Patient Perspective: Maria
January 2016 got here quite calmly – until January 26th – the day of my breast cancer diagnosis. Why me? I did things the “right” way. I breast fed my five children, I sort of eat okay and I sort of exercise. My husband and I were settling in to our fifth year of marriage and combining our family of eight children. On top of that, I was eight months in to my favorite job with the Jekyll Island Authority. I am way too busy for this. I spent about a minute contemplating “Why me”? I have a family to take care of – my number one priority! I reluctantly changed my thoughts to “Why not me?” God’s plan is not my plan and this was another moment in my life where I prayed my breath prayer…..”This too shall pass, God how do you want to use me on this journey?” I pray that a lot! With the all-important support of my faithful husband, our four parents, our children, my brother and sister and the rest of our extended family and friends, I underwent a double mastectomy and removal of the right sentinel node on February 12th. With the help of my gynecologist who delivered my five children, I met an amazing cancer surgeon and plastic surgeon who scheduled me quickly and that was a blessing. An integral part of my journey has been the team at TurningPoint – they truly were my turning point. I heard about TurningPoint from both of my wonderful surgeons and their assistants. The day I left my first physical therapy appointment, I cried in the Roswell Road parking lot and thanked God for placing the TurningPoint team in my life. I knew I had found the answer to prayers. I left my first appointment with Lauren and for the first time since January 26th – I felt like I would be normal again – a new normal, but normal. Beyond feeling normal, they helped me to feel so much better physically and emotionally. Lauren and Anita were so patient with the myriad of questions and incredibly reassuring. As women, mothers and full time employees – we take care of others first. The most important thing to do during this time in your life is to take care of yourself first. I didn’t do it – none of us do – but make the time for TurningPoint and encourage others that you meet in our fight to do the same. Let others cook your meals. I didn’t cook for two months. For my family, this was the best part of having Mom down for a while. The prayers will be felt and you will meet people you never knew existed that will enhance your soul. I have been so blessed by the angels that have crossed my path. Would I take back everything that I have been through? Absolutely, because I am not a fighter. However, I have learned that I can fight this because I want to be here for my husband and my children. I want to love on my grandchildren and be with our parents for years to come. I can’t wait to go to my first TurningPoint Pink Affair on March 11, 2017. That night, I will celebrate with other cancer survivors and embrace that I am just over one year cancer free. To all of the newbies out there, be strong, be brave and lean on those us who have “been there, done that”. Know that each journey is individual and frightening, but remember, “THIS TOO, SHALL PASS!” Thank you TurningPoint Team for being part of my team and continue to do your wonderful work inspiring your patients to be survivors.
Evidence Update: Joint Pain and Aromatase Inhibitors
Joint Pain and Aromatase Inhibitors Aromatase inhibitors (AIs) have now been established as successful adjuvant therapy for breast cancer survivors who are post-menopausal and whose cancer is estrogen-receptor-positive. These include anastrozole (Arimidex), letrozole (Femara) and exemastane (Aromasin). Unfortunately, nearly half of women taking AIs report joint pain, or arthralgia. It is estimated that 20-30% of patients discontinue AI treatment due to joint pain. The pain and/or stiffness is usually symmetrical (i.e., on both sides) and often affects hands, feet, knees, hip and back. In a recent publication, researchers searched for and evaluated studies that examined the effect of several different ways of managing arthralgia related to AIs. Five types of interventions were identified that have been studied: pharmacological (drug) approaches, acupuncture, nutritional supplementation, relaxation techniques and physical exercise. Pharmacological approaches, including duloxetine (Cymbalta), immunotherapy and changing between AI options showed promise in relieving arthralgia symptoms. Acupuncture was promising in reducing pain in four studies. Two studies showed a possible positive impact of Yoga and Tai Chi on AI joint pain, function and quality of life. Several studies looked at exercise, primarily walking, and found a trend to decreasing pain with exercise, but this decrease was not statistically significant. Bottom Line: There may be several approaches to managing AI-related joint pain. Your medical oncologist will be helpful in choosing what is right for you. Acupuncture, yoga and tai chi appear to be helpful. Exercise, such as walking, shows promise in helping manage AI pain, but further study is needed. Keep in mind, that there are many other benefits of regular exercise for breast cancer patients (see this month’s nutrition section!). Consider joining us for this month’s education event ‘Bones, Joints and Breast Cancer’ and don’t forget that TurningPoint has a weekly Yoga class! Yang GS, et al. Interventions for the Treatment of Aromatase Inhibitor-Associated Arthralgia in Breast Cancer Survivors: A Systematic Review and Meta-analysis. Cancer Nurs. June 21, 2016. [Epub ahead of print]
Evidence Update: Pilates Based Exercise Beneficial
Pilates-Based Exercise Improves Upper Extremity Problems in Breast Cancer Patients It is well documented in the medical literature that breast cancer treatment, particularly surgery and radiation, contribute to upper extremity impairments, including decreased motion, weakness and difficulty doing usual functional tasks. A recent study examined the effectiveness of Pilates-based exercises, compared to combined exercise and home exercise as part of the rehabilitation of shoulder and arm issues for patients going through breast cancer treatment. Fifty-five patients were randomly allocated to one of the three groups: Pilates-based, combined exercise class and home program. The study was 8 weeks long and the Pilates-based and combined groups met three days per week for 40-45 minutes. The combined exercise class consisted of strengthening, stretching and range of motion exercises with a physical therapist. The home exercise group was instructed to do these same exercises at home. Pain, range of motion, strength and function were evaluated before and after the 8 week intervention. There were significant improvements in almost all parameters in both the Pilates-based and Combined Exercise group, and more significant improvements than in the home exercise group. This study showed that Pilates-based exercise results in significant improvement in upper extremity issues. There are, of course, many other benefits of Pilates-based exercise for breast cancer patients including Core strength and Balance. TurningPoint offers weekly Pilates classes with a Physical Therapist who is both an expert in breast cancer rehabilitation and a certified Pilates instructor. Pilates may be a great adjunct to your rehabilitation plan to help you get back to the things you love to do! Alpozgen AZ et al. Effectiveness of Pilates-based exercises on upper extremity disorders related with breast cancer treatment. Eur J Cancer Care (Engl). 2016 Jun 23. doi: 10.1111/ecc.12532. [Epub ahead of print]
Patient Perspective: Lorie
Patient Perspective: Lorie For the most part cancer has been good to me. I had some misconceptions about life after treatment; but, now I know better. Because I did well during treatment, I thought after treatment I would jump right back into life where I left off. I didn’t realize I would face a “new normal,” at least for a while, of having to live with discomfort and live a lesser life than the “old normal.” I am very thankful that Jill had a vision for a place like TurningPoint – a place that not only rehabs the physical body but serves to educate and renew the mind and spirit. When I first heard about TurningPoint I thought “Great!”…until I thought about having to drive the distance from my home to the clinic. The emailed intro form stayed in my inbox for two months before I filled it out and returned it. I spent most of that time trying to decide whether I was willing or wanting to drive the distance from Morrow. Since TurningPoint specializes in breast cancer rehabilitation I decided to at least give it a try – to see if they offered anything different than a physical therapist close to home. THEY DO!! I couldn’t believe I needlessly hurt so bad, for so long, and was ready to accept it as my “new normal.” Along this journey I have met many wonderful people and have had access to great resources. It is not enough to have resources available; in order to work they have to be utilized. I am still learning from this journey. I am thankful to be a lifelong learner. TurningPoint, like Dunkin’ Donuts, is worth the trip.
