Breasts and Hearts -- What's good for one, not necessarily good for the other

The sage advice that having a glass of wine every day might be good for you now may have a foot note attached.

A recent study by Catherine Berkey of Brigham and Woman's Hospital indicates that girls who have a history of breast cancer in the family and who have two glasses of red wine every day may increase their risk of benign breast disease.

Now, I didn't say cancer, but the leap has been suggested.

The study included 7000 girls and among the heaviest drinkers (that was about 1 drink a day in a 22 year old), the risk of benign breast disease was almost three times that of abstainers.

This comes on the heals of an article in JAMA (Journal of the American Medicine Association) earlier this month that alcohol may be linked to breast cancer. In their study, 3.5% of woman who had 13 drinks a week developed breast cancer compared to about 2.8% of those who didn't drink at all.

Many experts contend, though, based on the evidence to date, that stopping drinking would have very little impact on a woman's risk of breast malignancy.

Only time will tell.

And to make matters more confusing -- having a glass or two of wine may lower your risk of heart disease.

The take home message is that data obtained from retrospective studies is always useful, but many times it lacks the clarity of a prospective, randomized study.

- Posted using BlogPress from my iPad

Location:Dallas, Texas

Does Google give the wrong information on health care decisions?

Clearly using the internet to research any topic is valuable.  

Whether it's a new book you're thinking about buying on Amazon, researching the latest and greatest high definition television, or finding the value of your used car, the internet is a wealth of information.  

We all know that websites track our activity, constantly downloading cookies that both help and hinder our web experience.  They allow us to instantly be put into our "Recommendations" page on Amazon.com, but they also may contribute to mining our website activity and delivering us pop up ads.

But the latest use of complicated algorithms by search engines like Google resembles the ultimate over the shoulder look from big brother.  

In an effort to better put you in touch with the information you are searching, search engines have started to place context "relevant" items high in the search list.  That is, the search engine tracks both your searches and websites visited and then computes what search results would be the most relevant -- just for you.

This means that even though we might search the same topic, we might both be given a different set of results.

Now most of the time this is good.  

If you are hungry for catfish, searching for this crusty fried fatty protein would probably lead to restaurants that are near your home.  If you are a health fanatic (read: you aren't familiar with the word "fried") then you might find links to FoodNetwork.com recipes for grilled fish.

Now all of this sounds really helpful. 

But instead of the results providing a broad spectrum of information, they are actually providing information that is more focused -- just for you.

Imagine for a moment that you are somewhat of a conspiracy theorist.  If you search the word set "birth certificate," you might find yourself immersed in the world of the Birther's and President Obama's long guarded secret certificate.  You could have very well been really searching for the office of your local county clerk where you could download a copy of your own vital record.

These types of results are especially concerning in health care.

Now think about this scenario:  you are somewhat of a natural and alternative medicine follower.  You just returned from visiting your primary care doctor and she gives you your mammogram results.  It looks like you might have breast cancer.

You do what most patient's do:  you search breast cancer on Google.  

Given your past search patterns on health foods, alternative medicine, herbal products, and acupuncture, an article on "prune juice as a cure for breast cancer" pops up.  Further search of this bizarre topical combination begins to reinforce your findings:  there might be a link for a cure between this fruit juice and a breast malignancy.

So instead of providing a comprehensive analysis of breast cancer treatments, the algorithms have begun to reinforce your preconceived (pre-searched) thoughts on alternative medicine.

Now this isn't an attack on alternative medicine, rather it's meant to demonstrate how the internet can focus one's mind on a solution quickly rather than providing all of the necessary information to make the best decision.  

And the scary part?  There is very little you can do about it.

These algorithms are proprietary and aren't really subject to easy manipulation.  They are meant to reflect who you are and what you generally search for;  and they do a very good job.

Yes, you can log off and then log on with another name, try a different browser, search for other types of topics for awhile, or even replace the computer, but because many use the local ip address as the pointer for determining which results to deliver, this would all be done in vain.

Probably the best advice is to cognitively realize that this is happening when you perform a search.  So don't stop with the first articles or links that are returned.

Dig deeper and go off the search engine directed path a little.  Force Google to go deeper into other topics by continuing to search different but similar keywords.  

And know that ultimately you are in charge of your search experience.  Don't believe everything you see or hear;  have a healthy respect that it's good to challenge the information you are given.

Introducing Cancer Survivors New Normal with Dr. Linda

Dr. Linda as we know her is introducing her new video blog series that focuses on cancer survivors and the "new normal" that occurs after a cancer diagnosis. No one, I repeat no one can know what it's like to have cancer more than Dr. Linda Timmerman. She is a two time cancer survivor and a life long educator. Plus, she understands the pain, terror, and crisis that people feel when cancer enters their lives. Please help me welcome Dr. Linda to docdano.com.

When Cancer is a Family Affair

By Linda Timmerman, Ed.D.

According to a report from the CDC, there are nearly 12 million cancer survivors in the U.S. today.

That's 12 million people seeking "new normal" in their lives. Twelve million journeys. Twelve million stories.

Every cancer survivor is an individual, and no two journeys are alike.

My family of cancer survivors is a microcosm of those 12 million courageous souls.

My 86-year-old Dad approached his diagnosis of bladder cancer some 20 years ago the way he has always approached life: philosophically and through scripture. Ask about his cancer and he'll respond: "It happens. My God is in control, and I don't worry about it."

He does, however, think deeply about his cancer.

Shortly after he had completed his three-year maintenance protocol of BCG (Bacillus Calmette-Guerin, an inactivated form of the bovine tuberculosis virus that is instilled into the bladder to elicit an immune response), he called me and asked, "now that my treatment is over -- do I tell people I HAD cancer, or do I say I HAVE cancer?"

He's deeply interested in knowing how he got bladder cancer in the first place: he was a smoker for a number of years, but hadn't smoked in over 25 years when diagnosed. He was a dairy farmer exposed to pesticides and chemicals virtually every day.

Truthfully, it was Dad who found an article about BCG in Reader's Digest in 1991, took it to his urologist, and said, "they say this is a fairly new and promising treatment for bladder cancer -- can we try it?" It worked for him -- he's been in remission almost 20 years.

Today, BCG is still the gold standard for immunotherapy for bladder cancer.

Dad spends hours pondering the fact that I, his only daughter (who is still 16 years old in his mind), has bladder cancer and that having a first degree relative with bladder cancer is a risk factor.

"How did I pass that on to you?" he'll ask. Is there some test your children can take to see if they carry the gene?

My Mom, on the other hand, approached her journey with fear and trepidation. Mom is the official family worrier. She called me one day to say that she was so worried, "things are going so well, I just know something bad's about to happen."

Mom thought her lung cancer diagnosis meant certain death.

She grew up in that era. She and I were both there when her mother, my grandmother, died -- drowning in her own fluids from breast cancer that had metastasized to the lungs.

Mom didn't know many survivors in her life.

Mom never came to see me when I was undergoing treatment for breast cancer. She just couldn't. And  I completely understood.

To this day, Mom can't believe that her cancer is gone. "All they did was remove the upper left lobe of my lung," she'll say. "The doctors say I didn't need chemo. It'll probably come back."

She has to worry. I completely understand.

My husband approaches his cancer stoically. He has had three melanomas, but rarely talks about it and doesn't want anyone to "make a big deal" of it. He has a skin condition that requires him to use ultra-violet light therapy weekly. It has to worry him that he exposes his skin to UVB light, but he does it without complaint.

He is vigilant. He visits his dermatologist regularly and uses sun screen religiously.

He and I faced our biggest fear two years ago when his daughter, my step-daughter, was diagnosed with a liposarcoma in her leg. This was different for our family: she was too young, and the mother of young children.

The biopsy was clear, but pathology on the very large tumor showed that approximately one-third of the mass was cancerous. They couldn't remove all of the tumor without removing her leg.

She is teaching us how to use humor to cope. She respects the disease, and she knows that she must be followed closely for the rest of her life. She will do what it takes to thrive and survive.

I cope by being involved.

I participate in cancer "causes," -- Relay for Life, the Koman Breast Cancer 3-Day walk, I attend a support group for bladder cancer survivors, I speak to groups, I counsel fellow survivors, I raise money for cancer research, and I blog.

I use this involvement to find my "new normal." I use it to challenge the disease that has invaded my life and the life of people I hold dear: my husband, child, mom, and dad. My prayer is that my children and grandchildren will never have to battle this disease in any form.

12 Million Survivors. 12 Million journeys. 12 Million ways to cope. It's a good thing. It gives me hope.

Linda Timmerman, Ed. D. is a two-time cancer survivor and life long educator. She blogs regularly about cancer survival and real information from real people with the disease.

- Posted using BlogPress from my iPad

Location:Stonewall Dr, Harmony Harbor on Richland Chambers Lake

Study finds unnecessary breast biopsies: maybe needles should stick to being lost in haystacks

By Linda Timmerman, Ed.D.

So who do you listen to?

I get frustrated when I hear about research studies that say women don’t need mammograms every year or before a certain age, not all lymph node dissections are necessary, and now many breast biopsies are done just to line the pockets of physicians and hospitals.

A recent article in the American Journal of Surgery suggested that physicians are doing too many biopsies and should favor doing fine needle aspirations or biopsies (the "FNA").

The FNA is a procedure where a needle is inserted into the tumor either based on palpation of the lump or by the use of a sonogram to guide it to the proper location.

Then using suction, some of the cells are removed and examined under the microscope.

I thought about my friend, Robbie, when I read the findings of the research study.

Robbie found a lump under her arm. She was still young, so the doc thought it was probably just a cyst or infected lymph node. They did a fine needle aspiration (FNA). Results: all clear.

We celebrated with margaritas and Mexican food at Don Jose’s!

Three months later, the “lump” was growing – another FNA – good results – more margaritas!

Six months passed and Robbie went for her well woman checkup. Her OB/Gyn just didn’t like the feel of the lump – so a third FNA followed by the celebratory margaritas!

Fast forward a few weeks. Robbie dropped by to say she was going back to the surgeon. “I know it’s nothing, “ she said, “but it just bothers me knowing it’s there. I’m asking him to take it out.”

“Lump” removed – positive for cancer – invasive ductal carcinoma with lymph node involvement. A modified mastectomy, 8 rounds of chemo, and 35 radiation treatments followed – and Robbie’s been cancer free for 15 years.

Now to be fair, biopsies in general are samples.

Think of a loaf of bread.

You decide you want to serve it for Thanksgiving but you're not sure its fresh. So you pull out several slices and examine them. All ok. No green stuff here.

You put it on the table and then one guest pulls out a different piece, and guess what? A Pasteur prize addition to your holiday meal.

But FNA's are even more of a sample: small fragments of cells pulled through a hypodermic needle. Analysis requires special training and certainly has a margin of error that is bigger than examining a larger piece of tissue.

Robbie is alive today because she listened to her body and followed her “gut feeling” that the lump needed to come out.

So what’s the takeaway message?

If you find a lump, go to a center that specializes in breast cancer.

Find a surgeon and radiologist you can trust.

And most of all follow your gut feelings.

Listen to your body.

Maybe you’ll be one of the fortunate ones whose breast biopsy was unnecessary.

Linda Timmerman, Ed. D. is a two-time cancer survivor and life long educator. She blogs regularly about cancer survival and real information from real people with the disease.

What Are the Odds? Why information discovery about cancer on the internet might be like online gambling

By Linda Timmerman, Ed.D.

You might think the first place you visit after being told you have cancer would be to a cancer doctor, or oncologist.

But you'd be wrong.

The first stop for most of us? The internet.

Google any form of cancer, and a plethora of websites are instantly available. Some are good, and some are downright dangerous (but that's for another blog).

We tell ourselves we're looking for information about the disease, where to seek treatment, what types of treatments are available.

But what we really want to know is "what's the prognosis?"

"Can I survive this cancer?"

"What are my chances?"

"How long do I have?"

I remember the evening a friend and colleague called and said, "Can you come over? The doctor says I have esophageal cancer, and my wife and I just need to talk."

Truthfully, I didn't even know there was such a thing as esophageal cancer -- so before grabbing my car keys and husband, I starting Googling.

Unfortunately, my friend and his wife were doing the same thing.

By the time we arrived at their home, they were completely focused on the statistics: the 5-year survival rate ranges from 70% to 5% depending on the stage of the cancer at diagnosis.

His first words were, "this thing is going to kill me."

I certainly advocate knowing everything you can about your disease. Some cancers have low survival rates primarily because by the time symptoms appear the cancer is too entrenched or has spread.

It's the nature of the beast.

But how one copes with and acts on this information is vital, I believe, for every survivor traveling the road to the new normal.

Greg Anderson, diagnosed with stage IV lung cancer and given 30 days to live in 1984, went on to found the Cancer Recovery Foundation. He interviewed over 16,000 cancer survivors who had been told they were "terminal" and shares their wisdom in his book, Cancer: 50 Essential Things To Do.

It's a "must read" for survivors. Cancer, say Anderson, must be dealt with on all levels: physical, psychological, and spiritual.

When I was diagnosed with breast cancer in 1997, my first act was to look to the sky and ask, "Oh God, what am I supposed to learn from this?"

On hearing the diagnosis of bladder cancer just last year, my first thoughts were, "Obviously, I'm a slow learner."

To live with cancer, we must know and believe that we can have a quality life and achieve wellness. If the five-year survival rate is 2%, then focus your energy on being in that 2% group.

Emile Coue, a nineteenth century pharmacist in France, encouraged his patients to practice positive affirmation rather than focusing on the fears associated with a serious illness.

His words still ring true: "Every day, in every way, I am getting better and better."


Linda Timmerman, Ed. D. is a two-time cancer survivor and life long educator.  She blogs regularly about cancer survival and real information from real people with the disease.

- Posted using BlogPress from my iPad

Location:Stonewall Dr,Streetman,United States

Cancer Survivors New Normal: Dr. Linda Timmerman explores living through cancer -- twice!

 (Please join me in welcoming Dr. Linda Timmerman to docdano.com.  Linda is a two-time cancer survivor and patient champion with a long history in education and health care.  She will host a new video series blogging about cancer survival and the new normal that occurs after a cancer diagnosis. The focus will be on real stories from real people that survive, treat, or live with someone with cancer.)

By Linda Timmerman, Ed. D.

About a year ago, it became official:  I’m a “double D”! 

A Dual Diagnosis Cancer Survivor.

It was devastating in 1997 to hear the words from my breast surgeon, “what we have here is invasive ductal carcinoma.”   There are no words to describe how I felt thirteen years later when I heard my urologist say, “it’s a really large tumor and I’m 99% certain it’s malignant.”

During chemo and radiation for the breast cancer, all I wanted was a “normal” day.  I thought that would come at the end of treatment.

Silly me.

Cancer changes everything about life, physically and emotionally.  It took me several years to realize that “normal” simply didn’t exist.   So I started seeking my new normal – that place where I could feel comfortable, safe, and confident again. 

And I almost found it.

I no longer panicked when I made the annual appointment for my mammogram, chest x-rays, and blood tests.  I went days, weeks, and even a few months without thinking about cancer.  I changed careers, loved learning new things and meeting new people, my husband and I built a home on the lake and we bought a condo in the city.    

Our children got married and had children.  Life was good.

And then the day I’ve now named “Red Thursday” occurred.    Three surgeries, two rounds of chemo, and umpteen million tests later, I’m seeking that “new normal” again.  I still have two years of chemo treatments every six months and scopes of my bladder every three months, but I’m surviving.

During treatment, it’s physically difficult.  And there are days when I feel I’m hanging by a thread emotionally.  For right now, at least, that’s my “new normal.”    It’s very much like driving in the car with my GPS navigation system.  

Every now and then, I take a wrong turn – or I simply choose to go another way – and the voice sighs, “recalculating.”

That’s what happens in the new normal – we all recalculate and then press on.  Any like any journey where you’re not certain if you’re on the right path, there are both tears and joys in the unknown.

There are thousands on the road to new normal with me.  

My goal for this blog is to encourage cancer survivors to tell their stories, to become educated about their disease, and to draw strength and courage from each other.