Double Whammied | Everything was going great until this whole breast cancer thing

Time 2021-01-17 05:03:30

Web Name: Double Whammied | Everything was going great until this whole breast cancer thing

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Cancer and COVID-19: double trouble. Illustration by Kimberly Carney, Fred Hutch News ServiceLike a lot of people, I ve been consuming a ton of COVID-19 news and new research. And because it s my job, I ve been writing about it for the masses.Two things seem very clear.One, the novel coronavirus is more deadly to cancer patients who are older, who have other health conditions think diabetes and hypertension and who have active disease.Here s a piece I wrote for Fred Hutch that breaks it all down. It s based on new data just out from the COVID-19 Cancer Consortium, or CCC19.Published in The Lancet, CCC19 s data comes from a crowdsourced cancer/COVID-19 patient registry which was put together by a handful of Twitter-savvy cancer researchers in a matter of weeks. Since then, it s morphed into huge international collaboration with more than 2,000 patients and hundreds of clinicians, researchers and research institutions, all working to gather, analyze and disseminate crucial cancer/COVID-19 outcomes in near-real time.Here s a snippet and a link to the full story.What happens when cancer patients get COVID?Large new observational study of nearly 1,000 patients breaks down who’s most at risk with coronavirus, highlights need for additional careThe first large observational study of nearly 1,000 cancer patients who contracted COVID-19 was published today by The Lancet and simultaneously announced at a virtual ASCO 2020, the large annual meeting of the American Society of Clinical Oncology.The findings, gleaned from over 100 institutions participating in the international COVID-19 Cancer Consortium, or CCC19, patient registry, underscore how deadly the new coronavirus can be for patients with active cancer and other underlying health conditions.“If you have active cancer and are older or have multiple comorbid conditions that require therapy, you are likely at much greater risk from complications of COVID-19,” said co-senior author Dr. Gary Lyman of Fred Hutchinson Cancer Research Center.“That’s one of the major findings and one of the most concerning findings. However, the risk is greatest in those with progressive disease and poor performance status and less when the cancer is stable or responding.”The second thing, and this will come as no surprise to anybody who s been paying attention to the Black Lives Matter speakers the last few days, COVID-19 is also disproportionately deadly to people of color.It hits African-Americans, Hispanics, Indigenous people and other people of color much harder, just like cancer and chronic conditions like diabetes, hypertension, cardiovascular disease, etc.With COVID-19, though, it goes deeper: it s hitting black and brown populations harder because they re more likely to be essential workers. They re the ones working elbow-to-elbow in fruit and meat-packing plants. They re the ones nursing COVID-19 patients in clinics and ERs. COVID-19 has exposed who s privileged enough to safely shelter at home, safely work at home. And who isn t.It s a new disease that s underscored an age-old foe: racism and the systemic racism that s baked into every one of our institutions.Again, a snippet and a link to the full monty. Thanks, as always for the read. This is an important one.COVID and cancer expose society’s health care gapsFred Hutch researchers work to disrupt health disparities and misinformation as coronavirus ravages the medically underservedDisease hits black and brown people harder. Same for indigenous people, folks in rural areas, members of the LGBTQ community and others who are medically underserved. It’s what the research shows and what many of us have experienced firsthand.These disparities aren’t the result of genetic predispositions, but societal ones. It’s the person’s socioeconomic status, their insurance and immigration status, the neighborhood where they live and whether they have access to (and can afford) health care, nutritious food, social support. It’s how people treat them based on their looks or their heritage. These are the things that truly dictate who gets sick and who dies.It’s true for cancer, for cardiovascular disease and diabetes and in these times, for COVID-19.“The disparities we see in COVID-19 are very consistent with most forms of cancer and most health conditions in the U.S.,” said Dr. Christopher Li, an epidemiologist with Fred Hutchinson Cancer Research Center at a recent Hutch Town Hall on health disparities.And it’s crucial, especially as racial inequality has launched yet another national crisis, to understand them “within the context of the significant economic and social differences that exist in our society,” he said.Finally, one last story from April (yes, I m the world s slowest blogger) on Treating Cancer in the Shadow of Coronavirus. It outlines what oncologists and cancer policymakers are doing to keep newly diagnosed cancer patients and those in treatment safe from infection with COVID-19.Stay well, my friends. Keep wearing those masks, keep washing those hands, keeping lifting up the voices of those who matter and just keep swimming. Ghecemy Lopez of Los Angeles, a two-time cancer survivor who now has immune issues. She dons plenty of PPE for her doctor s visits. It s pretty much been corona, corona, corona these last few months — even in Cancerland — and I don t imagine that will change much moving forward.States are starting to open up — Washington will get there eventually —and I pray everyone out there stays safe as we slowly creep forward with our masks and mad soap water skillz and (hopefully) enough sense to stand far enough away from people that we don t accidentally breathe in any virus particles they may be talking, sneezing, laughing, singing, coughing or farting our way.Sadly, it looks like we re going to be here a while. Yet another new normal.Like everybody else, I m hoping science can find or fast-track better treatments than remdesivir (the Tamiflu of COVID-19, just emergency approved by the FDA) and that other drug combo the orange guy in the White House keeps chatting up, along with sunlight and bleach, as a fabulous miracle cure.Like everybody else, I m praying a vaccine isn t too far off in the distance. First time I typed that, I wrote vacuum, by the way, which may tell you where my head is.I used to blame that sort of thing on chemo brain; now I think it s more quarantine brain. It s Tuesday, right? June 32?As soon as we started hunkering down in early March and I saw how freaked out people were about the epidemic — all the uncertainty, the life or death odds, the extra precautions we all had to take to stay safe, the lack of a cure — it struck me as weirdly familiar. So I wrote about it for Fred Hutch News Service.For those who’ve been diagnosed with cancer, the onset of the coronavirus pandemic has felt a little, well, familiar. The frantic Googling and data-gathering. The denial and disbelief. The uncertainty and panicky behavior. Cancer patients have been there.Same goes for all the handwashing and hypervigilance. People who’ve been through surgery or radiation or chemotherapy or bone marrow transplants or other immunocompromising treatments are routinely forced to hunker down at home, avoiding crowds and friends with colds, skipping weddings and air travel and ordering their groceries online.As one Seattle survivor put it, “I’ve sheltered in place lots of times.”Did your cancer diagnosis and treatment prep you for the COVID-19 pandemic? Certainly feels that way to me, same for the enforced quarantine after my ankle break last August.Will the losses we ve endured as cancer patients — family, friends, fellow advocates gone to another invisible enemy — help us bear the inevitable COVID-19 deaths ahead? It s tough stuff, but as with cancer, we all have to somehow keep powering through.But right now, it s all feeling pretty old.I m getting corona-cranky after two months of hiding out at home. I m angry about the people who ve died and who keep dying because of our country s clown car response to a deadly pandemic. I m getting homesick (ironically) for restaurants and yoga studios and my old boring cubicle at work.So I m going back to peruse a few of these lessons from cancer patients in the time of coronavirus. Feel free to join me. Or send along your own. I m having way too many arguments with my cat (and the little snot keeps winning).#StayHomeStayAlive#JustKeepSwimming#FUcancer #FUcovid19 So now there s a pandemic. And my workplace and our scientists are right in the thick of it. I interviewed a couple of friends and Fred Hutch experts: one in infectious disease (Dr. Steve Pergam) and one in public health, health policy, outcomes AND oncology (Dr. Gary Lyman) to find out who s most at risk for contracting COVID19.That s the brand new coronavirus that apparently leapt from some type of animal to somebody in China and now the infection has spread from there to Italy, Japan, Iran, South Korea, Thailand, you name it and now Seattle, where I ve lived my entire adult life.As it turns out, we re now the country s COVID19 epicenter. Not really all that much better than our previous reputation as Serial Killer Central.Anyway, these two devoted scientists shared great data on COVID19 and who it picks on the most. They also had some great tips on little things we can do to boost our immune system (get that sleep!) and keep this new beast at bay.Here s their advice for cancer patients (past and present) and other folks with underlying health conditions (think COPD, heart disease, diabetes, HIV).Wash your hands and read on.Coronavirus: what cancer patients need to know: Advice for cancer patients, survivors and caregivers on who’s most at risk for COVID-19 and what you can do to stay healthyFULL LINK: https://www.fredhutch.org/en/news/center-news/2020/03/coronavirus-what-cancer-patients-need-to-know.html My science writing team at Fred Hutch put together this series of stories to help the public and especially cancer patients cut through all the harmful health misinformation and overhyped nonsense that s out there these days.Boy, could I have used this back in the day.When I was first diagnosed, it was hard to figure out what to believe, there was so much back and forth. Mammograms save lives! Mammograms actually give you cancer! Wine is healthy! Wine will kill you!  What was I supposed to take away from that? I would always try to go to the source, but deciphering scientific papers wasn t easy either, not once they descended into TILOA, The Indecipherable Land of Acronyms, a confusing place full of scientific doublespeak and mind-bending biostatistical models.If that s you, I m hoping this series will help. There are six stories in all. Great explainers on many aspects of clinical and epidemiological research (the stuff most likely to hit the headlines and get skewed), including sample size, correlation and causation, absolute vs. relative risk (spoiler: it has nothing to do with your family), open science, types of studies. There s even some baseball statistics. Naturally. The Hutch is the only cancer research center named for a baseball player.Spinning Science Series: Read all about it!Numbers don t lie, but sometimes our brains do99 problems when n = 1? Sample size matters  (props to Jake for best headline!)Coronavirus puts open science under a microscopeCorrelation is not (necessarily) causation Oversized headlines obscure tiny findings: Types of research studiesGive it a read and please share with anyone who s a little science curious around the  edges, like me. Here s a short link to the whole shebang: fredhutch.org/spinning-science  As always, thanks for the read and #FUcancer! Beautiful blood clot illustration by Kimberly Carney.I swear the last year has been a blur. Between the cancer whispering job at Fred Hutch, the cancer advocacy world and our crazy clown car presidency, I haven t had time to blog much. But I ve written and tweeted and advocated plenty!In days ahead, you ll find me at the Binaytara Foundation s 2019 Summit on Cancer Health Disparities (#SCHD19) next weekend, April 27 and 28, here in Seattle.On Tuesday, April 30, I m joining lung cancer patient advocate Randall Broad, physician-scientist Dr. Renato Martins and others for a C-SESSIONS discussion on Bridging the Gap, improving cancer patient/provider communication. More info here. Register for the free event here.And for the first time ever, I ll be attending the largest cancer research conference in the world, ASCO 2019, in Chicago  May 31-June 4. In a word, EEK!Writing-wise, here are a few stories that might be of interest to my breast cancer peeps Blood clots: What cancer patients need to knowWhen Don Stranathan’s left leg became swollen after a long day of shoveling granite for a buddy’s new bocce ball court, he didn’t think much of it. He even joked about it on Facebook. “Typical me, I posted a pic and said, ‘I worked so hard, my leg’s all swollen,’” said the 66-year-old metastatic lung cancer patient from Santa Rosa, California. “Then somebody said, ‘Don, if you have lung cancer, there’s a good chance that could be DVT, deep vein thrombosis. You should get that checked; it could be serious.’” As it turned out, it was serious — and not just for Stranathan. Blood clots, also known as thrombosis, or, when they break loose and lodge in the lung, venous thromboembolisms, are the next leading cause of death in cancer patients after cancer itself. They are a side effect of both treatment and the biological nature of the disease They’re common, they’re scary, they’re potentially lethal and they’re pricey — yet they’re not always on the radar of patients or clinicians.  READ MORE Is it possible to prevent breast cancer metastasis?Researchers at Fred Hutchinson Cancer Research Center in Seattle may have found a way to essentially smother cancer cells in their sleep, preventing them from ever waking up and forming deadly metastatic tumors. The work, led by translational researcher Dr. Cyrus Ghajar, has also turned on its ear the longstanding belief that chemotherapy can’t kill dormant disseminated tumor cells — cancer cells that escape early on and hide out in other regions of the body — because those cells are in a “sleeper state.” They’ve stopped growing so chemo, which blindly targets all fast-growing cells, healthy and otherwise, doesn’t work. That’s not quite the case. READ MORE Supper, sleep, circadian rhythms and cancer riskWhen you eat may be as critical as what you eat for your risk of breast and prostate cancers, a research team reported this week. The findings came from a Spanish study published in the International Journal of Cancer, which was led by environmental, occupational and molecular epidemiologist Dr. Manolis Kogevinas of Barcelona’s Institute for Global Health. Kogevinas is currently a visiting professor at Fred Hutchinson Cancer Research Center. In a nutshell, participants in the study who ate dinner before 9 p.m. or waited at least two hours after eating before going to bed had a 26 percent lower risk of prostate cancer and a 16 percent lower risk of breast cancer than those who either ate after 10 p.m. or ate and then promptly hit the hay.   READ MORE Last but not least, I celebrated (angrily acknowledged?) the eighth anniversary of my double mastectomy this week. Incredible that I have made it eight years. Really happy to still be here but man, I wish we could crack this nut. People are still dying.Peace out, much love, #FUcancer and thanks as always for the read! Discovered a new Twitter tool that I m geeking out about a little. It s called Moments and it lets you string a bunch of tweets together yours and others to create a short story.  It s a bit like Storify, which recently lost its battle with cancer er capitalism. RIP, brave fighter! ; )Anyway, I ve put a couple of cancer advocacy Moments together and am going to attempt to share them here. The first is from Lung Force Day at the University of Washington back in March, a very informative sweep of the latest in lung cancer screening stats; smoking cessation apps; electronic vaping and Diane Maping (sorry, couldn t resist). ; )It was also a lovely opportunity to see the UW s glorious cherry blossoms and hobnob with the area s lung cancer oncs, surgeons, radiologists, researchers and (maybe) one patient advocate? Let s fix that.Big shout out to Fred Hutch s Jonathan Bricker and SCCA s Donna Manders, who are both doing amazing work to help cancer patients get through treatment; kick their smoking habit and sidestep the creepy lung cancer shame and blame game. Remember, if you have lungs, you can get lung cancer. And even if people smoke, they don t deserve to get fricking cancer. Nicotine is super addictive.Ditto for a lot of the other things we do that give us this craptastic cluster of diseases: drinking too much alcohol; suntanning; sitting on the couch watching TV and eating crap food all the time instead of exercising.Just sayin .Here s my Lung Force Moment. Please excuse the typos, blurry slides and lack of chronology. You can reorder your tweets but I m too damn lazy the sun s shining and it s time for Miss Public Health Sciences to go practice what she preaches. ; )Hope the information is helpful!My second Twitter Moment is from the Inflammatory Breast Cancer talk that Houston area patient advocate Terry Arnold aka @TalkIBC gave in Seattle at the swanky, restyled Cancer Pathways (formerly Gilda s Club) on Capitol Hill. Terry is an IBC patient who went through seven kinds of hell trying to get a doctor to correctly diagnose her big red swollen feverish boob back in 2007.Seriously, health care? What a shitshow.Terry shared her diagnosis story and her path to advocacy (so far, her nonprofit IBCNetwork Foundation has raised $1M for IBC research) and some incredibly infuriating (and darkly hilarious) stories and slides of stupid things her five doctors told her before MD Anderson took one look at her and figured it out (FYI, they actually have an IBC clinic). None of the other docs would believe it was cancer. One guy told her her boobs were aging at a different rate, FFS.After giving a Patient Perspective talk to 30 or so young docs at Seattle Cancer Care Alliance, Terry brought it (and how!) to the breast cancer patient community, along with Drs. Julie Gralow (onc), Sara Javid (surgeon) and Diana Lam (rad onc).The breakdown: IBC comes on fast and aggressive; presents as a red, swollen, feverish breast, sometimes with orange peel skin; is often misdiagnosed / mistaken for mastitis and thus diagnosed later; and it s more prevalent in young women and African-Americans. It s a tricky one, a rare one (but data is incomplete so it may be more prevalent than we think) and it s absolutely treatable. One day, hopefully very soon, it will be beatable.Here s my TalkIBC Moment along with heartfelt thanks to all the patients and docs and researchers working to take this mofo down. Please share with your networks so more women and more importantly more doctors! learn about this creepy breast cancer subtype.As always, thanks for the read. Cheers and enjoy the day. Tags: Breast cancer, inflammatory breast cancer, Julie Gralow, lung cancer, Lung Force, smoking cessation, swollen breast, TalkIBC, Terry Arnold It’s been a busy few months in Cancer Advocacy Land and it’s going to get even busier as we head full on into spring. I’ll be lending my patient voice to a couple of Seattle conferences on cancer care cost, health equity/health disparities and policy in late April and early May. And my BC buddy Terry Arnold of the IBC Network is coming up from Texas to talk about inflammatory breast cancer at Cancer Pathways (formerly Gilda’s Club, Seattle) on April 19. As an oddball BC patient myself (diagnosed with ILC), I look forward to learning more about this subtype.Speaking of BC subtypes, make sure you check out the great new lobular breast cancer website (here’s my Fred Hutch story on ILC). Invasive lobular carcinoma (ILC) is the weird one where your cancer cells don’t have enough ‘glue’ to stick together so instead of a lump, they march through your tissues like creepy little ants. The upshot, lobular cells and ‘tumors’ grow more like a mesh or tree branch, which means in addition to not always making the standard lump, bump or “hard pea,” they’re hard to image. Mammograms can miss them; PET and CTs can miss them. Still a little unsure about MRI’s efficacy with ILC but would love to hear from radiologists/patient advocates on that point. ILC also pops up in some odd places when it metastasizes: your GI tract, your ovaries, the linings around your organs, even your eyeball area. It’s a freak.But knowledge is power, right? Thanks to lobular buddy Leigh Pate’s efforts (and that of all the Lob Mob), this great new site offers resources and links and new clinical trials and much more information than I can fit into this “short-and-sweet” blog posts. Please go here: Lobular Breast Cancer Alliance, read up on the cancer, its metastatic spread pattern and how it differs from other ER+ BCs, and make sure your oncologist knows that you’re a special unicorn and needed to be treated as such. If you’re interested, there’s also info there on how you can join the Metastatic Breast Cancer Project and/or attend a lobular cancer research conference back in Boston this summer.Good stuff is also happening with the Lymphedema Treatment Act, an “active bill” in the current Congress designed to help cancer patients who develop lymphedema after some or all of their lymph nodes are removed during cancer surgery. Breast Cancer patients are particularly vulnerable to this: full axillary lymph node dissection was standard of care for decades. In recent years, research has advised against this (thanks for your part in this, Gary Lyman!), so moving forward, breast cancer surgeons shouldn’t be harvesting healthy lymph nodes like ripe raspberries come summer.This lymphedema legislation – which could still use your support! – will serve patients who’ve had their nodes taken and gone on to suffer swelling, pain, infection and other complications because their insurance wouldn’t pay for a compression sleeve and they couldn’t afford it to by it on their own. The bipartisan LTA, sponsored by Washington’s Rep. Dave Reichert; Senator Maria Cantwell (also of Washington), Senator Chuck Grassley, from Iowa, and many more, will do the following:The Lymphedema Treatment Act (LTA) will improve coverage for the treatment of lymphedema from any cause by amending Medicare statute to allow for coverage of compression supplies. Although this legislation relates specifically to a change in Medicare law, it would set a precedent for Medicaid and private insurers to follow. Read more about the specific goals of the LTA here. Read my story on this common cancer surgery side effect here.Science / advocacy quick hits: Went to the two-day Life Sciences Innovation Northwest Conference this last March 27-28 and heard about a bunch of cool new biotech startups, including one from Fred Hutch researcher VK Gadi (and others) that definitely warrants follow-up. SEngine Precision Medicine takes cancer cells from patients’ tumors or cancery fluid (think ascites), grows tiny little organoids with them, then tests out dozens (100s?) of drugs to see if any of them work. If they don’t work on the organoid and its particular mutations, then they don’t bother giving them to the patient and putting ‘em through all that rigmarole for nothing. If it does work on the organoid, then beautiful things begin to happen. I realize I’m being a bit of a breathless fan girl here but it’s a new and very targeted approach and I have a couple of (hundred) friends who could use a miracle. I’ll keep you posted. Also went to Portland mid-March for Komen Oregon and SW Washington s Breast Cancer Issues conference. Was great to connect with some sisters to the south and hear about all the great health equity work that Komen Oregon is doing for people of color, for rural cancer patients and all the others who keep falling between the health care cracks. Was very honored that they asked me to share my story as the conference final speaker. Here’s a link to my talk (yes, I’m a hambone). Just doing what I can, while I can, to bring the information to the people. And kick cancer’s sorry ass, one bad joke at a time.Thanks for the read, people. Happy Easter, April Fool’s (I blogged!) and love to you all. Illustration by Kimberly Carney / Fred Hutch News ServiceFinally got a chance to write about lobular breast cancer, my particular flavor, and profile rock star patient advocate (and friend) Leigh Pate.Leigh was diagnosed about the same time as me; she s also a lobular gal and has already done a bit of advocacy around lymphedema, that really annoying swollen arm thing that breast cancer patients get when surgeons take out some or all of our lymph nodes.Leigh and I met first over the Interwebs and later over cocktails at The Triple Door in downtown Seattle where we talked about lymphedema (or milk arm, as it used to be known). Because, you know, cancer patients know how to party.After she recovered from treatment (and took a moment to breathe), Leigh sort of leaned into cancer research, as many of us do. She realized quickly that invasive lobular is lumped in (no pun intended) with invasive ductal and treated identically — mainly because lobular is almost always estrogen receptor positive (ER+ in cancerspeak).But lobular is a different animal entirely, down to its tiny biological bits. And it s a hard one to catch early, because it doesn t image as well as ductal. Particularly if you have dense breasts — that s where that whole doublewhammied thing came from. That and the fact I had two tumors in both breasts. Another weird lobular trait: many women have tumors in both breasts and/or have more than one tumor per breast.There are other differences. Lobular spreads to oddball places like the GI tract when it metastasizes. The cells travel single file, kind of like deadly little tree branches. This weird growth pattern means it doesn t always make a lump (mine was a tuck that pulled from inside and crumpled in when I raised my left arm).But again, the cancer has been cast as just like ductal for a long time. So not everybody knows these quirky differences. Not even patients or PCPs or sometimes not even oncologists. Women come in with weird abdominal symptoms and they re told they have irritable bowel syndrome (because hey, don t ALL women have IBS?). But no, they have stage 4 lobular cancer.Leigh Pate, lobular breast cancer patient/advocate. Photo by Robert Hood / Fred Hutch News ServiceAnyway, tired of the status quo and encouraged by an uptick in scientific interest, Leigh and a bunch of her BC buddies (the #lobmob), put together the Lobular Breast Cancer Alliance to raise its profile — and eventually, they hope, funds for more research. The timing is perfect because there are some cool new  lobular studies being done right now (at Fred Hutch and elsewhere) and we can all help get the word out.You can read my full story here, which includes some intriguing history regarding combined hormone therapy (HRT increases the risk of lobular, not ductal — I did not know this!). You can also see where scientists are looking, genetically, hormonally and otherwise, in order to shut this shitshow down.As always, thanks for the read. Enjoy your day, peeps! Big doins in the world of mets these days. And by mets, I mean metastatic breast cancer, not the baseball team. And by big doins, I mean the upcoming Northwest Metastatic Breast Cancer conference, which is happening Friday and Saturday, September 22 and 23, in Seattle.This party is being thrown with help from Komen Puget Sound and lots of other orgs. And it’s being held at Amazon Web Services which (for out-of-towners) is in South Lake Union not far from Fred Hutch, the cancer research cancer where I’ve been working these past (nearly) four years. And this thing is going to be the bomb.Is it weird to be geeking out over a cancer conference? Yes, absolutely. But that’s how it is these days. I’ve gotten sciency, people, which is a pretty strange turn of events considering the bad taste for science my condescending 7th grade teacher Mr. Sargo left in my mouth.Hmmm is it too late to switch majors? Does this lab coat make my butt look big? ; )This is the second annual NW MBC conference and it looks to be even bigger, better and more bad ass than last year’s inaugural event. The force behind it? Dynamic duo Beth Caldwell and Lynda Weatherby, two MBC patient advocates who’ve somehow managed to corral cancer peeps from nearly every MBC advocacy organization in the country to speak at the conference.And then there are the researchers. There will be a handful of scientists from Fred Hutch; a few folks from Virginia Mason and Swedish, including the onc who treated me (sounds like a movie title, doesn’t it?); people from the Broad Institute/Harvard, birthplace of the Metastatic Breast Cancer Project.  And lots, lots more.Topics include integrative oncology; inflammation; health disparities; financial toxicity; clinical trials; vaccines; and research, research and more research. There’s even going to a special session on filling in the mets recurrence data that’s currently missing from the SEER Cancer Registry (more on that here).Breakout sessions will cover mets sites (liver, lung, brain, etc.) and cancer types (triple negative, HER2, etc.). There’s even going to be a session on lobular breast cancer (my particular flavor) with experts from the University of Pittsburgh.As I always like to say, knowledge is power. Even more powerful? Free knowledge that might save your life — or the life of a friend! And this conference is free, folks. Here s the full agenda.Just so you can see what you’re getting into, here’s a link to a piece I wrote last year that talks a bit about the first conference. I’ll be covering it again this year. If you can make it, please come by and say hello (I’ll be the frazzled blonde furiously live tweeting and scribbling notes in a reporter’s notebook).If you can’t make it, the word on the street is, it will be livestreamed. Check the Komen Puget Sound website and/or FB page for more details on that.Peace out, peeps. I m going to go measure my P-values. Illustration by Kimberly Carney / Fred Hutch News ServiceSex after cancer is complicated. You know what else is complicated? Writing about sex after cancer.I tackled the topic last week in a two-part series for FredHutch.org. And even though it felt like I was walking around in my underpants when the stories came out (I talked a little bit about my own experience in this realm), I’m glad I covered it because it’s a big issue for cancer patients and it doesn’t get a ton of attention.As I said in the story, cancer cuts us to our sexual quick. We lose body parts. We lose our libido. Oftentimes, we lose our sexual selves. Men struggle with impotence; women are plunged into menopause decades before they would naturally arrive; and many are left to sort it all out on their own.Why? Because people often don t feel comfortable talking about this stuff – not doctors, not patients, not even their partners. Sex after cancer has become the elephant in the bedroom.Here’s a link to Part 1, which covers the sexual aftermath of cancer treatment and how surgery, chemo, radiation and hormone treatments — all those things they do to keep us alive — can cause all kinds of sexual side effects, from fatigue and body image issues to erectile dysfunction and vaginismus.And here’s Part 2, which offers a few experts tips and tricks that we as patients can use to hack our post-treatment sex life.As I said, it’s not easy to write about this stuff or talk about this stuff. So I’d like to give a huge shout out to two amazing patients: stage 4 anal cancer patient Michele Longabaugh and testicular cancer patient Jon Dibblee. Both were kind and courageous enough to talk about the sexual challenges they’ve faced since treatment and I can’t thank them enough for their candor and insights. Many thanks, also, to Nicki Boscia Durlester and her private breast and ovarian cancer Facebook group, Beyond the Pink Moon. It’s so important to have safe, supportive places like this where patients can bond and bare all.Did your cancer and treatment lead to sexual side effects? Did your doctor downplay the damage or mention it at all? Let me know in the comments section. Still have more to say? Please join me and the folks at Fred Hutch  tomorrow (August 4) at 10 a.m. (Pacific) for a tweetchat on the topic. Use #ChatFredHutch to join the conversation. Enter your email address to follow this blog and receive notifications of new posts by email. Email Address: Medical acronyms. Whatcha gonna do? #bcsmInvasive breast carcinoma of no special type = IBC-NST

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