Evidence Update: Body Image and Sexuality – You are Not Alone!
Breast cancer and its treatments may affect sexual functioning based on physiological and psychosocial mechanisms. A recent study examined various aspects of sexual and psychosocial functioning before surgery, six months and one year after surgical treatment in 149 women with breast cancer. Of interest is that they also compared sexual function with an equal number of women of the same age who did not have breast cancer. Compared to before surgery and to women without breast cancer, women after breast cancer reported significantly more problems with sexual desire and arousal six months after surgery. Problems were greater for women who had mastectomy versus lumpectomy. Interestingly, the study found that the women with breast cancer reported significantly more consensus in their relationship with their partners than the non-breast cancer group. The threatening nature of a breast cancer diagnosis and treatment may increase vulnerability in relationships that results in re-evaluating the importance of the other person in their life and the necessity of agreement on relevant issues between partners. The issues and concerns related to body image and sexuality are not unique to breast cancer survivors, but breast cancer and its treatment can produce a wave of physical, emotional and social changes that can greatly challenge breast cancer survivors’ quality of life. Join us this month for our education event, led by TurningPoint’s counselor Karen Savrin, MSW, as we explore these challenges and consider practical ways to address them. Aerts, L. et al. Sexual functioning in women after mastectomy versus breast conserving therapy for early-stage breast cancer: a prospective controlled study. Breast. 2014:23(5):629.
February Patient Perspective
Rachel Davidson I had my first mammogram at age 32. It would be my last. The mastectomy took care of that. Young. Not overweight. Breastfed two babies. I was low risk in every sense. It was the beginning of breast cancer awareness month. I was aware and did what I was supposed to do. None of the medical professionals expected that little lump to actually be cancer. However, 2 days after the biopsy the doctor confirmed I had joined the club no one wants to join. Breast cancer awareness month felt like a celebration and I was in no mood to celebrate. Or see all the pink. Just over a year later, I am beginning to again appreciate breast cancer awareness month. And pink. Throughout my journey with breast cancer, I learned a lot I never imagined I would learn – or at least, not this early in my life when I was trying to focus on raising two young children, maintaining a happy and healthy marriage, and staying busy with a fulfilling career in child welfare. I underwent a double mastectomy followed by radiation and long term anti-hormone medication. As a side effect, I am able to commiserate with my mom about hot flashes. No one prepared me for the possibility of needing physical therapy, but my plastic surgeon graciously referred me to TurningPoint following my initial surgery. One of the most healing aspects of this journey was the treatment and support I received there – both physically and emotionally, http://www.papsociety.org/ambien-zolpidem-10-mg/. The care, compassion, patience, guidance, and knowledge they provided were such that only someone personally familiar with breast cancer could. And the silver lining? Best massages ever. I am somewhat uncomfortable when people tell me I am strong or an inspiration, since I merely showed up for the doctors to care for me. I cried plenty of times. I get anxious about a recurrence. But I know such thoughts are normal. I will move on and put this behind me, because I have hope for the future. I have hope that I will continue to raise my amazing children alongside my incredibly supportive, humorous, loving husband. I have hope for my professional future. And I have many people to thank for that – medical professionals, family, and friends. A year ago, cancer was an ugly word. I now see it as a blessing. It brought me closer to my husband. It encouraged me to truly relish in the delight and wonder that are my incredible children. It introduced me to many amazing women. It reinforced that I am surrounded by more love and support than I ever could have imagined. It also reminded me to be sensitive to others, as everyone has a battle they are fighting – whether you know it or not.
The Angelina Jolie Effect: The Public Impact of Celebrity Breast Cancer
A recent research study examined the impact of Angelina Jolie’s announcement related to breast cancer. In May of 2013, the actress announced she underwent a double mastectomy to reduce the risk of breast cancer, after testing positive for a BRCA1 gene mutation. According to this study, this announcement triggered a significant rise in the number of women with a family history of breast cancer being tested for the mutation, and this increase persisted for the next 5 months. The findings show that when it comes to health news starring a high profile celebrity, it can have a long lasting effect on the health of the general public. In the article, Evans adds that this encourages more women to visit family history clinics so they can find out about any gene mutations early and take the appropriate action. Although this will mean some women may need to have a mastectomy, he says that others may be advised to take cancer-preventing drugs or adopt lifestyle changes in order to reduce cancer risk, https://www.childinjuryfirm.com/strattera-atomoxetine. Both BRCA1 and BRCA2 gene mutations can be inherited from a parent, and they significantly increase the risk of breast and ovarian cancers, among others. Approximately 12% of women in the general population will develop breast cancer at some point in their lives, but around 55-65% of women with a BRCA1 gene mutation and 45% with a BRCA2 gene mutation will develop the disease. The researchers found that in June and July 2013—immediately after Jolie’s announcement—referrals for genetic testing increased two and one-half times compared with the same period in 2012, from 1,981 to 4,847. A 2-fold increase remained until October 2013, after which time genetic testing referrals began to fall. Angelina Jolie stating she has a BRCA1 mutation and going on to have a prophylactic (preventative) mastectomy is likely to have had a bigger impact than other celebrity announcements. This is possibly due to her glamorous image and relationship to Brad Pitt. This may have lessened patients’ fears about a loss of sexual identity following preventative surgery and encouraged those who had not previously engaged with health services to consider genetic testing. Many of the women seen at TurningPoint have increased family risk of breast and other cancers. TurningPoint cares for women who have had preventative breast cancer surgery in addition to those going through breast cancer. It is important for at-risk relatives to be aware of their family history and request screening or risk-reducing strategies. The Angelina Jolie effect; how high celebrity profile can have a major impact on provision of cancer related services. R. Evans, J. Barwell, D. Eccles, A. Collins. L Izatt. Breast Cancer Research 2014, 16:442
January Patient Perspective
Wynetta Scott-Simmons I have always enjoyed learning; possessed a healthy thirst for the power of and comfort found in knowledge. That thirst led me to enroll in an elective high school class that explored world religions. It was in that class that I was introduced to the concept of karma. As a result of my teenager-framed interpretation of this life view, during those formative years, and in fear of upsetting the balance of my personal life continuum, I have worked to live by a religious-based moral compass and have also been a self-proclaimed rule follower ever since. Anyone who knows me will tell you that my life mantra is – Carpe Diem! But do no harm – live smart, live honorably, live fully present, live healthy, and ultimately live happy; chief among these has always been an endeavor to live healthy. Each year I scheduled my annual physical to occur on or near my birthday, as a symbolic gift and proof of my smart and healthy living. My 56th year was no exception. My life, to that point, had been a living blueprint of the stay healthy tips promoted by the American Cancer Society; staying at a healthy weight, healthy eating, taking part in an energetic exercise program, not smoking, and establishing a schedule for getting the recommended screening tests. My breast cancer diagnosis knocked me completely off of my balance-attuned orbit. Upon hearing the news I tried unsuccessfully to pinpoint the exact life action that had caused this disruption in my karma, in my life balance. My doctor, of sixteen years, unable to find the appropriate words with which to convey the test results had resorted to medical terms. Poorly differentiated carcinoma?! I understood each word individually. Spoken together in a medical context they made little sense. They made even less sense when applied to me; the rule follower, the life lived in balance. Poorly differentiated carcinoma?! Infiltrating ductal carcinoma?! Triple negative?! 3.3 centimeters?! The literacy professor in me tried desperately to tie each word to some pre-existing knowledge, some schema which might lead to a deeper level of enlightenment. However, in those first days following receipt of my diagnosis, balance had been destroyed and no karma-justified meaning, no understanding, no clarity, no comprehension was forthcoming. My mind did, however, instantly make connections between the news of this diagnosis and a host of possible ramifications for my immediate family – for my husband and our two daughters. In those first days post diagnosis and without full understanding of the specifics of my unique cancer profile I wondered just how many more momentous life events we would all witness together – birthdays, vacations, promotions, anniversaries, weddings and grandchildren. The triple negative nature of my diagnosis and size of my tumor added a sense of urgency to my need to begin a treatment plan. While still struggling to make sense of the news of my diagnosis, I resorted to the comfortable process of searching for knowledge. We researched the unfamiliar medical terms listed in every line of my diagnosis paperwork. We systematically collected referrals, read references, poured over evaluations, visited, interviewed, and made critical decisions about oncologists, surgeons, and plastic surgeons, and hospitals. The movie-reel version of my life, during that period, seemed to progress at a frenetic and chaotic pace, while simultaneously moving at a deliberate and measured pace. We know now that a divine hand was at work in bypassing waitlists, opening appointment doors, and ultimately assembling a team that would save my life; my dream team. Carpe Diem became my team’s battle cry and it helped me to focus on waging war against this uninvited infiltrating force! My assembled team – a renowned oncologist, celebrated surgeon and plastic surgeon, respected radiologist, phenomenal group of oncology and radiation nurses, my family, and a host of friends helped me to successfully conquer sixteen weeks of chemotherapy, vena cava filter placement surgery, six weeks of daily radiation treatments, bilateral mastectomy surgery, tissue reconstruction and expander insertion surgery, skin graph surgery, http://www.papsociety.org/accutane-isotretinoin/ and the final implant transfer and nipple construction surgery. Even after waging a successful fight to rid my body of the abnormally fast-growing cancer cells, my karma-tic turmoil had yet to settle. A new diagnosis of adhesive capsulitis (frozen shoulder) triggered a referral to TurningPoint. This medical diagnosis proved to be a pivotal moment in the process of rebuilding and adding to my life rather than the cancer diagnosis that had resulted in the process of breaking down and subtracting from my life. The individualized and focused care provided by the therapists at TurningPoint was specific to my particular and unique bodily needs as a breast cancer survivor and post-mastectomy patient. The therapists were committed to increasing my shoulder range of motion. They also validated my questions, affirmed my suspicions, and allayed my concerns, while arming me with the informational tools necessary to serve as my own self-advocate. With each session I began to regain my confidence. Everyone at TurningPoint helped me to restore a level of calm, a sense of balance and a renewed sense of positive karma to my life. The information, knowledge, and therapeutic strategies that I received at TurningPoint helped me to see that my new normal need not be one of limited mobility, ability, or possibility. My fighting mantra had been revived. Carpe Diem! – live smart, live honorably, live in the moment, live healthy, and live happy. I will be eternally grateful for the care and support I received at TurningPoint.
