2 million deaths each year. While 85% of the patients with lung cancer are smokers or were smokers, more and more lung cancer is occurring that is unrelated to smoking. In developing countries where smoking is more common and pollution is not as well regulated as in the United States, the incidence of lung cancer is rising.

2.      Many cancers are curable at an early stage. Skin cancers, breast cancer, testicular cancer, and prostate cancer all have excellent prognoses when detected early. Skin cancer is easy to detect and treat if you are having regular skin checks, reputation the reputation of most curable. 

3.      Though they are neck-and-neck, the combination of heart disease and stroke causes more deaths than cancer in the US, according to the Centers for Disease Control.

4.      Lung cancer is highly preventable by avoiding smoking. Having regular colonoscopies should reduce the diagnosis of colon cancer dramatically because precancerous growths can be removed before they turn into cancer. Cervical cancer, a major worldwide risk in developing countries, could be reduced dramatically by the HPV vaccine and by implementation of global screening for this sexually-transmitted virus.

5. A full 30% percent of cancer could be prevented by not smoking, eating fruits and vegetables, and maintaining a normal body weight through regular vigorous physical activity. Unfortunately there are many socioeconomic barriers to attaining these goals.

6. Tobacco smoking is the highest risk for cancer.

These answers may seem obvious, but I was amazed at the number of people who thought that breast cancer was the most common and most deadly worldwide. We take it for granted that people all over the world know the dangers of cigarette-smoking, but data show that people living in other countries are unaware of the health hazards of smoking.

Few people realized how rare some cancers are in the US. For example, there are only about 11,000 cases of cervical cancer diagnosed in the US annually, but this cancer is a leading cause of death in Sub-Saharan Africa. Again, lack of effective public health.


~ Dr. Melanie Bone