In our connected and complicated world, it can seem as if news of disease, natural disasters, violence and suffering bombards us from every direction. We’re more connected to a planet’s worth of chaos than we ever have been before. Combine that with dealing with the trauma of breast cancer as a young adult, and the effect can be overwhelming. If you’ve been feeling overcome by our 24/7 news cycle, know that news-related stress is a serious issue and you’re not alone.

Hearing or Watching the News Can Cause Its Own Form of Trauma

Too much trauma-related news can have a negative impact on individuals. This could range from coverage of an event such as a political debate, to natural disasters, to civil unrest. Events of 2020 have caused us to bear witness to incredibly scary events. There is even talk of a worldwide trauma due to COVID-19.

“Self-regulation about media intake is healthy and good. You have permission to take a break!”

It’s even possible to develop a sense of hypervigilance due to the vicarious stress symptoms of exposure to trauma on the news. The Anxiety and Stress Management Institute suggests that individuals pay attention to when the news is becoming too much.

You may be thinking, “That sounds great…But how?” We get it; it can be hard to avoid the news. Here are three tips for coping when the news becomes upsetting.

Three Quick Tips for Managing News-Related Stress

Put down the remote!
Seriously. Turn off, tune out and unplug. Limit the amount of media coverage you observe. Do something else, something that is nourishing and nurturing to your psyche, like reading a good book.

Talk it out
Surround yourself with those with whom you feel safe and comfortable. Talk with other young survivors who may mutually benefit from being able to talk about it. Setting boundaries and receiving support are important in many aspects of our lives.

Remember the importance of restful sleep
The National Sleep Institute (NSI) suggests that when we find ourselves ruminating on disturbing thoughts, our bodies tense and our hearts race. Relaxation exercises and creating healthy bedtime routines can assist in taking ourselves down a notch.

The NSI further reports that 90% of Americans report using a handheld device in the hour before bedtime. The blue light from these devices interrupts our body’s normal sleep process, so choosing to stop looking at our phones or tablets two hours before deciding to sleep is recommended. This would also organically mean two less hours of media coverage!

Take a Step Back

Allow for time needed to recover and re-stabilize in between events. Trauma care involves a need for a sense of safety and calm, of being able to solve problems for oneself or as part of a group (such as family or any school, religious or community group that the person can identify with), connectedness to social support, and hope.

In a time that feels chaotic, let these principles serve as a guide. How can you cultivate these in your life? Where and with whom do you feel safe? What brings your calm? As you begin to tune in with yourself, you will become more aware of when you need to take a break. Be good to yourself and each other.

Credits : This blog has been written by Jean and is sourced from https://blog.youngsurvival.org/ . Click here to read original blog.

I’ve been living with metastatic breast cancer for two years, two months, and 15 days. For the longest time – close to a year – I felt like a cancer newbie. In groups, I was always the youngest one, the one with the kid, the one with so much still on her plate. Until, all of a sudden, I wasn’t.

Clinical Trials

After I hit a year, I felt like I had hit a stride. I was adjusting to my life in this new normal (as much as I didn’t like it). And our family was finding new routines to accommodate my cancer diagnosis. And then, as life almost always does, things changed – my disease progressed in my bones, and I had to switch to my second line of metastatic breast cancer treatment, a clinical trial.

After living with bone-only metastases for over a year, I was diagnosed with brain mets in March of 2019. I underwent stereotactic radiosurgery (targeted radiation) to treat the two small lesions that had popped up.

Then about a month later, a CT scan revealed that my liver now had cancer involvement as well. I had been on a clinical trial but was kicked off the trial at that point due to liver progression.

Needing a bigger treatment than just hormone therapy due to the new involvement in both my brain and my liver, I switched to an oral chemotherapy. I was on this drug for about nine or so weeks before my oncologist noticed a rise in my tumor markers and elevated liver enzyme numbers in my bloodwork.

She ordered a PET scan ASAP, which revealed what she had suspected: the drug was not working and my liver lesions were growing. Onto chemo number two, and my fourth line of treatment.

IV Chemotherapy

Up to this point, all of my treatments had been oral therapies. This was the first time I was on IV chemotherapy. Several weeks into treatment, I lost my hair. After 12 weeks, my doctor ordered the first scan on this drug.

We were all hopeful and optimistic – although the drug was very hard on my system, we hoped it was working. It was not.

Onto another chemotherapy, my fifth line of treatment. As my oncologist and I discussed different treatment options over the following days, I had my regularly scheduled brain MRI – the six-month follow up to the targeted radiation I had received back in April. I was seemingly asymptomatic. None of us expected anything to show up on the MRI. We all hoped and anticipated that life would proceed as we had planned for my next treatment option.

“My first thought when I received my cancer diagnosis was ‘Oh My God, I’m going to die.’ Once I started treatment, my life developed somewhat of a new rhythm, but I couldn’t compartmentalize my fears.”

It turns out that I wasn’t asymptomatic. I had been experiencing numbness in the left side of my face, similar to Bell’s Palsy, that is a common symptom of leptomeningeal disease. Leptomeningeal metastases are often considered the big baddie of metastatic cancer. Lepto mets, or “lepto” as it is often called, are somewhat like meningitis, but with cancer cells. Lepto occurs when cancer cells are able to invade your cerebrospinal fluid and find homes on the meninges – the covering of the brain that acts as a protective barrier.

Once it is established in your cerebrospinal fluid, it travels throughout your brain and the full length of the spinal cord. You can develop lepto lesions anywhere along that route.

Typically, the only treatment for lepto is whole-brain radiation, and it is considered palliative and not usually curative. The life expectancy with a lepto diagnosis is grim, and measured in months, even with radiation. I was understandably terrified, hearing this diagnosis.

Proton Radiation

However, by some stroke of good fortune, I was referred to a research radiation-oncologist who has been using proton radiation to treat leptomeningeal disease with compelling results. As opposed to typical “photon” radiation, proton radiation is a much more targeted therapy. It damages far less healthy tissue while targeting diseased tissue very well. I immediately scheduled a consult.

Two weeks later, I found myself in New Jersey, receiving 10 rounds of whole brain and whole spine proton therapy. The little baby wisps of hair that had started to grow back fell out again. And the fatigue I experienced after the therapy was crippling. But I was still here, and, when not felled by my body’s exhaustion, still relatively functional.

My first thought when I received my metastatic breast cancer diagnosis was “Oh My God, I’m going to die.” I don’t think this thought is uncommon. Once I started treatment, my life developed somewhat of a new rhythm, but I couldn’t compartmentalize my fears.

I knew the breast cancer statistics I faced: less than 30% of those with a metastatic diagnosis live for 5 or more years. With each progression, each new drug, each new organ invaded, those fears haunted me. They taunted me, and brought out the worst in me, reminding me of the falling sand in an hourglass I resented. I couldn’t see how much sand was left, only that it kept falling, seemingly faster and faster, each time I looked at it.

Not Your Typical Bucket List

Finally, one day, while we were waiting for my proton radiation appointment, I told my husband I wanted us to make a bucket list. Not the typical bucket list, because that bird has flown for us in many ways. But a realistic bucket list: things close to home or driveable, for example.

We had always talked about trips to France, Italy, and Japan, but those were off the table. I’m a stressful travel companion in my best health. And my husband’s work obligations, my treatment challenges, medical expenses, and our son ruled out any sort of major travel.

While I’ll never be able to eat a chocolate croissant and sip espresso while I sit and look out at the Eiffel Tower, we’ve been able to start carving pieces out of that bucket list from home, surrounded by family.

And truthfully, that’s really what I want anyway.

Credits : This blog has been written by Emily Garnett, and is sourced from https://blog.youngsurvival.org/ . Click here to read original blog.

What is Chemobrain?

First, let’s clarify terminology: “Chemobrain” is often used in everyday language to describe cognitive changes (e.g., memory, thinking, or attention processing) due to cancer treatment that significantly interfere with an individual’s quality of life. This term is frequently used. But it’s not necessarily the best way to define what oncology professionals refer to as cognitive changes potentially related to the cancer experience.

Terms such as “chemobrain” or “chemofog” are less preferred. This is because cognitive changes can be related to sources other than chemotherapy alone. For example, previous research has suggested that there are several other factors that can potentially influence cognition. These include hormone therapy, corticosteroids, other medications, and even radiation (especially in those with metastatic disease to the brain and central nervous system). In addition, pain, fatigue, sleep problems, stress and emotional changes can all affect cognitive functioning or thinking skills. For this reason, much of the field is moving to using terms such as Cancer Related Cognitive Dysfunction (CRCD) or Cancer Related Cognitive Impairment (CRCI).

What Does it Look Like?

In my professional experience, I have had patients report concerns such as:

• I can’t remember details of conversations I just had
• It’s much harder for me to keep track of my ‘”to-do”s each day
• I’m having a difficult time finding the word that I want to say when I’m talking to someone
• It takes longer for me to respond when someone is talking to me
• I’m having a difficult time focusing on the material when I read

Who Is Affected?

Much of the previous research in cognition in adult oncology has been conducted with individuals with breast cancer. Previous work suggests that up to 75% of patients with cancer experience cognitive impairment at some point during chemo brain treatment. However, only 15% to 35% of cancer survivors experience cognitive problems in the months to years that follow the end of treatment. This means that although many individuals may experience cognitive changes initially, these changes tend to resolve for most people within 12-18 months after treatment ends. And they do not have lasting effects.

Why Does Chemobrain Happen?

The underlying causes of cognitive changes in the setting of breast cancer treatment are still being explored. Healthcare providers, scientists and survivor’s themselves observe that not everyone treated for breast cancer experiences cognitive changes, let alone changes that last long after treatment ends. One of the current goals in the field is to understand why there are such different outcomes given there are likely multiple factors that contribute to the individual’s experience of these changes. More recently, researchers are studying the role of genetics and its potential influence on differing cognitive experiences. In addition, researchers are considering potential pathways that contribute to the cognitive changes, including aspects of the body’s natural inflammatory response. It will likely take some time before we understand all the factors that contribute to cognitive changes.

What Can I Do?

Individuals may report different types of cognitive changes that make it difficult to accomplish daily life activities. These include quickly forgetting information and becoming more easily distracted. Or having difficulty verbally expressing themselves because they can’t find the word they want to say. If you have experienced these types of challenges and find they often interrupt your ability to get things done, you may consider the following:

Basic Self-Care:

We all know that good nutrition, getting a good amount of sleep and regular exercise are all important, and this is especially true for breast cancer survivors who may be experiencing cognitive changes. Maintaining these health routines is important for overall physical and mental well-being. They can also go a long way in supporting cognitive health, as well.

Practice Good Cognitive Habits:

These may include starting certain routines you haven’t used in the past. Use phone apps, a daily organizer or calendar alarms to remember information you used to “mentally track” before. These types of tools are not a “crutch”. Using them doesn’t mean that you’ll never get better. It just means you’re allowing your brain to use helpful resources which may keep you from feeling mentally stressed or overwhelmed. They’re the best way to support your cognitive function during this part of your journey. Other good cognitive habits include keeping your mind mentally active through activities, reading enjoyable material more often, playing games that make you think (e.g., bridge, chess, board games) and reducing multitasking. Our brains weren’t meant to juggle multiple challenging tasks all at one time. Give yourself the time to slow down. And try to focus on one thing at a time (or as few as possible!).

Know When to Talk to Your Medical Team:

Some individuals will go on to experience cognitive changes for a longer time (e.g., more than a year or so after treatment ends). If you feel this is happening to you, it may be helpful to talk to your oncology team. They may recommend further assessment of these concerns with a neuropsychologist (a professional who can conduct a comprehensive neurocognitive assessment). Not all cancer centers have this specialty. But other services, such as Occupational Therapy or Speech Therapy can sometimes provide brief cognitive screening and cognitive rehabilitation. Cognitive rehabilitation intervention provides strategies you can use in daily life to manage your cognitive challenges. Other services, such as Psychiatry or Neurology may provide recommendations for medication intervention if necessary. It is important to talk to your oncology team for specific information about what types of services are available at your treatment center.

Finally, it is important to note that your experience of cognitive changes doesn’t mean you have dementia or some other neurodegenerative disorder. They are two very different things. Talking with a professional like those mentioned above can help you determine the difference. Know that more than likely, you will only experience these challenges for a while, with every hope of them getting better not too long after treatment ends.

Credits : This blog has been written by Natalie Kelly, and has been sourced from https://blog.youngsurvival.org/ . Click here to read original blog.

Caring for your mouth is about far more than having a pretty smile. Poor oral health has proven to raise risks for a variety of medical conditions, such as heart attacks, strokes ⁽¹⁾, respiratory infections ⁽²⁾, pregnancy complications ⁽³⁾, and even Alzheimer’s disease ⁽⁴⁾.

After a breast cancer diagnosis, paying special attention to caring for your teeth and gums can help to reduce uncomfortable and potentially dangerous oral side effects. Minimizing oral side effects during treatments can also reduce risks for damage to long-term oral health and provide a better quality of life throughout survivorship and thrivorship.

Oral Health Risks from Treatment for Breast Cancer

The risks for experiencing oral health problems during treatments for breast cancer can depend on many factors including:

• How healthy your mouth is prior to starting treatments. A healthy mouth is less likely to experience negative oral side effects.
• Oral hygiene and lifestyle choices, such as diet or tobacco use.
• Additional medical conditions and medications may contribute to oral health problems.
• The types of cancer therapies administered.
  • Chemotherapy, depending on which chemo medications create the cocktail, dosage, and duration
  • Hormone therapies may contribute to dry mouth and loss of bone mineral density. Periodontal disease involves the loss of alveolar bone (the bone that supports your teeth).
  • Medications that carry a risk of a condition known as Osteonecrosis of the Jaw (described below)

Dry Mouth

Dry mouth is a very common condition caused by many over-the-counter and prescription medications. While dry mouth is often viewed as a comfort issue, it can dramatically increase risks for oral diseases. Saliva is full of beneficial elements that protect against cavities, gum disease, and bacterial, viral, and fungal infections. Saliva lubricates the tissue to prevent trauma, allows us to taste properly, and is our first step with digestion. The tongue’s surface has taste buds that are dependent on saliva to function properly; a dry mouth is more likely to experience problems with taste.

Mouth Sores

Oral mucositis can occur with certain types of chemotherapy medications and may range from mild tenderness in the tissue to large, painful mouth sores. Mouth sores can make eating difficult and put one at risk for serious infections that can spread beyond the mouth. When possible, see your dentist prior to breast cancer treatments to resolve any existing dental issues and remove potential sources of irritation in your mouth. Good oral hygiene and treating dry mouth can also help to protect against mouth sores.

Osteonecrosis of the Jaw

Some medications typically used with advanced stages can carry a risk of developing osteonecrosis of the jaw, which is when areas of the jaw bone die.

Examples include:

• • Bone-building medications may be used to prevent loss of bone mineral density or slow the progression of advanced-stages that have spread to the bone.
  • Targeted therapies, such as trastuzumab and pertuzumab, when used in conjunction with bone-building medicines

Symptoms include:

• • Pain, swelling, redness, or other signs of infection in the gum tissue
  • Oral tissue that doesn’t heal after dental work
  • Loose teeth
  • Numbness or a heavy feeling in the jaw
  • Exposed bone

While osteonecrosis (caused by medications) is very rare, it is wise to know if your treatment course puts you at risk and take simple steps to help prevent it from happening! The majority of cases are initiated by some type of trauma to the bone, like a tooth extraction. Prevention includes meticulous oral hygiene and preventive dental care to avoid the need for extractions and exploring less invasive treatment options as needed.

How to Prevent Oral Health Issues Related to Breast Cancer?

The main goal is to prevent oral health problems rather than fixing them. Keeping your mouth clean to reduce the number of harmful bacteria found in dental plaque while being as gentle as possible to avoid tissue trauma is key.

Brushing

• Use an extra-soft toothbrush with a small, compact head with small circular strokes; avoid aggressive horizontal brushing
• Brush teeth and tongue at least 3 times daily
• Soften bristles under hot water if necessary
• Replace brush at the first sign of bending or fraying or bristles, every 3 months at a minimum
• Protect your toothbrush from germs; do not store your brush near a flushing toilet or touching other brushes. Use your own tube of toothpaste to avoid transmitting germs from one housemate to the next.
• If brushing after a meal is not possible, swish with water to remove food debris

Flossing

If you have been flossing regularly prior to treatments, you may continue with the approval of your oncology team with respect to your platelets and white blood cell counts. Ask your dental hygienist to demonstrate the proper technique to thoroughly clean the inside edges of your teeth while avoiding trauma to the tissue.

Oral Hygiene Products

Not all oral care products are created equally and certain ingredients may accentuate problems, like dry mouth and mouth sores. During the treatment process, avoid irritating ingredients, such as Sodium Lauryl Sulfate (SLS), whitening ingredients, peroxide, and tartar control. Strong flavors, especially peppermint and cinnamon, may sting tissue and aggravate nausea.

Use products that have a near-neutral pH, or slightly alkaline to balance acidity levels in the mouth. Ask a trusted dental professional for recommendations as pH levels are not commonly listed on product packaging. Other product ingredients that are beneficial to oral health include fluoride, calcium & phosphate, arginine, chitosan, xylitol, and erythritol.

Rinsing

Rinse with a saltwater and baking soda mixture to soothe tissue, wash away debris, and neutralize oral pH. While recipes vary, the International Society of Oral Oncology recommends:

• 1 level tsp baking soda
• 1 level tsp salt
• 4 cups water

Mix together and store in a container with a lid at room temperature. Shake well before use. Use throughout the day and discard at end of the day.

Your oncology team may provide you with additional prescription rinses as needed for mouth sores or infections, like thrush. Prescription rinses known as Supersaturated Calcium Phosphate rinses can help reduce dry mouth and mouth sores while protecting long-term oral health.

More Ways to Combat Dry Mouth

• Stay hydrated with frequent sips of water
• Avoid caffeine, alcohol, and tobacco
• Use a humidifier at night
• Breathe through your nose, not your mouth.
• Use sugar-free hard candies and gum sweetened with xylitol

Xylitol is a natural sugar substitute used in a variety of oral health & breast cancer products that can protect against cavities. Look for products 100% sweetened with xylitol as lower levels will not provide the same benefit. Its sweet taste helps to stimulate saliva to reduce dry mouth. Introducing xylitol into your routine slowly allows your body to get used to its use and will reduce chances for stomach issues, as it is digested as a fiber. Keep xylitol products away from pets. Dogs cannot digest xylitol and can become very ill if they consume it, similarly to chocolate, raisins, and grapes.

Dental Appointments

Ask your oncology team when you can safely return to routine professional dental care. During the treatment process, low blood counts may limit you to emergency dental visits only.

When you return to your dentist and hygienist:

• Report any health changes to your dental team
• Bring a current medication list to each appointment
• Inform your dentist of any bone-building medications or targeted therapies used even if you are not currently receiving these meds. Some meds can potentially stay in your system for years after they are administered and may alter treatment recommendations
• Antibiotics prior to dental care may be recommended with a surgically implanted port or low blood counts

Seeing your dentist regularly can not only catch problems early so they can be treated conservatively but prevent them from occurring.

Protect Your Smile

“My hair will grow back, my teeth won’t.” This is a concern that a patient once expressed to me as she was going through chemotherapy that I will never forget. As a Registered Dental Hygienist, I have witnessed the dramatic impact that oral health problems can have on one’s quality of life. Preventing oral side effects and dental disease can avoid unnecessary pain along with added financial and emotional stress both during and after the treatment process.

It’s also easier to smile when you have a healthy mouth. Neuroscience has proven that smiling releases neurotransmitters that act as a natural pain reliever and antidepressant; reducing stress levels, relaxing your body, and lowering blood pressure and heart rate ⁽⁵⁾.

Your smile is important in so many ways! Taking simple steps to proactively protect your oral health can provide many benefits for years to come.

Credits : This blog has been sourced from https://blog.youngsurvival.org/ . Click here to read original blog.

The issue of pregnancy after breast cancer is an important one for younger patients who are often diagnosed before they’ve had a chance to complete their families. A young survivor may wonder if they can still get pregnant after treatment. Will they have a healthy pregnancy? And, most pressing for many young survivors, will pregnancy increase their chances of recurrence?

“Our ambition in cancer care in the 21st century should be more than mere survival, it should be return to a normal life. This includes the possibility to have a family.”

At the December 2020 San Antonio Breast Cancer Symposium, Dr. Eva Blondeaux presented the work of a team of researchers from around the world who tried to answer some of these questions.

The researchers, including YSC Research Advisor Dr. Matteo Lambertini who coordinated the project, conducted what is known as a “meta-analysis” – they analyzed information from 39 previously completed studies that included both women with and without breast cancer and compared the pregnancy outcomes in these women.

Is Pregnancy after Breast Cancer Safe?

The researchers concluded that the meta-analysis provided solid evidence of the safety of pregnancy after a prior breast cancer diagnosis.

Pregnancy did not negatively affect survival in survivors with hormone receptor positive or hormone receptor negative breast cancer types.

Pregnancy also appears safe regardless of BRCA status, node positivity, previous chemotherapy or the amount of time between breast cancer diagnosis and pregnancy.

Although the analysis found pregnancy after breast cancer treatment to be safe, the researchers did find that breast cancer survivors had significantly increased risks of low birth weight, a baby small for its gestational age, preterm delivery, and caesarean section. However, researchers did not see a significant increase in the risk of congenital abnormalities or other pregnancy or delivery complications like miscarriage or bleeding in pregnancies after breast cancer.

Because of higher risks of certain complications, the researchers noted that women with pregnancies after breast cancer should be monitored more closely as compared to women from the general population without prior exposure to anticancer treatments.

Can Breast Cancer Survivors Get Pregnant?

Interestingly, the meta-analysis found that compared to the general population and even to survivors of other cancers, breast cancer patients had significantly lower rates of pregnancy. The reasons for this are not fully understood.

For example, we don’t know how many of the breast cancer survivors included in the studies were actually trying to get pregnant. We also don’t know if the survivors in these studies were discouraged by their doctors from trying to get pregnant or were themselves discouraged because of a lack of information on the safety of pregnancy. We also don’t know if these women had access to oncofertility counseling or access to fertility preservation options prior to undergoing treatment.

The significantly reduced number of pregnancies observed in breast cancer survivors demonstrates the need for increased awareness of oncofertility counseling in young breast cancer patients wishing to become pregnant after completing treatment.

If you have been diagnosed with breast cancer and are considering pregnancy after completing treatment, be sure to speak to your oncologist as soon as possible about what you can do to support your chances of becoming pregnant. If it has not been offered to you, ask your doctor if you can be referred to specialists in oncofertility counseling before starting chemotherapy or other anticancer treatments.

Aspiration: A Return to Normal Life

Dr. Lambertini hopes that cancer care continues to improve and includes family building as a crucial component of their care. Dr. Lambertini said:

“Our ambition in cancer care in the 21st century should be more than mere survival, it should be return to a normal life. This includes the possibility to have a family and to live with as few side effects as possible. As a clinician and researcher deeply involved in the care of young women with breast cancer, I really hope that the results of this study will help for a deeper consideration of patients’ pregnancy desire as a crucial component of their survivorship care plan and wish to return to a normal life.“

This meta-analysis has provided us with important information about the safety of pregnancy after breast cancer, but a number of key questions remain. Specifically, for young survivors with hormone receptor positive breast cancer who are likely to receive five-ten years of endocrine therapy (including ovarian suppression, tamoxifen and/or aromatase inhibitors) the safety of taking a break from endocrine therapy for pregnancy remains an open question. The POSITIVE trial, which is a large international trial that will follow more than 500 patients with hormone receptor positive breast cancer from the time they take a temporary break from endocrine therapy for pregnancy and for years after, seeks to answer that question. The POSITIVE trial completed enrollment in 2019 and results of the trial are eagerly awaited.

Credit : This blog has been sourced from https://blog.youngsurvival.org/. Click here to read original blog.