Tag Archives: breast cancer

Screening and Measurement for Early Detection of Breast Cancer Related Lymphedema Part 1 of 3

Greeting!  Following is Screening and Measurement for Early Detection of Breast

Cancer Related Lymphedema by the National Lymphedema Network. 

Lymphedema and Cellulitis might well disappear one day – I hope! – if we are diligent and research continues.  It is a nasty disease … 

I am reprinting here in three parts only a smattering of information from the NLN website. 

In addition a reminder that I write here as a patient with diseases – one of them lymphedema.


Part 1 of 3 

Position Statement of the

National Lymphedema Network

By: NLN Medical Advisory Committee

Updated April 2011

TOPIC: Screening and Measurement for Early Detection of Breast

Cancer Related Lymphedema 

Breast cancer treatment places individuals at lifelong risk for the development of lymphedema. Early identification of lymphedema is believed to yield better patient outcomes. Patient education regarding the signs and symptoms of developing lymphedema and objective measurement of arms are needed to promote early identification and to improve patient outcomes.


• Patient education:


Patients should be made aware of the need to contact a healthcare provider immediately if they begin to experience feelings of heaviness or tightness in at-risk arms; if they notice swelling in the affected area; or if the arm and/or at risk chest or truncal areas becomes hot or red.


• Objective measurement:


Pre-treatment baseline measurement of arms is essential, as this serves as the base-lined at which subsequent measurements can be compared.


See http://www.lymphnet.org/pdfDocs/nlnBCLE.pdf



Thanks for reading … Sharon O’Hara <familien1@comcast.net>

National Lymphedema Network urges the American College of Surgeons to …

Greetings… Following is a copy of an email plea from the National Lymphedema Network to the Journal Of American College of Surgeons.

I’ve produced it here almost verbatim because I have leg lymphedema and it is one of the most painful difficult to live with diseases I have.  Last year it flared again and oozed, taking  about 10 months to heal, including a month in Harrison, a month at Martha and Mary Rehab Center, and months of my husband daily cleaning and re-wrapping my lower legs and feet.

Breast cancer survivors need to be educated to the risks of getting lymphedema.  I can promise – as a patient with lower leg lymphedema – nobody should get this disease if it can be avoided.

Patients, please talk to your doctor about lymphedema.  If she/he will not discuss it, find a doctor who will.


“National Lymphedema Network

In response to an article published in the March issue of the Journal Of American College of Surgeons (http://www.journalacs.org/article/S1072-7515(12)01312-9/abstract) the NLN Medical Advisory Committee is responding to a Press Release released on February 25, 2013 (http://www.facs.org/news/jacs/lymphedema0313.html)  in the Journal of American College of Surgeons, “Breast Cancer Patients Fear for Developing Lymphedema Far Exceeds the Risk


Saskia R.J. Thiadens RN

Executive Director


“March 1, 2013

On 2/25/2013 the Journal of American College of Surgeons released a statement entitled, “Breast Cancer Patients’ Fear of Developing Lymphedema Far Exceeds the Risk.” The press release was in response to findings from a single-site study published in the March issue of the Journal of the American College of Surgeons noting that some breast cancer survivors take extraordinary measures to try to prevent lymphedema that may not be necessary. The rate of development of lymphedema in the limbs of the study patients (N=120, followed to 12 months) was similar to reported incidence in the medical literature. Three percent of patients having a sentinel lymph node biopsy developed lymphedema and 19% of patients having an axillary lymph node dissection developed lymphedema. The study indicated that patients with sentinel lymph node biopsy worried and took precautions as much as those who had axillary node dissections.

The National Lymphedema Network agrees with the statement in the press release that “future research should be aimed at better predicting which women will develop lymphedema, thus allowing for targeted prevention and intervention strategies and individualized plans for risk-reducing behaviors for each woman during and after her breast cancer treatment.” However, since this type of risk stratification and broad education does not currently exist, it is important for patients to be given accurate information by their doctors and oncology care providers on reasonable approaches to reducing the risk of developing lymphedema.

The American Cancer Society estimates that in 2013 there will be about 232, 340 new cases of breast cancer in the US and there are approximately 2.9 million breast cancer survivors in the US. If 20% of those who have axillary dissections, and, conservatively, 3% with sentinel lymph node biopsies, are at risk of developing lymphedema, this is still a very large number of women who have reason to be concerned about their risk of developing lymphedema.

Lymphedema is a progressive, debilitating condition that is not merely swelling, but an immune system dysfunction. When recognized late in its course, or inadequately treated, lymphedema leads to chronic infection and progressive disability. Women who are at risk for lymphedema have reason to be concerned and these concerns should not be minimized.

The National Lymphedema Network advocates a reasonable approach to risk reduction guidelines, given that a large population of women is still at significant risk of developing lymphedema. In the NLN Position Paper on Risk Reduction, revised in 2012 and available at www.lymphnet.org , a risk stratification approach is detailed so patients can take appropriate precautions according to their medical situation. Every breast cancer survivor deserves accurate information about her or his risk of developing lymphedema and reasonable precautions based on the available scientific evidence.

The American College of Surgeons, and all providers of care to breast cancer patients, are encouraged to provide every breast cancer patient with accurate information about lymphedema, so patients can make informed choices. Given the imperfect state of the science on risk reduction for lymphedema, there are many reasonable, healthy suggestions for patients at risk of lymphedema to reduce their risk, such as weight management and exercise. The Position Papers on the NLN website on Exercise, Risk Reduction and Screening for Breast Cancer Related Lymphedema were written by a panel of medical experts in the field of lymphology and lymphedema treatment.

The National Lymphedema Network urges the American College of Surgeons to endorse the NLN Position papers, provide them to their members, and acknowledge that a large number of breast cancer survivors are at risk of or currently have lymphedema. These patients need education and information that will allow them to take precautions that are reasonable and not excessive.  Education is the key and then what each one does with that information is a personal choice and a part of personalized health care.”

…NLN Medical Advisory Committee  *  Hotline: 1.800.541.3259

National Lymphedema Network | 116 New Montgomery St. | Suite 235 | San Francisco | CA | 94105


Best wishes and thanks for reading …   Sharon O’Hara <familien1@comcast.net>

Mark Mangus Tells the COPDer How to Live – EXERCISE

Pulmonologists and COPDers – take note – patients really do WANT to be educated and too many physicians are shy about encouraging patients to exercise and WHY WE MUST EXERCISE to have a life.

Following is the noted exercise guru for the COPDer, Mark W. Mangus, Sr., BSRC, RRT, RPFT, FAARC of San Antonio, TX answer to a patients question about her FEV-1 and FVC decline.  Mark’s answer was posted on my online support group, EFFORTS.  www.emphysema.net.

A gentle reminder that Mark had to move beyond traditional COPD treatment because his daughter, Kim, born with Cystic Fibrosis was not helped by traditional medicine methods for lung patients.  Kim’s only hope was to stay alive until she was old enough for a lung transplant.  She has had double lung transplants now and currently works for Vanderbilt Medical Center.

Hi _ _ _,

First, let me say that there is nothing you can do to stop the decline you

are experiencing in your FVC and FEV-1, though you CAN slow the inevitable

progression to some (unknown) degree by exercising increasingly VIGOROUSLY

as you embark on your pulmonary rehabilitation effort.


Your stress testing and echo tell a story of long developing pulmonary

hypertension which has advanced with poor intervention with regard to timely

detection of hypoxemia and earlier oxygen therapy support.  Your breast

cancer bout and treatment are potentially responsible for part of what you

are currently experiencing.  Radiation treatment is notorious for triggering

a process of radiation fibrosis, though it usually happens more profoundly

in treatment of lung cancer than more superficial cancers like breast

cancer.  But, if lymph nodes under your arm were irradiated – in other words

– the radiation was applied broadly over an area larger than simply the

breast tissue, chances are that you are seeing some effect from that.  A

high-resolution CT of your lungs, maybe with enhancement, if deemed helpful,

might better illuminate the presence of fibrosis and its extent and progression.


Your FVC has dropped disproportionately with your FEV-1, the FVC dropping by

almost double that of the FEV-1 during the same period.  This is also

suggestive of the possibility of fibrosis.  As well, your DLCO being reduced

to around 30 % of what it should be AND the confirmed and significant

hypoxia discovered with your walking and sleeping oximetry tests correlate

with the reduced DLCO and FVC.  The reduction in FVC is yet further

suggestion of a restrictive process being combined with your obstructive

lung disease process.


I am disappointed that your 6 minute walk was conducted as it was, but,

unfortunately, not surprised, as it is one of the most variably conducted

tests done in this area of medicine.  You SHOULD have been allowed to

continue – hypoxia detected or not – as long as you were able to AND at a

pace that YOU chose.  If monitoring was to be done, then it should have done

no more than to document the extent of changes – NOT signal a point at which

the clinician decided to stop you and THEN to totally alter the validity of

your test by setting your pace!  So, the 620 feet you walked is meaningless

to determine anything with regard to the clinical state of your disease

and the limitations it imposes upon your ability to ambulate or to

extrapolate any determination of functional adequacy.  None of that is your

fault.  It is due to the poor understanding of the test purpose and method

on the part of the clinicians.


Your sleep saturations are very telling of significant hypoxemia that is

more likely associated with your fibrosis and pulmonary hypertension.

Pulmonary hypertension aggravates hypoxia, making it worse, which in turn

makes the hypertension worse, which in turn, makes the hypoxia worse . .

You can see where that is going. That is why you bottom out so low at 78 %

during sleep.


First, I hope that 2 liters during sleep is keeping you saturated to at

least 88 % as a bottom low point.  If you have not had a follow-up sleep

study to determine the effect/benefit of the oxygen during sleep, you should

push for it to be done.   You should ALSO be using oxygen for ALL ambulation

and exertion – and possibly more like 4 to 6 liters – as I’m doubtful that

any less will saturate you adequately to counteract your pulmonary

hypertension.   Treatment of the pulmonary hypertension should be a point of

primary focus for you and your medical team.  Oxygen, at this point is the

most powerful and effective treatment you can use to slow the inevitable

progression towards profound heart failure you can expect if the pulmonary

hypertension is not controlled a LOT better than it has been over the recent

past.  That wll likely ‘do you in’ a whole lot sooner and with much interim

misery than the combined lung disease process that has caused it.


It is good that you are starting a pulmonary rehab program.  I am surprised

that they don’t have a pulmonologist directing the program.  Do you know

what kind of doctor is acting/serving as their medical director?  Make the

most of it.  Push hard to learn to work against the difficulties of the

breathing symptoms that accompany your disease, especially at this point.

Don’t let the staff hold you back because of hypoxia.  Push them to give you

all the oxygen you need to be able to push yourself to the maximum.  Short of

such an effort and you will be mostly spinning your wheels.  Working hard to

breathe and overcoming the difficulties and fear it can impose upon you are

not easy.  NEVERTHELESS, working hard to breathe – even when it makes others

uncomfortable to watch you work so hard – will NOT harm you, despite what

many might opine.  It may ‘feel’ like it’s gonna kill you.  HOWEVER, it will

NOT!  It is not an easy path you must travel.  But, others have traveled the

same path.  The good news is that you still have 29 % FEV-1.  That might

creep back up to 35% with hard work.  AND, it would be worth it because that

little 5 % raw change represents a 20 % change in your overall FEV-1.


If you have further questions as you go along, I am happy to try to answer

them for you.       Best Wishes,                                  Mark


Mark W. Mangus, Sr., BSRC, RRT, RPFT, FAARC

San Antonio, TX


COPDers, a new study indicating what I have shouted about for years – recumbent cycling (trike)…

“…This study showed that an eccentric cycling protocol based on progressive increases in workload is feasible in severe COPD, with no side effects and high compliance…”

COPD. 2011 Jul 5. [Epub ahead of print]

Eccentric Cycle Exercise in Severe COPD: Feasibility of Application.

Rocha Vieira DS, Baril J, Richard R, Perrault H, Bourbeau J, Taivassalo T.


Respiratory Epidemiology and Clinical Research Unit (RECRU), Montreal Chest Institute, McGill University Health Centre, Montreal, Quebec, Canada,1.


Eccentric cycling may present an interesting alternative to traditional exercise rehabilitation for patients with advanced COPD, because of the low ventilatory cost associated with lengthening muscle actions. However, due to muscle damage and soreness typically associated with eccentric exercise, there has been reluctance in using this modality in clinical populations. This study assessed the feasibility of applying an eccentric cycling protocol, based on progressive muscle overload, in six severe COPD patients with the aim of minimizing side effects and maximizing compliance. Over 5 weeks, eccentric cycling power was progressively increased in all patients from a minimal 10-Watt workload to a target intensity of 60% peak oxygen consumption (attained in a concentric modality). By 5 weeks, patients were able to cycle on average at a 7-fold higher power output relative to baseline, with heart rate being maintained at ∼85% of peak. All patients complied with the protocol and presented tolerable dyspnea and leg fatigue throughout the study; muscle soreness was minimal and did not compromise increases in power; creatine kinase remained within normal range or was slightly elevated; and most patients showed a breathing reserve > 15 L.min(-1). At the target intensity, ventilation and breathing frequency during eccentric cycling were similar to concentric cycling while power was approximately five times higher (p = 0.02). This study showed that an eccentric cycling protocol based on progressive increases in workload is feasible in severe COPD, with no side effects and high compliance, thus warranting further study into its efficacy as a training intervention.”

PMID:     21728805

[PubMed – as supplied by publisher]



COPDers–talk to your doctors- get educated and educate them to what patients CAN DO.

Thanks for reading… Sharon O’Hara

Cancer Loses – Kathi Trostad of Poulsbo Wins

Cancer Loses – Kathi Trostad Wins

13 Jun e 2011 marks six months cancer-free for survivor Kathi Tronstad of Poulsbo!

After four operations in five and a half months, after times being told, “You have Cancer”, Kathi celebrates six months CANCER FREE.

Where does the Kathi Trostad cancer story begin?

Did her childhood add to the someday-adult Cancer risk?

1. Kathi’s mother took DES to avoid miscarriages when she was pregnant with her.

2. Kathi was sexually abused as a young child that turned her as an adult into an outspoken child advocate

3. Kathi took HRT and lived with stress.

5.  Female

6. Kathi’s mother’s aunt died of breast cancer about 1942.

7. Kathi’s mother had breast cancer, developed Lymphedema and lived another 27 years with COPD and the Pulmonary Fibrosis that killed her brother.

8.  Kathi’s father had prostate cancer, and it spread later to his bones and lungs.  His stomach ruptured and he bled to death.

9.  Her uncles died of lung and prostate cancer. Each of Kathi’s parents had a sibling female with uterus cancer in their 30’s but both survived to their 70’s.

“Then cancer came to my cousins but still I was told I had only a small risk.”


Following is Kathi’s story

In April of 2010 after feeling rotten and in treatment for a UTI and kidney stones, I went to the ER in Silverdale.  An urgent care doctor said I might have Diverticulitis. Of course I said oh, no wouldn’t I know if I did?

2 1/2 weeks in the hospital to drain the abscess in my colon then home to rest and of course I had a hole although it didn’t show up on the test so then I had a fistula.  I was making 3 dozen krumkake one night and was on #30 when I thought I was getting too warm from the iron, so I put on summer pajamas.

On the #34 krumkake, I went in the bathroom, saw a red round circle on my tummy, and took my temperature,   102ᵒ.   After doing #35 and #36 krumkake, I told my husband to get me to the Silverdale ER fast. Emergency surgery drained the wound.  They left it open for a colon resection the next week.  I was feeling lucky, feeling great and could eat for the first time.

I was on 4 West and I love those people – they were so good to me!  My surgeon is Dr. Halligan and what an angel of a man.  I had 18 inches of colon removed – all old abscess scars – so how I am alive is a miracle.

Of course, I had to change my check up with my gyn doctor and to get my regular mammogram so when I was well enough in August, I had no idea what was ahead.

December 13th I was diagnosed with breast cancer and then again on the 21st so I had a double lumpectomy on the 22nd.  I had one node involved.

Hearing it was cancer 3 times is a tad much.  I felt sorrier for Dr. Halligan than for myself but he did a fabulous job.  It looks more like the cosmetic mini-breast reduction that I was wanting.

Two years ago without all these new tests now available, they would not have found the spots.   I had tumor tests so did not need chemo and the 60 dose4s or radiation left me only a little tired.

The day after my last radiation treatment, I started my work on the NK Relay For Life.  Claudia Kilburn has joined the team too.  I spoke for a couple minutes at Poulsbo’s Daughters of Norway, they donated $100 to the ACS, and another member gave me a check for $25.  We have lost too many members to breast cancer.

Dr. Halligan has ordered two low key years for me -maybe a tad boring!!!  4 surgeries in 5 1/2 months is a bit much but it is all on the same deductible so it is all good!  I have met so many wonderful people it has been a blessing and I have renewed passion for some things I do.

My tumors were found in a regular mammogram and could not be felt by me or any of my doctors.

I was shocked when my doctor told me that the Norwegian community in the PNW has a lot of MS and breast cancer.  I have heard of pockets of both here.  They do not know why.  My brother just passed away May 29 of Muscular Dystrophy at 42 years – most of those years in a wheelchair.

I now have about 36″ of scars on my torso!  The cancer center has a knitting class for us to help us think after all the meds, drugs and such.  I was new that day and we were of course discussing things.  We were thinking of all the positive things that had happened to us during treatment.

Breast Cancer survivors is a real sisterhood (men get it too).  Cancer does not care who you are or what your plans are.  Nobody cares how much or how little money you have, what kind of house you live in, or if you have many degrees or none.

One of the funny comments was that now I have no need for dental records!

The NK Relay For Life is July 8-9. God is good.  Our team name is the Peninsula Cancer Center.  Dr. Madsen asked me to join on one of my first visits to her, which to me was a good sign!  The good Dr. thinks I will be here to do it!

The morning of Dec. 13 when I went for the first report after having a biopsy at the hospital I was planning lunch with my husband and then some more Christmas shopping for the grandkids.  The sun was out and the sky was blue!  When my doctor told me I just got light headed and thought, he is saying something I do NOT want to hear, but I simply said how much of this can you do before the end of December so I can get it on the same deductible as my resection!  The blessing here was I had already had 3 surgeries with Dr. Halligan and so I knew I was in good hands and could trust his judgment.  My breasts look great, the incisions are pristine, and fine lines almost the same color as my skin.

I saw three doctors at the Peninsula Cancer Center in a calm atmosphere instead of me driving around the County to different appointments.  They had met before I arrived to discuss my case and the plan. The bottom line is I am not maimed.  When I count my blessings, I count Dr. Halligan twice!

I am in the best health of my life after 60 doses of radiation and I have met so many wonderful and helpful people in this past year.

We have a wonderful health community here.  Dr. Halligan, Dr. Truong, Dr. Chiricella, Dr. Madsen, Dr. Meeks and Dr. Esser all got me the best care right here at home.  I know me and if I had to go to Seattle every weekday for six weeks for radiation I would not be this far along to recovery!  In addition, my tumors were tested so I did not need chemo because of the type they were.  I do need to say that Harrison Hospital, AMI, the 4 WEST staff, Kristen Bakke at KPT and KPS did so much to make my recovery seem easy.  My husband of almost 44 years, Rob, did everything he could to make recovery easier.  There are so many people to thank.

Over the last year, I have learned so much about myself.  So many people have helped along the way.

The day after my last radiation treatment, I met with Brie Storset at Starbucks to discuss the NK Relay For Life.  Brie oversees the Relays in Kitsap and Mason County.

I know I am blessed and I do count my blessings every morning. I thank God for life.

While 4 surgeries in 5 1/2 months is a bit over the top, I do know lots of prayer and God given skill by my caregivers set me on a better path.  I feel great, which is new to me but I am adjusting after feeling so awful for so long.  I believe there is purpose in all of life’s experiences and I intend to spend the rest of my life doing things to help find a cure.  Cancer still makes me grit my teeth.

I have had too many friends and family die from it and some at a young age.  My daughter said that cancer will be sorry it paid me a visit.

One of the staff at the Center told me that I know how to make lemonade out of a basket of lemons.  I do indeed!

Today I am a six-month survivor of Sequential Breast Cancer.  I intend to have many more birthdays!!

One of the North Kitsap Cancer activities is the NK Luminaria Ceremony honoring those still fighting and those who have passed away.

Melanie Cena is the Luminaria Chair for this year’s North Kitsap Relay For Life.


American Cancer Society | www.RelayForLife.org |1.800.227.2345

Following are faces of cancer.  The photographer for the first 5 is Kathi’s husband, Rob Trostad – 6th photo was taken by son-in-law, Marshall Menne.



1.  Me in the radiation room with Anthony, a radiation therapist.  It was not scary or embarassing. He was showing my husband and they let Rob see the computer and watch while they did the treatment.

2.  Me in front of the Peninsula Cancer Center

3.  Me ringing the bell to celebrate my lst treatment, it is a tradition in cancer centers and let people in the clinic know that one more person has graduated.

4.  Sometimes I wore costumes.  One the second day Anthony said he could see me in a Vking helmet and my hair braided!  The cake is a Boob Cake to celebrate the best breast care anywhere.  Dr. Madsen loved it!  You need comnedy relief during treatment.  I went as the first day of spring,a leprechaun and a Viking Warrior princess and I wore hats.

5. Me with my radiation therapists, Cheri and Anthony

(these might me out of order as my memory is still a little off)

6. Life goes on.  Be with my grandchildrens who are teenagers first cousin on their daqd’s side.  I look healthy and holding newborn mattox was a healing experience.  This is the best photo I have had of me in years!!!


































































































Thanks, Kathi!  Your inspiring story is a Shout Out – why so many people are so passionate about cancer.  My own daughter led a Federal Way Cancer team last night.

Thanks for reading….  Sharon O’Hara

Vanderbilt Takes Cancer Personally? Me too.

Meet Molly, Cancer Survivor.

Between Cancers
Resolute Molly

Molly is my wonderful re-homed girl and my fourth dog to get cancer in ten years. The only difference is she is still alive. Molly recently had a second cancer surgery and is almost healed.
Most of you already know more than you ever wanted to know about cancer, many of you have have lost loved ones to it. The faces of cancer in my family pale compared to most of you, but let me show you a few glimpses and faces of cancer in my family.

You are welcome to share a cancer photo here with us. Send it to me and I’ll add it here with mine.

Fresh From aDip in Smelly Pond
Hold Still, Ashley, We Will Cool You Down-fresh swim from smelly pond.
Annie Cut Her Baby Teeth on that Bench
Annie - A Favorite Bench
All 164 lbs of him
Mr G''s Buddy, my Mom
Mr Green standing, Annie behind, their Mom Sonja and my mom.

A few years later, June 6, 2008 my mom died from Pancreatic cancer… twelve years earlier my dad died of  Prostate cancer.

Cancer, cancer, go away. Don't come back any day.
Molly, Moving Easy at Home and Healing
A Good Healing
Cancer Caused Stitches, a second time around.

Molly, another look of cancer

A new bamboo shoot emerges
What does a bamboo shoot from a seemingly dead bamboo plant and cancer have in common? Survivors and dedicated researchers.
Puppies for All Time
The Kids at Rest
The Queen Surveys Her World
Sonja Waits for Her Ride
Queen Sonja, Mr. Green and Ms. Annie
Chuck returns Queen Sonja, Mr. Green and Annie ashes home to Ivy St.

The following story is verbatim so that nothing is lost in the telling. Vanderbilt takes cancer personally. Yes.

“Vanderbilt takes cancer personally.

That’s what the dominant Page One headline in today’s Tennessean says. It’s a play on words because the story is about Vanderbilt’s newly announced Personalized Cancer Medicine Initiative. (You can read more in the Vanderbilt-Ingram Cancer Center’s News Center).

But it’s also true in its most literal sense. The nurse who takes calls about this new initiative in the morning and then goes to her own chemotherapy appointment in the afternoon takes it personally. The physician-scientist who can share with his lung cancer patients his own experience with lymphoma takes it personally. The breast cancer survivor whose good friend is now in treatment and who read about this initiative on VICC’s Facebook page this morning takes it personally. The 1 in 2 men and 1 in 3 women among us who will face a cancer diagnosis, well, they have or will take it very personally.

As someone who has been an observer of cancer science for more than 15 years, I can tell you that no one takes this disease more personally than the investigators at the Vanderbilt-Ingram Cancer Center.

For months, Dr. William Pao, who directs the initiative, and his colleagues have focused on every detail, making sure the science was exactly right and the process of delivering on the promise of this discovery could go as smoothly as possible. Much time and energy has been spent in getting the announcement just right and making sure folks who might get questions from patients and families know what this means (and importantly what it doesn’t mean).

Whatever you take away from the coverage of this announcement, please know this. It’s a big deal, one in which everyone at Vanderbilt can and should take pride. No, we didn’t cure cancer this week. But we did demonstrate a leadership role in what many predict will be a sea change in how we diagnose and treat our patients, not only with cancer but with myriad other diseases as well.

So feel free to take it personally. I know I do.”

More later… Sharon O’Hara

Restless Leg Syndrome, Breast Cancer Prevention, Radiation Treatment Hope for Tomorrow

Restless Leg Syndrome (RLS), Breast Cancer Prevention and Radiation Treatment effectiveness or, What do three students from the University of Alabama have in common?

Why are they so important?

For those with RLS or Breast Cancer and those who have experienced Radiation Treatment, it is an easy answer.

The more research leading to discoveries, treatment and cures, the fewer future patients.

Atbin Doroodchi, 20 is a member of the Science and Technology Honors Program and an undergraduate researcher in the lab of Yuqing Li, Ph.D., investigating a gene’s relationship to my particular interest, restless leg syndrome.

Shweta Naran Patel is 21 majoring in molecular biology. She is a member of the University Honors Program and undergraduate researcher for Trygve Tollefsbol, Ph.D studying the natural compound role in breast caner prevention.

Tamara Michelle Burleson, 20 is majoring in Chemistry and a Supplemental Instruction Leader. She is investigating the role between certain proteins and radiation treatment effectiveness in the lab of Christopher Willey, M.D..

The Barry M. Goldwater Scholarship and Excellence in Education Foundation have named Doroodchi, Patel and Burleson 2010 Goldwater Scholars.

The faculties of colleges and universities select the Goldwater Scholars based on academic merit and the one and two-year scholarships cover school expense up to $7,500 a year.

Heartfelt congratulations to all!


More later… Sharon O’Hara

Lung Cancer COPD Confusion

Lung cancer is almost entirely caused by smoking…just as in COPD and COPD kills more people per year than lung cancer and breast cancer combined.

A vast difference though is that COPD is a long slow smother without treatment other than inhaled steroids, several other inhalers, lung reduction and lung transplant while physical exercise beyond the shortness of breath and inhalers, is the single most important thing a COPDer can do to help them live a quality life

Lung cancer is usually faster from diagnosis to death since most lung cancer is not diagnosed until a late stage.

Because there is no proven screening process that can find it earlier while early detection is possible for COPDers with the simple Spirometry test …the only problem is finding a doctor willing to give the quick, inexpensive test….and the only opportunity to give the patient, if a smoker, a chance to change behavior knowing what lies ahead.

Keep in mind too, only about 20 % smokers develop COPD while about 80% COPDers were smokers. (Speaking of patient changing behaviors if the consequences and benefits are known…my next post here will challenge me to do what I preach and throw out a challenge)

According to Jennifer Croswell, MD, of the National Institutes of Health…” Low-dose computed tomography — now under study in two large randomized trials — has delivered significantly more false positives than chest X-rays…”
The false positives can lead to “… more invasive diagnostic procedures among patients screened with the low-dose CT, Dr. Croswell said at the annual meeting of the American Society of Clinical Oncology and “”False-positive results may create increased psychological stress in patients and an increased burden on the healthcare system…”

“According to the American Cancer Society, the five-year survival rate for localized lung cancer is 49.5%, but that falls to 20.6% for disease that has spread outside the lung and 2.8% if there are distant metastases.

The authors of the current study “break a little bit of new ground” in that they are looking at a study with a comparison group, according to Peter B. Bach, M.D., of Memorial Sloan-Kettering Cancer Center in New York.

But it has been known for some time that CT screening uncovers a “very, very high” frequency of lung abnormalities — up to 50% in one study and usually in the same range found by Dr. Croswell and colleagues.
Such findings can be nerve-wracking for patients, he said, and can require invasive procedures to pin down the cause of the “abnormal thing in the lung.”

But “only very rarely is that thing a lung cancer,” he said. “

Complicating the issue, Dr. Bach said, is that for physicians, the results of a CT scan that showed a minor abnormality are rarely a Yes or No issue. Instead, he said, they may increase suspicion and lead a doctor to follow a patient more or less closely.

The work of Dr. Croswell and colleagues, he said, adds to the available information, but “nothing really changes here. There is no organization in the world that recommends screening for lung cancer with CT” or any other technique.
“The status of the science is that (screening is) unproven, no one has ever shown it’s beneficial, numerous studies have shown it causes harm, and no one should be doing screening until we have randomized trials that are completed and show a benefit that outweighs all the harms,” he said.

On the other hand, “there is no question that CT screening will detect many lung cancers,” said Martin Edelman, M.D., of the University of Maryland Greenebaum Cancer Center in Baltimore.

The question is whether the approach will reduce the risk of death and illness, while minimizing harm to patients, said Dr. Edelman, who is on the independent committee verifying the endpoints of the National Lung Screening Trial.
So far, there is still a “complete absence of evidence that this approach decreases mortality or morbidity due to lung cancer,” he said.

Advocates for screening “have long claimed that there is little or no risk of harm, Dr. Edelman said, but Dr. Croswell and colleagues “demonstrate that there is a small, but real potential for harm from screening.”
What’s more, he said, “the potential for false positivity is highest in those at greatest risk for lung cancer.” “


More later… Sharon O’Hara