Surviving Breast Cancer

Sharing your stories
breast cancer
surviving
Local women reveal the ups, downs and in-betweens of a breast cancer diagnosis
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Chemo Cravings To Reconstruct or Not to Reconstruct Inside Triple Negative A Husband's Lesson
Breast cancer patients are logging onto the Internet to seek comfort and guidance from those that already have fought the good fight
The Salem News
THE SALEM NEWS Breast Cancer Awareness Tuesday, October 16, 2012
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For local leaders, the power of pink prevails

people will die this year alone, and 400 will be men. Were all touched by breast cancer in some way, said Gayla Bartlett of Pink ribbons. Pink Cranney Companies. Friends, coT-shirts. Pink sneakworkers, mothers, sisters. This awareers, shoelaces, hats, ness campaign is hugely important, scarves, ties. Even pink wristbands, pink and were pleased to be a part of it. Forty-one sponsors have come football socks and together, in partnership with The pink soccer mouth Salem News, to bring you this special guards. news section devoted to breast cancer A bit overboard? awareness. Along with this section, No way. youll see their awareness messages in In October, the power of pink preadvertisements all month long in the vails. The more pink, the better. And your community leaders agree. daily pages of The Salem News and The North Shore has come together online on salemnews.com. I am very grateful to each of the 41 this month, October 2012, to spread the power of pink and support Breast partners, whose logos fill the pages to the left. Please take a moment to drop Cancer Awareness. Lawyers. Mayors. Bankers. Realtors. a note or make a quick call to thank them for their generosity and commitThey did not hesitate when asked to ment to community. support this important community A special thank you goes to our campaign. three Pink Ribbon sponsors: North I am deeply committed to the Shore Medical Center, North Shore cause, said Beverly Shafer, a top plastic surgeon who devotes countless Music Theatre, and The Butchery of Danvers. These three businesses were hours healing and supporting breast especially generous to this campaign. cancer patients. Thank you Bob Norton, Bill Hanney Thank you for including us, said and Glen St. Cyr. Marcia MacClary of Footprint Power, When you see pink this month, I the company that now owns the Salem hope you are reminded of the imporPower Plant. District Attorney Jonathan Blodgett tance of early detection, which is so important in battling this disease. is a proud sponsor of this breast cancer initiative. So are Coldwell Banker, Take this pledge to be a survivor: I PROMISE TO: North Shore Community College and Schedule my annual mammogram the YMCA of the North Shore. Perform a monthly self-exam All of us have lost friends and famExercise regularly ily to this devastating disease, said Follow a healthy, low-fat diet sponsor Betsy Merry of Merry Fox Quit smoking Realty in Salem. Merry and partner Dan Fox wanted Copies of this Breast Cancer Awareto specifically pay tribute to Kelly ness section are available in the front Wyke, a mother, wife and friend. She received theshocking news on lobby at The Salem News. Please stop her 35thbirthday that she had termi- by our office on Dunham Road in Beverly if youd like a few extras to pass nal breast cancer, Merry explained. along to all those you love. And please, Her beautiful spirit lives on in her dont forget to thank the sponsors, amazing three daughters who were all under 8 years old when she passed whose generosity has made this effort possible. away. The facts are startling: Every two minutes, there is a new breast cancer Karen Andreas is publisher of diagnosis. Every 14 minutes, a life is The Salem News. Contact her at lost to the disease. More than 40,000 kandreas@salemnews.com.
Karen Andreas
Tinti, Quinn, Grover & Frey, P.C. Attorneys At Law
Mayor Kim Driscoll
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Doctors take a risk adapt approach

Technological advancements have made breast cancer not only more detectable at an early stage of development, but have also lessened the impact the process of cancer treatment can have on a womans quality of life. Weve already upped the ante with digital mammography, said Dr.Andrea McKee, chair of radiation oncology at Lahey Clinic. We see much more early stage breast cancer. Breast cancer is classified in stages, on a scale of 0 to 4, with stage 4 being the most serious. Early stage breast cancer in women refers to stage 0, also called a precancerous condition, or stage 1, which means a tumor has developed, but it is less than 2 centimeters in diameter. For decades, radiation treatment for breast cancer at any stage meant treating the whole breast. We didnt have the capacity of targeting the radiation to a more effective area, McKee said. According to McKee, most women present with a single focus of cancer in the breast. In severe cases, a mastectomy is necessary. But for many early stage patients, a lumpectomy followed by radiation destroys the cancer. Today, there are radiation techniques available that are less onerous to earlier stage patients. For example, one procedure allows radiation to flow to where a tumor used to be with breast cancer. Risk adapting means that doctors take several factors into account, including the type of cancer, size of the tumor, location of the tumor within the breast, and whether the cancer has spread to the lymph nodes, when determining a recommended course of action.At Lahey, a team of healthcare professionals, including the breast surgeon, medical oncologist, radiation oncologist, a social worker and a breast health navigator meet with Dr. Andrea McKee each patient to discuss treatment options. through a catheter, targetWere counseling them ing only the cells in direct regarding the options we contact with the tumor. We risk adapt, she said. think are appropriate for them, McKee said. Basicallywe dont do the But its also a time for same thing for every patient women to have a say about what happens to their bodies. We really listen to the patient, McKee said. Were really trying to kind of engage women by allowing them to participate in the decision-making. That puts them in the drivers seat as much as they can be. McKee said a lot of women today say they dont want to have radiation on certain parts of their body. For example, radiation on cancer in the left breast could also expose the heart to those rays. In these cases, theres the possibility of treating the patient in the prone position a woman would lie face down on a specially designed table that allows the breast to hang forward, so the radiation exposure on the chest wall is minimal. In another technique, called gated radiation, a woman would take a deep breath just before the radiation hits. When you take a deep breath, your heart retracts a little bit into your chest, McKee said. You basically are controlling where the heart is. McKee said she loves when a patient comes to the first team meeting armed with knowledge about her cancer and treatment options, either from friends, family or from the Web. Thats a sign of someone who wants to be involved, she said.
My Heartfelt Thanks
To the many breast cancer patients and dedicated researchers:
During the month of October, this special time dedicated to breast cancer awareness, I pause to applaud the many brave men and women who confront such challenges in their lives. Your courage and tenacity is truly inspirational,and I am consistently amazed by your strength to battle against breast cancer.I also say thank you to the incredibly talented researchers who continue the fight for innovation and excellence, allowing the medical community to have the important advancements necessary to serve our patients. My deepest gratitude. Patients and researchers, I applaud you. Sincerely yours,
Beverly M. Shafer, M.D.

BEVERLY M. SHAFER, M.D. FACS
PLASTIC & RECONSTRUCTIVE SURGERY

900 CUMMINGS CENTER, SUITE 112 W BEVERLY 978-927-8844
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Annual walk/run honors Danvers native

Cheryl leCesse
STAFF WRITER
Lynda Talbot was a very private person. Only close friends and family knew about her lengthy battle with breast cancer. Shewas diagnosed four times over a 23-year period before succumbing to the disease in 2010. She was 61. She was very strong, very committed, said Stacy Bazylinski, one of Talbots two daughters. Bazylinski was 12 when her mother was first diagnosed with breast cancer. She battled this disease for a long time, 23 years. She wasvery determined to get better. Theres a certain amount of determination, she noted, to recover from three prior diagnoses. On Sunday, Oct. 21, friends, family and the Danvers community will honor Talbots memory and others who have fought the disease in the second annual Lynda J. Talbot Memorial Walk/Run.
The event kicks off at 9 a.m. at the Danvers YMCA. Our family lived in fear of this disease all our lives, and our worst nightmare finally came true, said Julie Donnelly, Talbots daughter. Every doctor appointment, every mammogram, every blood test, etc. took on a whole new meaning for us. Now we have to do something to help others. Last year, Bazylinski and friend Kristen Clark were thinking about participating in a Susan G. Komen for the Cure three-day walk. But after talking it over with others, they decided to hold a walk of their own. It made sense to do something locally in honor of my mother, Bazylinski said. The first Lynda J. Talbot Memorial Walk/Run was a success. More than 600 people participated. The money raised went to Making Strides Against Breast Cancer, ArtBecause, the Danvers YMCA and two scholarships for Danvers
From left, Jodi Fish with her son Thomas, Sharna McNeill with her daughter Mya, and Stephanie Rooney during the first Lynda J. Talbot Memorial Walk/Run last year.
Courtesy photos
On Sunday, Oct. 21, friends, family and the Danvers community will honor Talbots memory and others who have fought the disease in the second annual Lynda J. Talbot Memorial Walk/Run.
High School graduating seniors. Bazylinski said the money raised through this years walk will go toward breast cancer research for a cure, but the exact organization has yet to be determined. Organizers also hope to continue to fund scholarships for Danvers High seniors. A graduate of Danvers High herself, Talbot met her husband, Bruce, in high school and raised her family in a community she loved. It was family and mostly close high school friends who were her support system, Bazylinski said. A lot of the support has come directly through the community, she said. And although Talbot kept her battle private, the mark she left on her community is plain to see. For us, the amount of community support that weve received has been overwhelming, said Bazylinski, who is also raising her family in Danvers. Danvers is a wonderful town and people are very committed to one another here. For more information or the preregister for Sundays walk/run, visit racewire. Ashley Clark, 8, of Danvers at last years Lynda J. Talbot com/talbot.
Memorial Walk/Run.
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A new era in breast cancer diagnoses and therapies
the women being tested but for her family members and her children. Finally, some women may be canreast cancer is the didates for preventive medications most commonly that have been shown to decrease diagnosed maligthe incidence of breast cancer. Most nancy in women in importantly, breast health profesthe Western world. sionals like those at The Breast Many of us know Health Center at Beverly Hospital someone who has at Danvers are knowledgeable been touched by about new investigational studies the disease: a friend, a neighbor, a colleague, a sister or mother. That that would have otherwise been assessment tools have been develand are able to offer leading edge someone may even be you. undetectable on routine mammog- care to women. oped for breast cancer. We have embraced innovation in raphy. This spring, we are excited Our breast center is dedicated It is estimated that one in nine the fight against breast cancer right to incorporate a new, cutting-edge to the comprehensive care of our women may at some time in their here on the North Shore at Beverly generation of mammography called breast patients, from screening and life be afflicted with breast cancer. tomosynthesis or tomo-mammogHospital. We have incorporated diagnosis, to treatment and long But our future is not so grim, as free breast cancer risk assessment raphy. This technology is similar to term follow-up. We incorporate a advances in the science of breast a CT scan, in that images appear as team approach, with a dedicated at the time of an annual screening medicine are making a significant cross sectional slices of breast tisstaff of nurses and imaging techdifference. Diagnostic imaging tech- mammogram, utilizing one of the nologists, radiologists and surgeons, nologies continue to evolve, improv- newly developed tools. The results sue. Our radiologists may analyze slices of breast tissue, rather are then incorporated into a mammedical and radiation oncologists, ing in their ability to detect and than the entire loaf. It will now mogram report that is sent to the nurse navigators and genetic coundiagnose breast cancer at earlier be much easier to identify a small selors. We gather weekly with our referring doctor. Women who are stages. Basic and applied science marble placed in the center of the patients in our Multidisciplinary identified as high risk (currently research in the field of molecular loaf, particularly helpful in young Conference, along with our patholobiology and genomics show promise defined as a 20 percent greater women with very dense breasts. lifetime risk of developing breast gists, and (by video conferencing) a in both treatment and prevention. Breast health specialists, surcancer compared to their contemsecond-opinion medical oncologist The academic medical community geons and breast navigators poraries), are notified by letter. It from the Beth Israel Deaconess Hosis in constant quest for new therais recommended that these women (nurse practitioners who specialpital. As a team, we recommend the pies and treatment protocols, and consider consultation at The Breast ize in breast health) are available optimal, tailored treatment program with the help of the tens of thouto counsel women on preventive Health Center at Beverly Hospital for each patient with newly diagsands of women willing to particinosed breast cancer. We are compate in clinical trials, there is great at Danvers for further counseling measures that can further impact and screening recommendation. A a womens risk of developing mitted to providing comprehensive hope in our battle against breast breast health specialist will review breast cancer. These risks can be care, looking out not only for your cancer. breast health, but for your emotional We are transitioning to a new era a womens mammogram with a separated into those that can be of personalized medicine, which radiologist specialized in breast modified, allowing a woman to bet- well-being throughout the process. imaging at the time of her visit to utilizes the information related to ter shape her destiny, versus those And it is our goal to bring the promising advances in knowledge and a persons unique set of genes com- determine if additional imaging that are non-modifiable. Examples technologies into our community. bined with relevant environmental or preventative strategies may be of modifiable risks include diet, beneficial. One factor considered factors in order to effectively preweight management, exercise, is the overall breast density of her vent, diagnose and treat diseases, alcohol intake, breast feeding and Audrey Duva-Frissora, MD, is mammogram; the more dense, the including cancers and non-cancer hormonal use. Non-modifiable risk board certified in diagnostic radimore likely a potential cancer could factors include gynecological hisrelated medical disease. So called ology and a member of Beverly be masked on a mammogram. risk assessment models and tory, overall breast tissue density, Radiology Associates Inc. located Studies have shown that with the genetics, family history of all cansophisticated genetic testing are in Beverly, where she serves as the being developed to identify patients selective addition of breast ultracers to name a few. If approprimedical director of breast imagsound, and at times breast MRI, who may be unknowingly at high ate, genetic testing for the BRCA ing. She is an active member of the additional early breast cancers will gene may be recommended. These American College of Radiology and risk for developing a particular be identified in high risk women disease. A number of such risk results can be valuable not only for Society of Breast Imaging.
By Audrey duvA-FrissorA, Md
We have embraced innovation in the fight against breast cancer right here on the North Shore at Beverly Hospital. We have incorporated free breast cancer risk assessment at the time of an annual screening mammogram, utilizing one of the newly developed tools.
182 North Street
THE BUTCHERY
The Difference is Delicious!
DANVERS
978-777-3000
Open 9AM-7PM 7 days a week
2 Morgan Avenue
NEWBURY
978-463-3001
Open 9AM-7PM 7 days a week
Supporting Breast Cancer Awareness Month
ink Th nk Pi
Directions to the Danvers Store: Take Route 1 North Danvers To Traffic Lights, Turn Right Directions to the Newbury Store: Take Route One North to Rotary. Take 1st Exit onto Parker Street. Proceed across 1A to Morgan Ave. (next to Town Hall)
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I refuse to let this disease be what defines me and my family

Beverly womans fight inspires Making Strides team
Liesl Voosen Fields, 35, was diagnosed last year with inflammatory breast cancer, also known as IBC. The disease accounts for only 1 percent to 5 percent of breast cancer and presents itself with symptoms such as redness, swelling, and tenderness in the breast symptoms that mammograms dont always detect. There often is no lump, and there is no early detection for IBC. And the prognosis and survival and recurrence rates for this type of cancer are much worse than typical breast cancer, Fields said. The five-year survival rate is somewhere between 25-50 percent for IBC. But Fields forged forward with an aggressive treatment.Her constant positive attitude inspired her family and friends from Calumet, a Lutheran summer camp in New Hampshire where Fields worked during her high school and college summers, to form Lutherans for Liesl, a team in the American Cancer Societys annual Making Strides for Breast Cancer walk. The team raised $22,000 last year within weeks of the walk, earning recognition from the society as a Making Strides Pacesetter team. The team participated in this years walk, held Oct. 14, and is still accepting donations athttp:// main.acsevents.org/goto/ Lutherans4Liesl. Originally from Auburn, she and her husband bought a house in Beverly in 2004, two years after they got married. She is the global senior Web producer at Bain & Company, a global management firm, and still works part-time. my worse fears and she wanted to rule out IBC as soon as possible. She had one patient the year before me with IBC, so she was familiar with it. It was the ONLY other IBC case she had seen in her 20 years of practicing medicine. Because IBC is so rare, it is often misdiagnosed (as mastitis) or ignored. At that point, I began a whirlwind two weeks of tests and scans. Within days I was diagnosed with IBC in the left breast. The cancer had spread to two of my nearby lymph nodes and to one spot on my spine. This meant that I was diagnosed at stage 4, but what I always joke as barely stage 4 but the fact is that the cancer metastasized already by diagnosis. I cursed myself for putting off a visit to the doctor for so long. But I soon came to realize nothing good would come of that. I had to move forward and beat this thing. I started chemotherapy just 12 days after first visiting my primary care doctor.
Tell me about your options for treating your cancer. What treatment option did you decide to go with, and how did you come to that decision?
Treatment for IBC is different than early-detected breast cancer. It starts with Tell me about your diagnosis. Did you know something chemotherapy, followed by wasnt quite right? a modified radical mastectomy (where they remove I first noticed some pink/ associated lymph nodes) redness on my left breast and then radiation. At stage in the middle of the sum4, by definition, the cancer mer of 2011. I thought it has already spread outside was weird, but chalked it the breast, so often people up to a summer rash and (and their doctors) choose figured Id wait and see to skip the surgery and what it did. It started to get radiation, opting instead worse and soon I suspected for systemic treatment I had some sort of infec(chemotherapy, antibody tion. I hadnt nursed my treatments or hormone daughter for a year at that treatments). This focus on point, but thought perhaps keeping the cancer at bay I had a blocked duct that and improving quality of life got infected. My symptoms is often referred to as palwere consistent with masliative care. But, because I titis, though I had no pain. was diagnosed as oligometaThe redness worsened, the static (often defined as canbreast was swollen and the cer confined to less than five skin started pitting a bit. lesions to a single organ) Then my nipple started and Im young, my doctor to flatten and I knew I recommended we move had to get to the doctor. forward with an aggresMy symptoms progressed sive plan with a curapretty quickly, but I didnt tive intent. Basically, we let myself Google anything wanted to throw everything online I think somehow I Where are you undergoing we can at itand that is still knew that it might be more treatment? our approach. My cancer is than just an infection. So, I I am undergoing treatHER2+, which means that waited until after my famment through Harvard ilys vacation in August Vanguard Medical Center at its a fast-growing cancer, 2011 and searched the Kenmore Square in Boston. but also that there are a Internet the night we got They are affiliated with both lot of new, effective drugs available now and on the back. That is when I first Beth Israel and Dana Farheard of IBC. I had all the ber. My surgery was done at horizon. The decision for me to classic symptoms. My heart BI. My care team has been sank. I knew this terrible, outstanding and my oncolo- treat the cancer aggresrare disease was exactly gist has always involved me sively was easy. With a then 4-year-old and 17-month-old, what I had. in her decisions and been I want to make sure I am The next day I was able to open to discussions about fighting with all that is out see my PCP in Boston. The treatment options and difthere to be with them for look on her face confirmed ferent therapies.
Lisel Voosen Fields, right, with her husband Mike and daughters Marika, 5, and Valena, 2, at Calumet, a Lutheran camp in Freedom, N.H., during Labor Day weekend.
a long, long time. My kids have served as a huge motivation and distraction. The thought of not being there when they grow up was and still is just too much to bear. Im going to do everything I can to be here with them, my husband and our family and friends.
Courtesy photos
and to give the doctors time to figure out what to do with me. In the end, I was sent home and started daily injections of blood thinners, which I am still taking seven months later. I started back on chemo every three out of four weeks. We waited to see what the clot did on the thinners, with the expectation that it would melt Where are you now in the treatment process? away. Fast forward a few months and the clot barely I completed my initial changed. So, this summer, chemotherapy in January my care team decided the of this year. At this point, I clot was stable and it was also received a clear scan, which was an amazing first- safe to move forward with surgery. response to my significant Seven months after I amount of disease. A maswas supposed to have the tectomy was scheduled for surgery, I finally had my Leap Day (which I thought was nice not an anniver- single mastectomy on Sept. 19. I am recovering well sary I need every year!). and quickly. The best part But, it wasnt in the cards for me. A routine heart echo is that my pathology report found a 2 centimeter clot in came back and there was NO residual cancer! While my right atrium that was inadvertently caused by my my clinical response had been outstanding from the port-a-cath (an implanted get-go, my care team and device which is used to access a vein to administer I were collectively holding our breath for the pathology chemo). I was ironically report. IBC is sneaky and it hospitalized in the cardiac really is almost unbelievable ward at Beth Israel on Valentines Day for more tests that they found nothing in
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the tissue and skin examined. Starting in two weeks, I will move on to targeted radiation therapy for six to seven weeks. They will radiate my chest wall, under my arm and a targeted part of my spine. Even though my pathology came back great, the idea is to mop up any remaining cancer cells that may still be lingering. Through radiation I will continue on a drug called Herceptin, a HER2-targeted therapy and a breakthrough drug that is likely at the root of my success thus far. I will receive a Herceptin infusion every three weeks for a very long timeeither until it stops working for me or they find a cure for cancer.
I think the hardest part has been staying strong and positive for my kids. Telling a 5-year-old you have cancer and later that you need your breast removed, is NOT easy and I wish it on no one. And yet, for me, staying positive and as optimistic as possible, was the only way I could get through this, though often difficult for a realist like myself. I had a couple weeks soon after diagnosis last fall that I felt sorry for myself and was weepy all the time. I quickly realized that it wasnt going to get me anywhere. I need to enjoy the time I have with family and friends and make as many memories as possible. Physically, the hardest part was probably the hair loss. It seems so superficial and vain, but losing your hair is such a kick when you are down. Not only do you feel crappy from treatments, but you LOOK like you feel. Its not easy. And I was so fortunate in that even though I went through 35 chemo treatments this year, my hair started growing back in January, so I really only had a few months bald and a few more with super-short hair. And Im still waiting for my eyebrows and eyelashes to fill back out to normal!
What has been the hardest part so far, and why?
Liesl Voosen Fields during her chemo treatment in late 2011.
tremendously when we needed it the most. She was invaluable to our family, going to chemo with me or watching the girls when I couldnt. When I finished the harsher, first chemo, she got a job offer and was able to go back to work. Also last fall, friends from Calumet, the Lutheran camp Mike and I worked at, organized a benefit concert for us and a fund was set up by our church in Marblehead. We used the proceeds from the concert to take a spur-of-the-moment trip to Disney World in January, right after my first clear PET scan. My parents and siblings both dropped everything and found ways to be there to share in the magic of Disney with us. It was an awesome trip with priceless memories. My colleagues at Bain created amazing and generous care packages for my family each month for about six months. Each one had a theme and a creative array of gifts for my whole family that brought smiles to our faces when we needed them most. My husHow have your family and friends supported you? bands colleagues at Winter Street ArchiI have received an overwhelming amount tects in Salem also sent care packages and donated cleaning services to help make of support from pretty much every aspect things easier for us during a tough time. of my life. Whether it was help with the My parents have also been a huge supkids, making dinners for my family, rides to chemo, or just sending a package, a note port to us, particularly this fall while Im or prayer, so many people reached out and recovering from my recent mastectomy. supported us. I am so blessed and my diag- They have been staying with us, watching the girls and just making our lives easier. nosis really drove that home for me. And of course my husband of 10 years, One of my closest friends happened to be Mike, has been with me every step of the out of work last fall. She had been desperately looking and interviewing all summer, way. I couldnt have fought as hard without but to no avail. But because she was out of his confidence and assurance that I was just going to kick this cancer. work, she was able to help our family out
me to be more spontaneous and focused on today and making as many memories as possible with family and friends. During this past year, we took a trip to Disney World (conceived and planned in three weeks!), packed the kids in the car and took Tell me about Lutherans for Liesl. How did the a roadtrip to my sisters wedding in Misteam come about? souri (with stops to family in D.C. and Tennessee on the way), I flew to Germany for As the daughter and granddaughter of work, went to Baltimore with my husband Lutheran pastors, Ive been a Lutheran all of my life. And as a child, I was a camper at for my brothers engagement party, took a last-minute cruise with a dear friend to the Calumet, a Lutheran camp up in Freedom, N.H. At age 16, I spent the summer as a CIT Bahamas, and spent a week tent-camping (counselor in training), followed by six life- with life-long friends and their families! changing summers on staff (I even met my Right now, I am enjoying planning a trip to the Big Island of Hawaii for my younger husband at Calumet and we were married brothers wedding in June. Its been awethere in the Outdoor Chapel in 2002!). Two some to have something to look forward to of my fellow CITs and dear friends, Sarah and plan towards (since this year was such Carlson Arens (of Melrose) and Shannon a whirlwind of spontaneity still out of my Dunne OBrien (Medford), wanted to do something to help after my diagnosis. They comfort-zone!). Of course, the nature and viciousness of IBC doesnt stray far from quickly organized a team, Lutherans for Liesl, for the ACSs Making Strides Against my mind. The sad and sobering fact is that the recurrence rate of IBC is extremely Breast Cancer walk in Boston. Sarah and high, particularly within the first two years Shannon are both my age and have young of diagnosis. But, I cant live my life wonkids of their own. I think they felt this was dering whats going to happen, so we are something that they could do at a time when Im pretty sure everyone was feeling moving forward the best we can. We will keep adjusting to any new normals along a little helpless and shocked by my news (me included). They created the team three the way. And I refuse to let this disease be what defines me and my family because we weeks before the walk, a week after my diagnosis. They recruited other team mem- are so much more than that. bers, mainly friends from our camp family, including my husband and parents. Is there anything else you would like to add? I would like to thank the American CanI hear the team raised a tremendous amount cer Society and the Making Strides Against of money last year $22,000! How does that Breast Cancer Boston team. Because of the make you feel? staggering amount of money we raised in The support of the team was completely three short weeks, I asked the ACS if they could direct the funds specifically to IBC overwhelming. To me, the most amazing research. I figured it was a shot in the dark, part was that there were very few donabut that sending an email to check couldnt tions more than $100, and there were no hurt. We were very fortunate as they were corporate donations. The sheer number able use the funds to help support an IBC of people who donated was incredible. An email went out to my colleagues at Bain & research grant. This isnt something that ACS is able to do often, and my case was a Company, telling my story and sharing a link to my husbands Making Strides page. bit of an exception, and it makes me even Within hours, thousands of dollars in dona- more thankful that we could help in this tions flooded in from Bain employees, many way. A lot of people are aware of breast cancer whom I had never even met before. Their already. It impacts the lives of so many generosity and words of support were so and with all the pink out there in October, moving. My colleagues really my Bain family contributed about half of the total its hard to miss. But inflammatory breast cancer is still unknown by most. And while funds we raised last year. it does account for less than 5 percent of breast cancers, it is still very real and a How are you doing? very scary disease. It is often found too late As far as how Im doing, Im recovering or misdiagnosed. I strongly urge women really well from my surgery! I even went and men to read up on IBC and be mindful to a friends wedding this weekend, only of changes in your and/or your partners two weeks post-op. My energy is starting body. Tell those you know about IBC. Even to pick back up and Im gearing myself up for the next step in this journey, radiation. though there is no early detection, early By nature, I am a big planner in life. But my diagnosis could make a big impact on the life of one of your loved ones. diagnosis with IBC has taught (or forced!)
The prayers and well-wishes from family and friends have not stopped, even a year later. I am still supported and often overwhelmed by the love and thoughtfulness of others.
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Black bean and corn salsa served with yellow corn tortilla chips, on a woven Mexican table runner.
Better healing through food
ALWAYS HERE FOR OUR COMMUNITY

YMCA of the North Shore
www.northshoreymca.org
October is Breast Cancer Awareness month. Help us celebrate this month in bringing hope to those who have been touched by Breast Cancer and lets band together in finding a cure.
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Why healthy eating is important for breast cancer recovery

By Bev Bennett
CTW FEATURES
Being a health nut is a lifestyle people will want to embrace literally. If youre recovering from breast cancer and getting your appetite back, you may wonder what you should be eating now. Perhaps youre experiencing fatigue; youd like a diet that gives you some energy. If your taste buds were affected during treatment, youd like to once again eat foods that taste good. Most of all, youd like a diet plan that reduces your risk of a cancer recurrence. Your food choices can help you improve your health and stamina, as well as your mealtime enjoyment. However, dont search for magic bullet foods such as broccoli or a super-berry. Instead, look at your entire dietary pattern. Design it so youre emphasizing plant foods, including produce, whole grains and beans, while limiting meat, says Alice Bender, registered dietitian. At the same time, control your caloric intake. If youre overweight or obese, getting to a normal weight is important once youre finished with treatment. Being overweight can put women at risk for a recurrence, says Bender, nutrition communications manager, American Institute for Cancer Research, Washington, D.C. Gain weight after recovery and you could increase your risk by as much as 50 percent, depending on how much you gain, according to data from breast cancer survivors within the Nurses Health Study (an ongoing study of womens health, with more than 200,000 nurse participants). The same foods produce, whole grains and lean protein that benefit your health can help you lose weight without feeling deprived, says Cheryl Rock, Ph.D., registered dietitian, professor, University of California, San Diego School of Medicine. Maybe youll still crave the occasional piece of chocolate, but if you fill up on vegetables before you reach for chocolate, youll eat a smaller portion, Rock says. Salsa and chips are such a decadent treat you might not consider the zesty duo in your post-treatment diet. But this tasty
Design your diet so youre emphasizing plant foods, including produce, whole grains and beans, while limiting meat.
version is chock-full of nutritious vegetables and low in fat. The chips are baked, not fried. The recipe is from The Back in the Swing Cookbook by Barbara C. Unell and Judith Fertig (Andrews McMeel Publishing, 2012). 2 (15-ounce) cans black beans, rinsed and drained 1 (15-ounce) can corn, rinsed and drained 1 cup canned tomatoes, drained and chopped 1 cup finely chopped red onion 1/2 cup finely chopped green bell pepper 1/4 cup chopped cilantro 2 garlic cloves, minced 1/2 teaspoon ground cumin 1/2 teaspoon sea salt 2 teaspoons olive oil, grapeseed oil or canola oil 1 small jalapeno chile, seeded and finely diced Juice of 1 lime Baked tortilla chips: 12 (6-inch) corn tortillas 1 tablespoon grapeseed oil or canola oil 1 teaspoon kosher or sea salt 1. For the salsa, combine the black beans, corn, tomatoes, onion, bell pepper, cilantro, garlic, cumin, salt, oil, chile and lime juice in a large bowl. Toss to blend. Cover and refrigerate several hours to let the flavors blend. 2. For the chips, preheat the oven to 350 degrees. With a sharp knife or pizza wheel, cut each tortilla into eight wedges. Arrange the wedges on two large baking sheets. Brush the tops with oil and sprinkle with salt. 3. Bake for 6 to 7 minutes, then rotate the trays in the oven. Continue baking for 6 to 7 minutes longer, until the chips are lightly browned. Serve right away or let cool, then store in an airtight container. Makes 12 servings. Each serving has 207 calories, 3.5 grams total fat, 38 grams carbohydrates, 8.5 grams protein, 400 milligrams sodium and 10 grams dietary fiber.
Black Bean, Tomato and Corn Salsa with Baked Tortilla Chips
Hereditary gene means a greater risk of breast cancer for some

Genetic testing has shown that some women arepredisposed to developing breast or ovarian cancer, especially at a young age. Unfortunately for some, its hereditary.Dr. Luisa Kontoules, Dr. Luisa a boardcertified Kontoules general ObGyn physician who has practiced on the North Shore since 1988, talks below about the BRCA gene and what it means for women and men who have a history of breast or ovarian cancer in their families. Q: What is BRCA? A: BRCA 1 and 2 stands for BReast CAncer gene 1 and gene 2. We inherit one copy of each gene from each of our parents. When these genes are damaged or abnormal (called a mutation), there is a higher chance of developing breast and ovarian cancers.Men who have BRCA mutations also have a higher chance of developing breast cancer, as well as other cancers. Q: What risks does a woman who carries BRCA face? A: She has an up to 87 percent lifetime risk of developing breast cancer, and an up to 54 percent lifetime risk of developing ovarian cancer. Remember that most women have only a 1:8 (about 12 percent) lifetime risk of developing breast cancer, and a 1 percent lifetime chance of developing ovarian cancer. Q: How can a woman find out if she carries BRCA? power, and it opens the door to learning about all BREAST CANCER AWARENESS the various options that are available for both prevention and early diagnosis of these cancers. control pills, prophyllactic A: BRCA mutations are Q: Are there any lifestyle mastectomies and removal detected by a blood test. changes a woman can Q: Is BRCA and hereditary of their fallopian tubes and make to reduce the possiovaries after completion of ovarian or breast cancer a bility of developing heredirelatively new discovery in childbearing. BRCA 2 muta- tary ovarian or breast tions also increase the risk cancer? the medical field? of developing melanoma and A: No. The BRCA genes A: Lifestyle changes no, pancreatic cancer. They can because these are genetic were discovered in 1994. be referred to dermatoloQ: Are there additional traits. But there are other gists and gastrointestinal options for treatment for options available to reduce specialists for increased a woman diagnosed with their risk (as described surveillance for these types above). breast or ovarian cancer of cancers. who carries BRCA? Q: Are there any current Women who have already medical guidelines for testA: Yes. Women who carry developed breast or ovarBRCA mutations need to ing women for BRCA if they ian cancer can still benefit have a history of breast canstart their screening tests from BRCA testing. Its also cer in their family? for breast cancer at age extremely useful informa25, and for ovarian cancer A: Yes. There are certain tion for their genetic relaat age 30. They also need red flags to look for: counselling about medicaAn individual with, or a tives. If a woman carries a tions and surgeries that can BRCA mutation, there is a family history of, any of the greatly reduce their risk of 50:50 chance that any one following: developing these cancers, of their genetic relatives Breast cancer diagsuch as tamoxifen, birth have it too. Knowledge is nosed at age 50 or younger
age
Ovarian cancer at any
Two primary breast cancers (breast cancer in both breasts) Male breast cancer Triple-negative breast cancer Pancreatic cancer with a breast or ovarian cancer Ashkenazi Jewish ancestry with breast or ovarian cancer Two or more relatives with breast cancer, one under age 50 Three or more relatives with breast cancer at any age A known BRCA mutation in the family
For additional information about early detection for breast or ovarian cancer, Kontoules suggests Bright Pink (www.brightpink.org). The national nonprofit organization has a Boston area chapter.
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In every company there are compelling reasons to support Breast Cancer Awareness Month. At Moynihan Lumber these are our reasons: Vikki Rundlett, wife of Webb Rundlett, breast cancer victim - 2003 Sandra Moynihan, wife of Gerard Moynihan, breast cancer victim - 2005 Lisa Bernstein, breast cancer survivor Carol Karsadi, breast cancer survivor Cathy MacMullen, breast cancer survivor Eileen McNeil, breast cancer survivor Rita Mullin, breast cancer survivor Barbara Surdam, breast cancer survivor
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Surgeon explains the breast reconstruction process

implants after a mastectomy has reduced. Previously, a breast surgeon would perform a mastectomy, Many women who and then tissue expanders undergo a mastectomy would be put into place. following a breast cancer diagnosis also opt for breast The expanders hold space reconstruction. Andrecon- for implant or reconstructive surgery at a later date. struction options have Today, both surgeries the changed dramatically over the last 10 years, according mastectomy and implant surgery can be done at to Dr. Lifei Guo, chair of once. plastic and reconstructive Finally is the advent of a surgery at Lahey Clinic. new perforator flap called First, the timing of the the DIEP flap. In this proreconstruction process cess, a surgeon takes tissue has changed. Before, the mastectomy and first recon- from the abdominal area to use to reconstruct the structive surgery would be breast. But the DIEP flap completely separate. Now it has become more process does not affect the and more immediate, Guo abdominal muscles. Guo completed his trainsaid. ing in the Harvard system. Along those same lines, the time in between placing He came to Lahey from
STAFF WRITER
By Cheryl leCesse
Guo is part of a team, including the breast surgeon, medical and radiology oncologists, social worker and breast health navigator who sit down with a patient to discuss treatment options. Depending on the type of breast cancer at which stage the patient is diagnosed, Guo said breast conservation options, such as a lumpectomy, arent viable. If Im involved early on, Brigham and Womens I am able to guide their Hospital, where he worked primarily with breast recon- decision a little bit, Guo said. struction patients. In fact, During the team meetmany of his patients followed him to Lahey, he said. ing, Guo fields questions At Lahey, Guo said one of pertaining to cosmetics, the best parts of the process as well as concerns about how radiation would affect is the multidisciplinary approach the hospital takes the reconstruction process, since radiation can distort with its cancer patients.
At Lahey, Guo said one of the best parts of the process is the multidisciplinary approach the hospital takes with its cancer patients.
about two to three surgeries. If a patient chooses reconstruction, hell meet with her three to six weeks before the initial surgery, then on a weekly basis for about a month, followed by check-ups every couple of months and follow-up surgery as needed to complete the process. If theres no radiation or chemotherapy, Guo said the reconstruction could be complete in less than a year. Dr. Lifei Guo Guo said, with many patients diagnosed at a the tissue. young age, faced with the The patient is always reality of having to lose a concerned with how long breast, he knows his work the surgery takes, he said. can make a big difference in Although reconstruction their lives. starts immediately after a Its a very rewarding mastectomy, Guo said the surgery field to be in, Guo full process is a series of said.
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NEGATIVE, NEGATIVE, NEGATIVE

One of the most invasive forms, triple-negative breast cancer is difficult to treat and accounts for 10 to 20 percent of all breast cancers. Today, however, it doesnt have to be a death sentence. Heres what you need to know.
By AnnA SAchSe
CTW FEATURES
From a scientific standpoint, triple-negative breast cancers (usually invasive ductal carcinomas) are those whose cells lack estrogen and progesterone receptors, and do not have an excess of the HER2 protein on their surfaces. Because the growth of the cancer isnt supported by these hormones or too many HER2 receptors, it doesnt respond to common hormonal therapy (such as tamoxifen) or therapies that target HER2 receptors, such as Herceptin. Anyone can get triple-negative breast cancer, but it is more likely to occur in premenopausal women, says Patricia Prijatel, author of Surviving Triple-Negative Breast Cancer (Oxford University Press, 2012) and founder of the Positives About Negative blog (HormoneNegative.BlogSpot.
Patricia Prijatel, author of Surviving Triple-Negative Breast Cancer.
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com). In addition, although African-American women are less likely to get breast cancer than Caucasian women, if they do get it, they are more likely to get triple-negative. While this group of cancers is not hereditary, Prijatel notes that it does have a strong association with the BRCA genetic mutation, which is hereditary. The correlation works one way, but not necessarily the other, she adds. Women with the genetic mutation who get breast cancer are most likely to have triple-negative breast cancer than other forms, but women with triple-negative breast cancer do not necessarily have the mutation. Other studies have found that women with triple-negative were younger at the onset of menstruation, on average had more children (at least three) than non-triple-negative women, they were less likely to breast-feed for more than four months, and they were more likely to not breast-feed at all if they had at least three children, Prijatel says. Another risk factor she finds intriguing is related to metabolic syndrome a combination of risk factors such as high blood glucose, high blood pressure and abdominal obesity, plus problems like low good cholesterol, high bad cholesterol and high triglycerides. Women diagnosed with triple-negative breast cancer are much more likely to have metabolic syndrome
the individual tumors that respond to treatment. So, a treatment may only work on 5 percent of triple-negative tumors, but if we can identify the 5 percent, then we are making good progress. Also, now that from a genetic point of view these cancers are no longer black boxes, we can also learn from other tumor types. (Our) study, for example, suggests that a drug used for malignant melanoma might be useful in a small subset of the triple-negative cancers. Of course, this would have to be rigorously tested, but its an excellent lead already. If you have a strong family history and the BRCA mutation, you have several options. The most extreme is a mastectomy and salpingo-oophorectomy to remove ovaries and fallopian tubes. Less extreme than those with other forms of and more in our control are breast cancer, Prijatel says. Some exercise and diet modifications that research suggests that insulin can help reduce the risk of all forms resistance might be associated with of breast cancer and a batch of other triple-negative breast cancer. illnesses, including cardiovascular Although triple-negative isnt disease and diabetes. a good candidate for hormonal In general, this means at least therapy, it can be treated with sur- five servings daily of fruits and gery, radiation therapy and chemo- vegetables, with an emphasis on therapy. In fact, some research has cruciferous veggies such as broccoli, shown that chemotherapy is more kale and cauliflower; complex careffective for triple-negative than for bohydrates, such as whole grains, hormone-positive, Prijatel says. seeds and nuts; and little or no trans Knowing that triple-negative or saturated fats, Prijatel says. I breast cancer is a family of diswould save alcohol for special occaeases, the goal going forward is to sions only and keep it to one understand the genetic makeup of drink at those times.
Although triplenegative isnt a good candidate for hormonal therapy, it can be treated with surgery, radiation therapy and chemotherapy. In fact, some research has shown that chemotherapy is more effective for triple-negative than for hormonepositive, Prijatel says.
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Survivor sets sights on half-marathon goal

lumpectomy at Emerson Hospital in Concord. Before her diagnosis, Broach and her husband had decided to It was an extra special moment for Anita Broach when move to the North Shore. With she crossed the finish line at the their daughter in college and jobs that didnt require them Twin Lights Half Marathon in to stay in the area, the couple Gloucester this past May. wanted to be closer to the ocean. Broach was diagnosed with ductal carcinoma in situ, a stage Theirmove to Rockport fell right between Broachs initial 0 non-invasive form of breast surgery and treatment. Her cancer, during the summer of surgeon referred her to Mass 2010. She was 48. General, which, fortunately Having something like that for Broach, includes the North happen to you does make you Shore Center for Outpatient rethink things, she said. You Care in Danvers. try to make the best of the They really are a team, situation. Living in Concord at the time, Broach said of her North Shore doctors. They were all on the Broach had gone in for her same page. They all had access regular mammogram when to all of my records. doctors found something not Her treatment team was quite right. A biopsy lead to her diagnosis, and she underwent a able to schedule her radiation
STAFF WRITER
By Cheryl leCesse
Anita Broach, a breast cancer survivor, ran the Twin Lights Half Marathon in May.
around her work. With appointments close to home at 7 a.m. for six weeks, Broach didnt miss a day at the office. Luckily, she didnt suffer side affects from the radiation, either. At the same time,Broach started to run. Exercising not only helped her efforts to live a healthier lifestyle during her treatment, but also provided some much needed TLC. We had a mild winter, so I did not miss one day [of running], she said. The beautiful scenery we have here in Rockport made it easy, and it was good for stress relief. She ran her first 5K the Hangover Classic in Salisbury, which ends with a plunge into the icy Atlantic with her brother on Jan. 1, and did well. That kicked me off saying, I
can do this, she said. So she set a larger goal: To run the Twin Lights Half Marathon in May.She followed a five-day, 12-week half-marathon training program offered by coolrunning.com, and never looked back. Broach says her family provided a tremendous amount of support. Her diagnosis was even more personal for her and her three sisters, all of whom have had some form of breast cancer in the last 15 years. One sibling has battled the disease twice. All four are doing fine now. Since we have the history in my family, they do watch me, Broach said of her doctors, whom she still sees about once every six months. Im lucky that mine was caught early.
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I never thought it could happen to my Mom

A breast cancer diagnosis affects everyone
sorry she ran away, but I totally understood. In the same circumstances Im convinced Id have done the same Eleven years, 263 days and I am thing. The harsh reality that followed thankful for every one. On June 14, her departure was unfortunately not 2001, I was told, You have breast missed by her 16-year-old brother. cancer. And yet, I was lucky. I had TODD SCHULER the best family, friends and medical College Application Essay excerpt: staff who lifted me up and carried me I never thought it could happen through the surgeries, the chemotherapy and on to recovery. Thats the to my Mom. She was in the fight of simple truth. The deeper truth involves her life, with breast cancer. My whole world has been turned upside down. I a 16-year-old boy, my son, and an am constantly thinking about her no 18-year-old girl, my daughter. matter where I am or what I am doing. Fear can be paralyzing. For my My sister was going off to college daughter, it was devastating. The media had made so much about breast and my dad had to work every day. I knew that I had to help my mother cancer and breast cancer deaths that with everything. I wanted to make my at a young age she had heard enough mother feel comfortable and ensure to scare the hell out of her. It wasnt that she would have whatever she just about me, because the media needed. When she first started to lose talked constantly about hereditary her hair I knew she felt out of place. genes, being Jewish making one predisposed, and so on. For her, it was my In order for her to feel comfortable I death sentence and hers. After seeing shaved my head so we would be bald together. the after-effects of the surgery, she It wasnt easy for me, balancing couldnt get away fast enough. Colmy moms needs with school, sports lege was her salve and off she went. and friends, but I knew that the most In retrospect, she says that she was By Penny Schuler
Penny Schuler, right, and her son Todd. When Penny began losing her hair from chemo treatments, Todd shaved his head so they could be bald together.
wasnt me II say it imagineeasy for was but, cant how it for my mom, and I still cant.
Todd Schuler, in college application essay
important thing to me was my moms health, comfort and happiness. I say it wasnt easy for me but, I cant imagine how it was for my mom, and I still cant. She has fought in the toughest fight of her life, and won. She is my hero. I know what happened to my mom was a horrible thing, but I believe good things come from every situation, good or bad. Because of this experience, I have changed. I have become closer to my mom and my family. I have changed how I view the world and my life. I dont want to travel through life without a purpose. I am more determined than ever and this is all because of my moms incredible courage and strength. And so it goes.

Penny Schuler is a Marblehead resident and board member of the Sue de Vries Cancer Foundation.
Penny Schuler and her son, Todd.
Courtesy photos
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Boxford woman, survivor grateful to have ridden in 11th PMC

Claudia Worth of Boxford began riding in the PanMassachusetts Challenge before being diagnosed with breast cancer. And she kept riding, too. To date, Worth has participated in 11 PMC rides and has raised a total of $70,000for adult and pediatric patient care and cancer research at DanaFarber Cancer Institute. This past summers event drew 5,450 cyclists, who rode up to 190 miles over one or two days with the goal of raising $36 million. For more on the PMC, visit www.pmc.org. The weather matched my mood perfectly. I was going through the motions but my head was elsewhere. All I could think about was that I had cancer. We took off at 6 a.m. and I rode to the first water stop in misery. The hills felt tougher than ever and I started wondering if the cancer had made me weaker. I broke down at the water stop and told my friends I didnt think I could go on. They were totally supportive and understanding. Finally, still not wanting Courtesy photos to feel defeated by the canClaudia Worth of Boxford rode in her 11th PMC her ninth as a cer, I decided to try riding to breast cancer survivor in August. the next water stop. I made it there and thought I could I received my diagnosis of make it to the next one. I It started raining Friday breast cancer the day before devastating news. But the did this for the entire ride night in Sturbridge and it my second PMC ride. I was thought of just giving up and ended up finishing triand sitting at home felt like poured all night long. We terrified and really didnt lined up at the starting line umphantly in Provincetown know if I could handle doing I would be giving in to the and it was pouring buckets. on Sunday. I did ten 20-mile the ride after receiving such cancer, so I decided to go. training for my third PMC as a cancer survivor. I made a sign to wear on my PMC ride that said Im a one-year cancer survivor. Thanks for riding. I got an unbelievable response to the sign. It just seemed to motivate and inspire the other riders. So every year I cross out the prior years number and add one more year as a survivor and wear that same sign. I wore it on my 11th PMC my ninth as a survivor in August. I feel so grateful to have become part of the PMC family. I have made many special relationships and at the same time have been able to be proactive in fighting cancer, both my own and the thousands of others who have been touched by this horrible disease.
Claudia Worth has worn this sign in every PMC since beating breast cancer.
rides that weekend, never knowing if I would actually finish. After that PMC, I had surgery, chemotherapy and radiation. I was all done with treatment by the following spring and began
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WHAT YOU SHOULD KNOW ABOUT BREAST CANCER

Breast cancer accounts for 1 of every 3 cancer diagnoses in women in the United States. 200,000 women will be diagnosed with invasive breast cancer in the United States this year. Nearly 40,000 women will die from breast cancer this year. 21/2 million breast cancer survivors are alive today in the United States. 95% of women in the United States who are diagnosed with breast cancer are age 40 or older. Source: Susan G. Komen for the Cure (www.komen.org)
Women in the United States have a 12.15%, or 1 in 8, chance of being diagnosed with breast cancer. Source: American Cancer Society (www. cancer.org)
In the Vietnam War, more than 50,000 Americans died. Each year, almost as many women die of breast cancer. A woman is diagnosed with breast cancer every 3 minutes. A woman dies from breast cancer every 11 minutes. In the 1960s a womans risk of breast cancer was 1 in 14; today a womans risk of breast cancer is 1 in 8. 85% of women diagnosed with breast cancer have no prior family history. Mammography detects approximately 2 to 3 times as many early breast cancers as physical examination. Breast cancer is the leading cause of death among women aged 35 to 54. Source: Men Against Breast Cancer (www.menagainstbreastcancer.org)
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Sherri Temkin, shown here with her boyfriend Bob Oliver, is a breast cancer survivor.
KEN YUSZKUS/ Staff photo
I knew what I had to do and that was that

By Cheryl leCesse
STAFF WRITER
PEABODY Sherri Temkin considers herself one of the lucky ones. Temkin, 53, was diagnosed with ductal carcinoma in situ in August 2007. Ductal carcinoma in situ, or DCIS, is considered to be one of two stage 0, or noninvasive, breast cancers. Her mammogram that year actually came back negative. But Temkin has a history of breast cancer in her family her mother had battled breast cancer when Temkin was young, and another family member had recently been diagnosed with a form of the disease. Her doctor sent her in for an
ultrasound. The test picked up shadows in both of her breasts. MRIs and biopsies followed, and her right breast tested positive for cancer. When you hear the word cancer, shock sets in immediately. You dont know how to react, said Temkin, who lives in Peabody. I got over the initial shock and then went into gotta do this mode. I knew what I had to do and that was that. Doctors gave Temkin a range of options. In many cases, DCIS can be treated without removing the entire breast. But Temkin opted for a bilateral, or double, mastectomy and breast reconstruction. Because of the family
history, I didnt think I had much of a choice, she said.For Temkin, it helped to have seen her mothers experience first hand, although treatment options have evolved exponentially since then. Her mother was diagnosed with a stage two form of the disease, underwent a mastectomy and radiation, and wore a breast prosthesis. After 17 years, cancer reappeared in her esophagus, in the form of a tumor believed to have been at least partially caused by the radiation. I think, after knowing what my mother went through, I think at that point I decided that, if I was ever diagnosed, I would get a mastectomy, she said.
She made the right decision after the mastectomy, tests showed Temkin had the beginning stages of cancer in her left breast, too. But reconstruction didnt go as smoothly as she had hoped. Her surgeon used the TRAM flap method, in which a piece of the abdomen is cut and used the reconstruct the breast. But Temkin says her surgeon didnt explain the surgerys side effects, including abdominal weakness, or that she should refrain from lifting anything overhead. To make matters worse, Temkin said, the surgeon also told her the cosmetic effects couldnt be fixed. It looked like I had a tire around my stomach, she
said. So on top of the breast cancer and the surgery, its very depressing. At the urging of a friend, she scheduled a consultation with Dr. Beverly Shafer, a plastic surgeon in Beverly. Shes very, very compassionate, said Temkin of Shafer. She guaranteed me she could fix it. Temkin said Shafer fixed the stomach surgery, and everything fell into place from there. Her father, daughter and close friends were extremely supportive throughout her recovery. Having people to talk to made a big difference for Temkin. I think the best thing, after a diagnosis, the best thing anybody can do is talk
to people, she said. You can go online and theres women online discussing it all the time. Today, Temkin is cancer free but still goes for blood work every six months. And the emotional reminders of the experience remain. Its a tough process, she said, especially since she was single at the time of her diagnosis. I think its really hard for single women. You dont want to get to that point where you get intimate. Youre self-conscious about things. Its a tough choice. But those pieces have since fallen into place, too. I have a boyfriend who doesnt care about what happened, she said.
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Diagnosis a life-changing event for local business owner

By NaNcy McGoNeGal At 25 years old I was diagnosed with stage 3 breast cancer. After undergoing a bilateral Halsted Radical Mastectomy and many treatments, my journey of living with cancer began. Because of my breast cancer being third stage, my doctors never could feel confident to tell me I would be OK. Instead, they would say I was in permanent remission. The situation was so bad just the word permanent gave me some hope. So I continued my journey and had to make many decisions, wearingan external prosthesis for five years then deciding to have reconstruction. Because of the severity
Looking back over the 30 years, there were good and bad times but I am glad I chose just to move forward and enjoy the good in whatever each day brings.
of my surgery, the plastic surgeon did the best he could with implants,but I was still left with having to wear small external silicone prostheses. After consulting with my doctors and hearing the negative and positive, I decided to go ahead and have children. I have two daughters: Kate, a scientist who works at Biogen Idec, and Anna, who works as an registered nurse at Spaulding Rehab. Now, 30 years later, I am a survivor after stage 3 breast cancer. This is just part of my life that I have shared. Every breast cancer patient has their own unique journey. We all have to make difficult decisions about our own health and family after being diagnosed. Looking back over the 30 years, there were good and bad times but I am glad I chose just to move forward and enjoy the good in whatever each day brings. I have dedicated many years of my life facilitating cancer support groups and providing services
From left, Nancy McGonegal and her daughters, Anna Pullo and We Care Breast Forms and Kate McGonegal. Accessories is an American
from my company, We Care Breast Forms & Accessories, located at 100 Cummings Center Suite 344E, Beverly. We Cares private fitting facility works Board Certified Facility and American Board Certified Fitters.
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by appointment Monday through Saturday. Home fittings are available in the privacy of your home. We Care carries breast prosthesis, partial breast forms and mastectomy bras and other supplies for your post surgery needs. Medicare, private insurances and private organizations will help to cover all or part of the cost for your post surgery needs. A prescription from the doctor is required. Please call the office at978-927-0749to set up an appointment and ask any questions you may have.

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Pink is the new school color

By Lynne Hendricks correspondent Crimson and gold are Newburyport High Schools traditional school colors. But this month, the schools athletic teams areincorporating pink accents into their uniforms. Recently, the varsity field hockey team showed up to battle North Andover dressed entirely in pink. Members of the varsityfootball, soccer and track teams have added a splash of pink as well with the addition of pink shoelaces for every player. Its all part of an unprecedented school-wide effort that Athletic Director John Daileanes said is aimed at shining a spotlighton October as Breast Cancer Awareness Month. The effort is inspired by former school district staffer and three-time breast cancer survivor Marilyn Flaherty, who has beenspreading awareness and raising money for research into the disease since she was first diagnosed nearly three decades ago,at age 34. This year, Flaherty, a longtime assistant to the Newburyport superintendent of schools, asked Newburyport High for some help. Daileanes had his own personal reasons to oblige. My dad passed away from lung cancer in 2008, so thats been something thats been on my mind, he said. I think about himevery day and he was a huge influence in my life. We all know someone who has had cancer, whether it be breast cancer or anothercancer. Flaherty said she has seen first-hand how awareness of the disease and money raised for research have had an effect on increasinglife expectancy for people like her. On Oct. 14 she led Team Flaherty, comprised of family members and friends, as participants in the American Cancer Societysannual Making Strides Against Breast Cancer Walk in Boston. It was her 20th time on the trek. From when I had my first diagnosis and my last one two years ago, it is incredible what the money has done in terms of researchand treatment, said Flaherty, who was named a Making Strides Against Breast Cancer SuperFan last year in recognition of herfundraising efforts and commitment to the annual walk. Flaherty recalled being so sick from weekly chemotherapy treatments during her first bout with breast cancer that she hadto be hospitalized overnight to receive experimental medications to control her debilitating nausea. When she underwent a bilateral mastectomy two years ago, her chemotherapy was delivered every three weeks over a period ofthree months instead of a year, and effective antinausea medication could be dispensed by her local pharmacy. Way back when, they would use a needle biopsy and the needle would stay with you while you went to another floor to havethem do a film (for detection), Flaherty said. This last time, that was done immediately. I knew the result right away insteadof having to wait for a week. This year, Flaherty was thrilled to bring even more locals into the fight on behalf of Team Flaherty. At the Institution for Savings in downtown Newburyport, the staff shelved the banks staid white deposit slips and replacedthem with a months supply of pink ones. Pink ribbons decorate the lobby, and employees some donning pink hair extensions are chipping in to beat last years donation totals for Team Flaherty. The Greater Newburyport Chamber of Commerce encouraged downtown shops to decorate their windows and offer apink product to customers, with a portion of proceeds from sales donated to Team Flaherty. At AbrahamsBagels on Liberty Street, owner Linda Garcia contributed a portion of last Fridays sales to the cause. So the high school athletic department,along with the sophomore, junior and senior classes, ordered 790 bagels fromAbrahams to be delivered to everyclassroom. All across the school, students affixed pink ribbons to windows and bulletinboards and pink stickers on every classroom door, and in the lunchroom they sold pink shoelaces and passed a collection can seeking spare change for Team Flaherty. Kids have been really generous, donating money at the lunches, Daileanes said. One kid put a $20 bill in the other dayat lunch.
Daileanes said he hopes this years activities lay the foundation for a greater fundraising effort next year. Hed like tosee schools across the Cape Ann League expand on what Newburyport started this year by designating some of its sporting eventsin October as official Breast Cancer Awareness games.
For Flaherty, the effort being made at Newburyport High and across the city is heartwarming. The breast cancer survivor saidseeing young people getting involved means only one thing. Theres going to be a cure, she said, and it wont affect my daughter and granddaughter.
Sam Wahlgren, 18, left, and Liz Fiascone, 17, sell pink shoelaces at lunch at Newburyport High School to raise breast cancer awareness.
BRYAN EATON/Staff Photo
Supporting Breast Cancer Awareness Month
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ASK THE EXPERT
CHANDINI PORTTEUS
Susan G. Komen for the Cures vice president of research and evaluation talks about the organizations past, current studies and the continual search for a cure
By Lisa iannucci
CTW FEATURES
We need to find a cure for cancer. Its a common sentiment among those who have it, had it, lost someone to it or know someone whos suffered from it. The Susan G. Komen for the Cure has made it their sole mission to help and, in May, released their 2012 research program grants, which take aim at early and late-stage breast disease. Since 1982, the Komen Foundation has funded $685 million in research grants, 154 grants in 22 states and seven countries. But what does that mean for patients? We had a chance to talk to Chandini Portteus, the vice president of research, evaluation and scientific programs at Susan G. Komen for the Cure. The important thing to remember about Komens research portfolio is that weve been funding since 1982, but our portfolio has shifted over time, Portteus says. It has a sense of urgency now. The requirement for the research we fund is to show impact within a decade for women and men, so we focus on research that reduces the incidence and mortality of breast cancer. We take discoveries from the lab and translate them into the clinic where women participate in the furthering of that knowledge.
We are beginning to understand every womans cancer, tailoring it to that person and targeting therapies that come with better outcomes.
Chandini Portteus
more study is that estrogen preceptor positive breast cancer has treatment options, but within five years after diagnosis, they are coming back with a recurrence of their cancer. What is going on there? This year, we focused on the causes.
and 90s we didnt know much about the biology of breast cancer. We funded some important discoveries back then, including Dr. Mary King discovering BRCA1 genes that have a great disposition for breast cancer. (Editorial note: a single gene on chromosome 17, later known as BRCA1, was found to be responsible for many breast and ovarian cancers). Now, there are exciting things with research on triple-negative breast cancer and we know that this is a more aggressive type of breast cancer. An important thing we learned from studies we did then and the work we do now is that breast cancer isnt one disease, there are sub-types of cancer and women come to the table with complicating factors. All of those things need to be taken into consideration when treating a woman or man. We are beginning to understand every womans cancer, tailoring it to that person and targeting therapies that come with better outcomes.
to us, especially during our Promise Grants, and tell us they thought they were going to find something, but their path has changed and they want to redirect their research. Or sometimes a drug treatment wasnt the right one or the drug wasnt available. We know that science is an art and we have flexibility. We also have an eight-member scientific advisory board that looks at our Promise Grant projects and gives feedback on its direction.
A: At first, our portfolio was biology-based because in the 80s
Q: When can we expect to see results from the research youre funding now? A: Of course, science fails and What about the research in previous every experiment we do isnt going years are you seeing results now? to turn out to be a cure. The impor-
Q: What happens if you fund a study that doesnt have a positive result or falls completely flat during the research time?
A: We were already set to fund $58 million, and we met our goal. Research is a priority for Komen and always will be. We are mindful that the economy has affected A: A few years ago, we funded a us all, but weve been pleased to mammography reminder system on telephones, and the data showed see how people are still passionate for what we do. Komen will still that even women who are insured, be there to help you, provide educollege-educated and Caucasian cational resources. Well be there arent getting mammograms. Cellphones are a norm for us, and while at your diagnosis, and to provide support. We were the first advocacy awareness, education and access organization. We know women are are important, we needed to bring dying every day, and until no one cellphones into the study and see dies from breast cancer, our work how it makes a difference. isnt done.
Q: In one study, Hee Lee, Ph.D., at the University of Minnesota is working to develop a prototype cellphone study to deliver information and messaging to empower Korean American women. Why not just create an app, and how has technology changed your studies?
A: We dont fund drug development. Instead, we fund early stage clinical trials for stage 1 or 2. Were at that translational bridge and we do things that are really moving out of the lab and to the patients. Funding drug development can be cost-prohibitive for us, and we feel our mission is to urge scientists to get from the lab to the bedside where the women can see progress.
Q: What about funding drug development?
Q: Its been a rough year. How are you looking forward?
A: This is one of the things we For more information on the tant thing is to understand the les- talk to our advisers about, and this Susan G. Komen for the Cure, sons learned. Researchers can come year, one area we noted that needed visithttp://ww5.komen.org/.
Q: What research is lacking?
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The team behind you can make all the difference.
IN THE FIGHT AGAINST
Need a New Primary Care
Doctor?
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The Mass General/North Shore Breast Health Center is a collaboration among experts from North Shore Medical Center and Massachusetts General Hospital who provide coordinated care to support your breast h ealth, from annual mammograms to an array of advanced treatment options.
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Kristy Cahill, M.D., M.P.H. in Danvers
Our primary care physicians are ready to care for you and your family. With offices located throughout the North Shore, our physicians can offer you and your family an appointment with little to no wait time. And all of our primary care offices use electronic medical records that connect the experts of North Shore Medical Center, Massachusetts General Hospital and the other specialists of Partners HealthCare. To learn more about our primary care physicians, please call our Physician Finder service at 1-877-NSMC-MDs (1-877-676-2637) or visit us online at nsmc.partners.org.
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All Mass General and North Shore Medical Center mammography facilities are licensed and accredited by the ACR, FDA and the Commonwealth of Massachusetts, Department of Radiation Control Program.
2013
Since its inception in 1991 the North Shore Cancer WALK has raised more than $17 million for cancer care in our community! Join us Sunday, June 23, 2013 for the 23rd annual WALK where thousands will come together for the largest single-day fundraising event on the North Shore. www.northshorecancerwalk.org
Mass General/North Shore Breast Health Center radiologist Claudia Reynders, M.D. (L) and surgeon Jeanne Yu, M.D., represent a team of experts to care for you.
Mammograms are available at North Shore Medical Center sites in Salem, Lynn, Danvers and Gloucester.
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A number is applied to each diagnosis, but what does it mean? Here, a simple guide to understanding the stages of breast cancer, what they mean and the types of treatments to expect.
By Lindsey Romain
CTW FEATURES
On a scale from zero to four
A breast cancer diagnosis is overwhelming enough on its own. But throw in the new terminology that family and patients must comprehend to process and understand the disease, and that overwhelming factor is ramped up tenfold. One of the hardest to grasp concepts can be the stages of breast cancer. Doctors use stages to classify the progress of the cancer, as well as the origins and prognosis. From zero to four, each stage can be broken down into even more categories and types, depending on factors like size, the involvement of lymph nodes and whether the cancer has spread. Here, Dr. Lise Alschuler, a naturopathic physician, author of Five to Thrive: Your Cutting-Edge Cancer Prevention Plan (Active Interest Media Inc. 2011) and breast cancer survivor herself, walks us through each stage. Many people are unaware of the very first stage of breast cancer, stage 0. Considered a precancerous condition, not all of it goes on to become cancer, Alschuler says. While patients may still be offered treatment such as radiation or a lumpectomy, Alschuler calls this more of a wait and watch period, before an official diagnosis can be confirmed.
Stage 0
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still involve aggressive treatment, she says. When a sample is taken through a biopsy, the The main difference between stage 0 and pathologist will give a grade to the tumor. stage 1 is that (the cancer) is now invasive, The higher the grade, the more aggressive, Alschuler says. Alschuler says. A stage 1 diagnosis means that a group of cells Not everyone with the same stage is treated have been mutated enough that they are able to the same. At stage 2, the treatments differ; a grow into a tumor. Stage 1 tumors are considered patient may undergo chemotherapy, or a masfairly small less than 2 centimeters in the tectomy, or maybe just radiation. The intent greatest diameter. At this point, they have not of the treatment in these stages is to cure spread to the lymph nodes, or if they have, there because it hasnt spread yet, Alschuler says. are only microscopic cells that have moved.
Stage 1
treatment. There are not as many effective treatments available for this type. The cancer is still treatable at stage 3, but it generally has a greater degree of risk for reoccurrence. Its more aggressive than the other stages, with systemic treatment. Alschuler says its very rare that doctors wouldnt recommend chemo at this point.
There are two types of stage 2 breast cancer: type A and type B. In type A, the tumor is larger than type B, but there are no cancer cells in the nodes, or cells are in the nodes but on the same side as the tumor and in small numbers. In type B, the tumor is between 2 to 5 centimeters, but there is more lymph node involvement. There is also a rare type of B with a large tumor but no node involvement. Stage 2 is still considered early stage breast cancer, according to Alschuler, meaning its a potentially curable disease. But it does
Stage 2
Stage 4, the final stage of diagnosis, is the most serious and the most progressed. Any Stage 3 size of tumor or lymph node involvement can A stage 3 diagnosis indicates a 5-centimeter appear at this stage, but the main indicator of or larger tumor. The tumor is on the same side stage four is that the cancer has spread, typias the lymph nodes where it has spread, usucally to the bone or liver. Alschuler says to ally in the armpit area. There are more nodes expect very aggressive treatment at this point. involved, typically more than three, usually The treatment is typically sequential at this four to nine. Sometimes in stage 3, the tumor stage, she explains. Youll go through an has grown deeper into the chest wall or up initial round of treatment, get a break, then go into the skin, affecting different types of tisback into it. Its about managing the growth sue. At this stage, a different type of breast so people can live with the disease as long as cancer may be on display: inflammatory. possible. Inflammatory breast cancer is a different While this may be the final stage of diagnosis, type of cancer cell, Alschuler says. It tends Alschuler points out that, rare as it may be, a full to be more aggressive, and more resistant to recovery is still possible.
Stage 4
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Support from friends, family and community are an integral tool in the fight against breast cancer. Many are taking their illness to the Internet, creating online support groups on Facebook, Twitter, blogs and forums.
By Renee Lee
CTW FEATURES
Laura! Jane! Laura! This went on for a few minutes because Laura forgot to ask Jane what room she was in on the sixth floor. The two went on screaming until they found each other in the hall. Then, it was like something out of a movie, Laura says. The two hugged, and cried and laughed at the same time. They reached over and touched the tufts of hair on each others otherwisebald heads. Just as everything else theyd shared as breast cancer sisters during the past 11 months, at that moment both women shared similar amounts of regrown tufts of hair on their heads. Breast cancer survivor and lawyer-turned-rockmusician Laura Roppe turned to an online forum the day she got diagnosed with triple-negative breast cancer. The next day, as if a private prayer had been answered, Jane Barker from Sheffield, U.K., wrote that she had been diagnosed with exactly the same type of breast cancer on the same day. The two also went on to start their chemotherapy treatments on the same day. While Roppe also had what she called flesh and blood friends and family that supported her, she found one of her biggest sources of support online. Roppe, of San Diego, is just one of many people now turning online to social media sites like Facebook and Twitter to seek support when a diagnosis of breast cancer is found. Many women are starting online
groups to unite all of their friends and family, which makes sharing information easy, fast and effective. It also makes connecting with strangers going through the same thing easier, something that can be a source of both strength and information for women that often feel alone and isolated. Just being diagnosed the same day as someone doesnt ensure a lifelong bond, Roppe says of Barker. We were meant to be sisters, though. We bonded over our love for the BBC version of Pride and Prejudice and I called her My dearest Jane. Roppe chronicled the emails she and Jane sent back and forth in her book Rocking the Pink: Finding Myself on the Other Side of Cancer (Seal Press, 2012). Marci A. Schmitt from Chandler, Ind., turned online to find information and support and wrote March Forth (Outskirts Press, 2011) as a way to provide support for others battling breast cancer. Schmitt was diagnosed in January 2009. Her mother had passed away from breast cancer in 2004, and she went on to lose her father-in-law and brother to cancer in the years surrounding her own battle. After talking to another survivor who went on to give talks around the country Schmitt hung up the phone with one goal in mind: write a book and provide support for others in her shoes. She wrote and wrote until she couldnt think of anything else to write, Schmitt says, and it was a full year until she told anyone shed written the book, not even
died. Thats the last thing anyone with cancer wants to hear, she says. Roppe recalled the very worst days when she was in the thick of chemotherapy and love from her kids carried her through. I would feel little tiny lips kissing my bald head, Roppe says of her daughters Sophie and Chloe, who were in third and first grade at the time of her treatment. Then theyd squish into bed with me and I could feel their warmth.
On the other side of cancer

Jane Barker, left, and Laura Roppe were diagnosed with the same type of breast cancer on the done, Schmitt had two mastectomies and has now been same day. They connected through an online support group.
Steve, her husband of nearly for it. Shes hoping to move 20 years. to the point where she can share a weekly tidbit with others to foster a commuA real sisterhood nity of support. Schmitt acknowledges Both Schmitt and Roppe two websites in the front of are huge proponents of supher book: breastcancer.org and breastcancer.about.com. port groups, whether they She got information on what be online or in person. Its a real sisterhood, would be happening to her Roppe says. You know body, asked questions, and received answers full of sup- youre not alone, and when youre talking to people who port and love. On the other side of that, have been there, youre free to be honest and you can however, some people share things you cant share expressed their negativity through the forums Schmitt with others. Roppe is currently still read. She certainly wasnt part of a Facebook group about that. Something I kept telling with 150 women who share the common thread of all myself, was even though I didnt want to go through all having had triple-negative breast cancer. of this there were so many others struggling and many worse off than me, Schmitt The best support says. I learned from my Sometimes, friends just mom not to have a pity need to let you know theyre party. I chose to not let can- available, Roppe says. People cer run my life. would drop by, bring a magaSchmitt has a blog for her zine, drop off some chicken book, 4MarchForth.com, and noodle soup or send an created a Facebook page email to check up, she says. Having people treat her like a normal person was very important. She recalls a moment when a friend asked if she had seen the previous nights American Idol. When its not all about cancer and mortality, you can begin to feel human again, Roppe says. During her journey through cancer, Schmitt says she and her husband learned to accept help from other people. About three times a week, whether it was a friend or family member, someone would bring over meals for the family, which includes sons Corey, 16, and Clay, 13, and a stepdaughter, Lindsay, 29. Schmitts biggest pieces of advice for friends and family members who arent sure how to act in front of a cancer-stricken loved one? Dont come with pity in your eyes, Schmitt says. And dont talk about other people youve known who have After it was all said and
cancer-free for three years. Shes going on quarterly visits and has been scanning clear, and is taking things one day at a time. Roppe currently has no evidence of disease, and its been that way for the past three years. Just weeks before the diagnosis Roppe signed a record deal with a Londonbased record level, achieving a longtime dream of hers. The diagnosis left Roppe with what she calls in her book, a victory in the sense that she quit her law job and dedicated herself full time to music. I followed my heart, my voice, Roppe says. Dont wait until you get cancer until you do what you really want to do. The question everyone has after reading her book, Roppe says, is What about Jane? How is Jane? Barker, forever Roppes breast cancer sister, also is in recovery and is doing great, Roppe says.
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Breast cancer fight inspired a special hat

By EllEn Hardy Hats, hats, all around. This years Peabody Essex Museums exhibition HATS: An Anthology of Stephen Jones, has prompted an explosion in the attention being given to hats. This year an exceptional entry crossed the threshold at Salem Arts Associations PEM-inspired show Off the Top of Your Head. For the sixth year, the SAA show drew entries from all over the region. The SAA actually drew in milliners and fashionistas in addition to conventional media. The exhibit hung in the carriage barn of the Andrew-Safford House in Salem (its use donated by PEM) for the month of September. $300 yet they cannot be reimbursed for hats? Most women prefer hats, especially in the summer months because they breathe, and in the winter because they can be warmer. When Grillo was first without hair she began to crave a hat that would keep the back of her neck warm. None could be found in her Artist Sue Grillo poses with research that could feel one of the hats she created. like the hair on the back of your neck. As an artist who Sue Grillo, a Salem artattended the School of Visual ist, entered one the most Arts in NYC and Mass Colimpressive pieces in the lege of Art and Design in SAA show. Grillo is a twotime breast cancer survivor, Boston, Grillo had worked diagnosed originally in 2002 15 years designing costumes and then again in 2010. Did for experimental theatre in Boston so it was natural you know that women can get reimbursements to buy that she began to sketch wigs because they lose their what she was looking for and could not find. The sketches hair sometimes up to developed during her first round but no prototype was created as she began her second round of chemotherapy. Although in her sketchbook it had developed into a full-blown, fleshed out, and complete concept ready to be executed. Along comes the PEM inspired show and voila she put her considerable talents into action and made the prototype of what she calls Warrior Coverage. As we know the media likes to say we are battling cancer as if we had weapons to combat it! Grillo wanted the comfort and coziness of a hat but to cover her head like a wig. A single mom, she remembers her young son stroking her hair and being left with a clump of hair in his hand. She went on to wear wigs because thats all you could get reimbursed for and to see her son stroke her head and be surprised that there was no hair left in his hand. But the idea of the Warrior Coverage hat in her sketches had yet to be realized until 2011, after she was diagnosed with stage 3 again in 2010 and the news emerged that SAA would hang a show about hats. She knew this time she had to do it! Despite myriad complications, including a flood in the closet where she stores her sewing machine, she managed to finish that plus another hat and both pieces were juried in the exhibition. They had to be completely hand-sewn. Working under the trade name Lily Royale Productions, she will make custom hats for those who would like them in the material of their choice. She can be contacted through Salem Arts Association, where you will find some of her work in the Salem Arts Gallery on Artists Row. Many folks stopped to enjoy her entry without the knowledge of the story behind it. In fact one woman wanted her email because she has a sister fighting the disease and it resonated with her unknowingly. Wigs can be itchy and hats are so much more comfortable!

Ellen Hardy, also a breast cancer survivor, is now interim executive director of the Salem Arts Association.
North Shore Bank is proud to promote Breast Cancer Awareness.
For the love of a Mother, For the love of a Sister, For the love of a Grandmother, For the love of an Aunt, For the love of a Friend, For love, schedule your screening today!
877-712-7000 l www.northshore-bank.com Beverly l Danvers l Middleton l Peabody l Salem l West Peabody l Vinnin Square
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For women in need, local help is available

RN, a nurse care manager inthe VNA Care Networks A breast cancer diagnosis Danvers officeand manager is stressful enough. But for of the support program. A some women, it also means lot of them have to travel struggling through a confus- into Boston two to three days a week for several ing healthcare system and weeks. making the difficult choice Women can also use the between paying rent and money for copays, medicapaying hospital bills. tions, deductibles and wigs, Thats where the VNA or even to pay for groceries, Care Network and Hospice comes in. For more than 10 utilities and rent. Especially with insuryears, the organizations ance costs going up, a lot of Breast Cancer Treatment women have trouble meetSupport Program has proing the copays and deductvided financial assistance and other support to breast ibles, Fitzpatrick said. Women who receive the cancer patients in need. stipends are asked to send One of 24 programs a note to the VNA Care funded by the MassachuNetwork, explaining how setts affiliate of Susan G. Komen for the Cures grant they used the money and whether it was helpful. program, and the only one The programs nurse that helps women statewide, care managers also help the Breast Cancer Treatwomen make doctors ment Support Program appointments, fill out appliprovides $250 stipends cations for other financial for patients to use where assistance programs, and theyre needed most. A lot of the women have understand other available resources that they otherissues with transportation costs, said Joan Fitzpatrick, wise may not have known
STAFF WRITER
Cheryl leCesse
about. They dont always know where to look, Fitzpatrick said. For women who dont speak English well or at all, patient navigators can help. Fatima Gomes and Lucy Clinton are fluent in English, Portuguese and Spanish, and the VNA Care Network has other translators on hand available to help women who speak a different language. Before receiving assistance, each applicant is assessed for financial and social need, any barriers to care, and whether she has insurance, Fitzpatrick said. Most are insured, she said. Every once in a while someone comes in who needs insurance. When that happens, the Massachusetts Breast and Cervical Cancer Treatment Program will provide MassHealth coverage for treatment of women diagnosed with either cancer. While some women
From left, Fatima Gomes, Joan Fitzpatrick and Lucy Clinton of the VNA Care Network and Hospice in Danvers. All three work in the organizations Breast Cancer Treatment Support Program.
seek help on their own, many come to the program through a referral. Fitzpatrick said social workers, the Dana Farber Cancer Center, and Lowell Community College have all pointed women to the program. So far this year,the VNA Care Networks program has helped 86 women statewide, buttheres always a greater need. Fitzpatrick said the program receives its funding in six-month increments, and theres already a waiting list for the next installment. Most women understand the VNA Care Networks limitations. And every year the program seeks more opportunities, such as its partnership with the North Shore Community Health Network. The Komen grant provides the bulk of the programs funding, and the organization is thankful for the support. VNA Care Network
employees do their part to give back, too -- they have a team in the 20th annual Komen Massachusetts Race for the Cure, taking place Saturday, Oct. 20, in South Boston. Statistics show that breast cancer is the leading cause of cancer death worldwide among women, and the VNA Care Networks Breast Cancer Treatment Support program falls in line with Komens mission -- to eradicate breast cancer as a life-threatening diagnosis by advancing research, education, screening and treatment. One of their goals is to really help people who are underserved or uninsured, Fitzpatrick said. For more information about the VNA Care Network and Hospice, visit www.vnacarenetwork.org or call 800-521-5539. For more information aboutthe Massachusetts Affiliate of Susan G. Komen for the Cure, visit www.komenmass.org.
BREAST CANCER AWARENESS EVENTS AND FUNDRAISERS

Barbells for Boobs, a nationwide fundraising event to benefit Mammograms in Action and breast cancer awareness, will take place at Be Fit Health and Wellness, 128 Park St., Building B, Beverly, at 8 a.m. Saturday, Oct. 20. The event is open to all North Shore residents of any fitness level, but will be capped at 50 participants. A $25 donation is requested. For more information, visit www.beverlypersonaltrainer. com. The second annual Lynda J. Talbot Memorial 5K Run/Walk will take place Sunday, Oct. 21, at the Danvers YMCA, 34 Pickering St., at 9 a.m. The run/walk honors Lynda Talbot, a Danvers resident for more than 60 years who died in August 2010 after a 23-year battle with breast cancer. Proceeds of the $30 registration fee ($20 for children under 18) go toward the Lynda J. Talbot Memorial Scholarship and to breast cancer research. Register in advance or on the day of the event. Same-day registration starts at 7 a.m. For more information, visit www.racewire.com/talbot. Zumba instructor Danielle Roberts will host a Party in Pink Zumbathon at Roller World, Route 1, Saugus, Sunday, Oct. 28. Doors open at 6:30 p.m.; Zumbathon takes place from 7 to 8:30 p.m. Event features a 90-minute Zumba class and raffles. Participants encouraged to wear pink. Party in Pink themed Zumba workout attire will also be for sale. Cost is $15 in advance, $20 at the door, with proceeds going to Susan G. Komen for the Cure. For more information, visit www.danielledroberts. com. Lorraine Roy Design Collections and Friends present Illusions, a magical fashion event to help make breast cancer disappear, Thursday, Nov. 1, at 6 p.m. at the Danversport Yacht Club. The event benefits the breast oncology program at MGH North Shore Cancer Center. Tickets are $75. For more information, call information, visit currans978-774-0825 or visit www. flowers.com or call 978-7741446. Curran Bros. is at 15 lorraineroy.com. Park St., Danvers. Beverly Cleaners is going pink. Throughout the month of Hair Crafters of Ipswich hosts October, the shop uses pink Streak for the Cure throughhangers and sells pink brace- out the month of October. lets, with proceeds going For $20, stylists will streak toward breast cancer aware- your hair pink, with 100 perness. Beverly Cleaners is at cent of the proceeds going directly to breast cancer 61 Elliott St., Beverly. research. Appointments are Curran Bros. Florist and Green- recommended but not nechouse will donate $5 to the essary. Hair Crafters is at Breast Cancer Research 26 Central St., Ipswich, and Foundation for every Cur- is open six days a week. For rans Charity Cyclamen sold. more information, call 978The plants wooden con- 356-2776 or visit www.hairtainer features a pink ribbon crafters.net. on its sides and doubles as a photo cube that can hold Donate $1 to Making Strides up to four photos. For more Against Breast Cancer at Plum Consignment throughout the month of October and receive 10 percent off any one item during the month of November. Plum Consignment is at 156 Cabot St., Beverly. For more information, call 978853-6623 or visit www.plumconsignment.com. Rows of pink pumpkins are available to purchase at Marini Farm, marking National Breast Cancer Awareness Month. A percentage of every pink pumpkin sold will go to the Pink Pumpkin Patch Foundation for cancer cure. Marini Farm is at 259 Linebrook Road, Ipswich. For more information, call 978-356-0430 or visit www. marinifarm.com.
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Local athletes show uniform support

Salem senior Danielle Pynn sets the ball for her teammate.
DAVID LE/Staff Photos
Salem High School senior Kayla Pellitier soars in the air and tips the ball over the net against Beverly.
Hamilton-Wenhams Jill Kefalas rips a shot on net against Ipswich.
Footprint power
Be Aware and beat breast cancer
Footprint Power supports our friends, family, and neighbors in our community in the fight against breast cancer. Schedule your screening today and take a step toward beating breast cancer.
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The Salem State Athletics Department has sponsored Think Pink events since 2008. Studentathletes compete in pink uniforms, raise funds, and help raise awareness on campus and in the community. Seaport Credit Union of Salem is this years sponsor for all events. Monies raised are donated to the North Shore Medical Center in honor of SSU alumni who have received treatment or are fighting the disease. The womens field hockey team kicked off this years events on Oct. 6.
Courtesy photo
Salem High Schools Jason Alas, left, wins a header from Marbleheads Paul Elder, right. Both Salem and Marblehead sported pink attire in recognition of Breast Cancer Awareness Month.
DAVID LE/Staff photo
proud to support
the Fight Against Breast Cancer
We support the fight against Breast Cancer. Never give up.
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Remembered With Love

Every 2 minutes, there is a new breast cancer diagnosis. Every 14 minutes, a life is lost to the disease. More than 40,000 people will die this year; about 400 will be men. October is National Breast Cancer Awareness month. Many have fought the battle against breast cancer. Honor those who have passed in this special feature in The Salem News on Tuesday, October 30.
JANE SMITH
Passed Away: March 11, 2005 Loved and missed by all your friends.
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CONSTANT
CHEMO
CRAVINGS
Radiation and chemotherapy cause many nausea and headaches, and can make eating nearly unbearable. Navigating food choices isnt easy, especially when healthy foods are the path to healing and chips are the only thing that sound good whats a woman to do?
BREAST CANCER
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s a health professional, Patricia DImperio urges her patients to make the most nutritious food choices. The chiropractic neurologist is a nutrition role model, who searches out wholesome food for her family. Then, theres Doritos. When DImperio has to have them, shes unstoppable.Im a craver of salt, says the owner of Healthy Living in Bayville, N.Y.Its not one; Ill consume an entire bag and have to get it out of my system. I cant stop even though I know better. DImperio, who finished her treatments for breast cancer, is struggling with an occasional craving for a salty snack as she tries to eat the best diet possible to stay cancer-free. Shes not alone. Some days Im good, some days Im not so good, says Cynthia Newsome, who is finished with radiation treatments for breast cancer. The Dairy Queen strawberry shake beckoned, and Newsome responded. It was good, says Newsome, weekend anchor for NBC Action News in Kansas City, Mo. You may have an itch for a particular ingredient, like DImperio and salt, which hits every two months or so. Perhaps you associate a certain food with a positive experience you want to recall. Whatever the reason, if you learn to manage your food urges, you can splurge without the guilt, while developing more healthful habits. While youre educating yourself, youll also look for ways to let your loved ones know how youd like to be supported. Getting into a breast cancer recovery nutrition program can help. Find a registered dietitian who will show you what you can eat. If you need to lose weight to reduce your risk of a breast cancer recurrence (or your risk of other diseases), you dont want a diet that feels like punishment. Emphasize enjoyable options, not what you should forgo, says Cheryl Rock, Ph.D., registered dietitian and professor, University of California, San Diego, School of Medicine. You may find you have a lot of
By Bev Bennett
CTW FEATURES
control with the occasional tortilla chips or milkshake, your loved ones may not understand. When her 9-year-old daughter sees her reaching for the Doritos, her eyes will get really wide and she says, MOM, DImperio says.My husband and daughter say, Moms on the Doritos again. I explain that this is one little thing I do once in a while. portion control as a way to enjoy favorchoices that are equally pleasurable, How do you tell your friends and ite high-calorie foods. Rock says. loved ones you appreciate their conIn Newsomes situation, a small shake cern but dont need policing?You can She is studying the effects of weight was satisfying. loss and increased exercise on qualprovide the answer. You can tell others I would have gotten a large in times how you want to be supported, accordity of life and on coexisting medical conditions in overweight breast cancer past, she says. ing to Unell.How you phrase the quesWhen youre more aware of nutrition, tion makes a difference. survivors. The women she counsels are helped you can stop beating yourself up over Dont say to the family, I want to eat the candy bar you couldnt resist. to change their behavior. better, help me. Theyll nag you with However, its easy to understand We dont hand out a list of foods you everything you eat, Rock says. shouldnt eat, but (advice on) how to fill the those feelings of guilt. Instead, suggest something specific: Your trust in your body is gone, plate. Its not a punishment, Rock says. Lets go to the farmers market and For example, she suggests switching says Barbara C. Unell, founder of Back pick up some salad ingredients for dinin the Swing USA, Overland Park, Kan. ner.Let friends know how to help you. from regular bacon to savory, fullYou think, If I have that extra cookie, flavored Canadian bacon. Newsome says she is looking for it will put me over the edge, says Pizza? information more than people motivatUnell, whose nonprofit organization You can have it. Its a wonderful ing me. promotes joyful and healthy living for vehicle for having vegetables in your The Kansas City television anchor breast cancer survivors. diet, Rock says. Her tip is to trade says, I like to read things that say Again, educating yourself about pepperoni for sun-dried tomatoes as a heres what to do; heres what to try, wholesome eating will help. pizza topping. like, for instance, a good-tasting sugarBut, even though you may feel in The health expert also teaches free ice cream.
When youre more aware of nutrition, you can stop beating yourself up over the candy bar you couldnt resist. However, its easy to understand those feelings of guilt. Your trust in your body is gone, says Barbara C. Unell, founder of Back in the Swing USA, Overland Park, Kan.
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Former resident talks about her diagnosis, treatment, and the lingering effects
Now 35, Kelly Miner is only a few months away from being able to say she is cancer-free. Miner was 30 when she was diagnosed with stage three infiltrating ductile carcinoma in her left breast. Originally from Olathe, Kan., Miner spent most of her childhood in Buffalo, N.Y., before her family moved to Framingham when she was 11, and later to Danvers when she was 17. She has since lived all over the North Shore until three years ago, when she moved to Pennsylvania for a better job opportunity. She underwent surgery and chemotherapy at Beverly Hospital. Of all the places Ive lived, I consider the North Shore my home, she said. A youth pastor and foster parent, Miner also has a blog, The Aftermath, about how her life was affected after cancer. For more, visit www.kellysaftermath.blogspot.com.
You are never the same
Tell me about your diagnosis. Did you know something wasnt quite right?
I felt something. I wouldnt even call it a lump. It felt more like one of those wiggle worm toys that slip out of your hands. In school they had you feel for lumps Kelly Miner, having her head shaved while undergoing chemotherapy in 2007.
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a week. I had my chemo and surgery at Beverly Hospital. I had my radiation in Peabody. Beverly Hospital did not have a radiation clinic at the time. My medical team was the best I could have asked for. People asked me if Id rather be in Boston and I said, no way. The nurses and staff knew me by name, fought for me, and What happened after your diagnosis? Did you undergo all truly cared in every way. of your treatment at Beverly I couldnt have asked for Hospital? better. Life was a whirlwind after my diagnosis. I had multiple Tell me about your options for tests and met many doctors. treating your cancer. What treatment option did you More people touched my decide to go with, and how did breasts than I could have you come to that decision? ever imagined. Appointments were scheduled Because I had stage 3 QUICKLY. I was never given cancer, surgery, chemo, and an official prognosis, but I radiation were all needed to knew it was bad because of save my life. I had the option how fast my appointments of going with a lumpectomy were scheduled. I was in a instead of a mastectomy doctors office once or twice depending on how much my the size of a pea. By the time I found mine, it was 5 centimeters wide. I was scared, but hoped for the best. I first knew something was wrong when the ultrasound technician looked at me and told me she was going to call in the doctor. The look in her eyes was one of terror.
People asked me if I d rather be in Boston and I said, no way. The nurses and staff knew me by name, fought for me, and truly cared in every way.
Kelly Miner
after my treatment ended. To the world, you are cured, the cancer is gone, but the reality is that the effects linger and you are never the same.
tumor shrank after some chemo, but everything I read pointed me toward a mastectomy. There was a brief discussion about harvesting some of my eggs, as I didnt (and dont) have any biological children, but my tumor was receptive to estrogen and progesterone and harvesting eggs would have been VERY dangerous.
My family and friends were a huge help during treatment. they provided of estrogen in my body. I see an oncologist every four food, cared for my foster child, sat with me through to six months. I have reguchemo, and kept me laughlar mammograms, chest ing. Laughter was the best x-rays, and visits with my medicine by far. gynecologist.
How have your family and friends supported you?
However, cancer has taught me to live each day to the fullest, as if it were my last. (Cliche, but true.) I am hoping to adopt through the foster care system. I truly love my life.
Is there a particular message you would like to send out to other women reading this?
Age doesnt matter. Family history doesnt matter. Know your body and get those regular check-ups no matter how annoying they are or uncomfortable they make you feel.
I am currently on tamoxifen to block the production
Where are you now in the treatment process?
Its hard to pick just one. 1: Hearing the shock in the voice and the fear in the eyes of the people I love when I told them I had cancer. How do you tell someone that you might die? 2: Everything that happened
What has been the hardest part so far, and why?
Im hopeful for the future and looking forward to the day when I can officially say Im cured. (Five years after I ended treatment Feb. 1, 2013.) I still struggle with fatigue, the fear of recurrence, survivor guilt, and more.
How are you doing now?
Dont think you are doing good just by going pink. If you want to truly be aware, read the blog of a cancer patient or survivor, visit a clinic, and research where your dollars actually go.
Is there anything else you would like to add?
We stand in strong support with those fighting for a cure.
With hope, Fred and Gayle Berry
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IN SICKNESS AND IN HEALTH

After a rocky start, breast cancer husband, Marc Silver, learned how to support his wife during one of the most trying times in her life, and the lessons he learned taught him to be a better husband and caregiver.
says. You get hit so hard and sometimes you dont know why youre reacting the way you are. After Marsha Dale called Silver recalls the first time her husband, Marc Silver, at he cried after his wife was work to tell him she had just diagnosed. been diagnosed with breast I was driving around cancer, she thought maybe doing errands and listening she had reached the wrong to Ray Charles. All of a sudhusband. den I heard these strange Silvers first reaction? sounds in the car and I was Ooh. That doesnt sound like, oh my God, Im crying. good. He recalls hanging Silver says. I remember up after the conversation I didnt tell my wife about and staying the day at work. Marc Silver and his wife Marsha Dale, a breast cancer survivor. it I was afraid shed think Silver wasnt looking Whoa, hes losin it. National Geographic, found Diagnosis, Treatment and to be callous he didnt When dealing with canhimself desperately wanting Beyond (Rodale Books) know how else to react. was published in September cer, you can feel like all a book that gave advice to He reacted, he said, by not the humor flies out of your 2004. breast cancer husbands. reacting. This was Labor life, Silver says. Hair was a Silvers book tells the In spring of 2002, as Dale Day weekend 2001, and it sensitive issue for Dale once finished up her active treat- story of his familys battle wasnt until they visited she started losing it, but with cancer, but he also ments toward what had with doctors and Silver the couple found a way to interviewed nearly 100 been stage 2 cancer, Silver heard the word mastecsneak in some humor when couples and found that tomy that he sprung out of drafted a book proposal. everyone coped with breast it came to wigs. His book, Breast Cancer denial. We were at the wig shop, Husband: How to Help Your cancer differently. During his wifes treatand I said, Honey, will you Youre in a daze, Silver Wife (and Yourself) During ment, Silver, an editor at By Renee Lee
CTW FEATURES
try on some for me? What ensued was a dress-up session of Dale modeling a big blonde Dolly Parton-style wig and one that made her look like Elvira from the 1988 film Mistress of the Dark. Silver and his wife found it was a lot easier to laugh at cancer than to constantly be afraid of it. Silver and his wife have been together now for more than 30 years. Dale was able to share any thoughts, whether good or bad, with her husband. As Silver says, if she couldnt share them with him, whom could she share them with? Being a caregiver to a sick loved one comes with its own burden. Silver recommends caregivers also take some time off to take care of themselves. Silver talked to some wives who said they would call their husbands
friends and ask them to go out with him to make sure he was getting time for himself as well. Other advice Silver has for caretakers? Take all the help you are offered from friends and family. Its also very important to go to doctors appointments with your wife, Silver says. You become part of a team, and you can listen and help discuss treatment options. Dale eventually had lumpectomies in both breasts and underwent chemotherapy and radiation therapy.At the end of treatment, Silver says his wife, a high school teacher, gave him a solid B for his efforts as a breast cancer husband. She gave me a B, but shes a tough grader, so I have no complaints, Silver says.
3-D mammograms offer new screening option

Mammograms have entered a new dimension, literally. At some screening centers, women are now being offered a 3-D technology that costs more and involves more radiation but may provide a better look. The Food and Drug Administration approved the 3-D mammography device in 2011, and the technique is becoming more common. Radiologists who use 3-D, also known as tomosynthesis, say its drawbacks are worth the greater accuracy. By itself, 3-D mammography delivers about the same amount of radiation as standard digital 2-D mammograms. But when the FDA approved the new device, it said 3-D could be used only as an add-on to standard mammograms, essentially doubling the low radiation dose. The FDA made 3-D an add-on only because there is not enough information yet about whether 3-D screenings detect cancers as well as 2-D mammograms do. Therefore, 2-D remains the standard of care and provides unique benefits for clinicians, such as familiarity and the ability to compare images from previous years. The 3-D image doesnt replace the standard 2-D mammogram, says Julianne Greenberg, a radiologist at Washington Radiology Associates, which has begun telling women who come in for their standard 2-D screening that they can add a 3-D mammogram to it for $50. Three-D is added value to an already existing, really good technology. In a conventional mammogram, the breasts are compressed and X-rayed four times: side to side and top to bottom, for both the left and the right breast. To take the 3-D images, an arm of the machine sweeps in an arc around the breast during each of the four compressions, taking anywhere from 20 to 60 pictures to produce a 3-D rendering of the breast. These images look almost like holograms; radiologists can spin and flip them around on a computer screen, searching for cancer in the tissue and lymph nodes. When looking at a 2-D and a 3-D image of a breast together, radiologists showed a 7 percent improvement in their ability to distinguish between cancerous and non-cancerous cases, according to two studies that the FDA considered during its approval process. More accurate detection reduces the rate of false positives. In the United States, about 10 percent of women who have a screening mammogram will be called back for additional imaging, such as a sonogram or more mammography, according to the FDA. The vast majority of those women do not have breast cancer (about four cases of breast cancer are found for every 1,000 women who are screened, Greenberg says), but they have to cope with the fear and anxiety of having abnormal mammograms and perhaps undergoing more invasive testing. Its terrifying for a patient, Greenberg says.
Wishing Wellness
Board Certified Physicians
Garden City Pediatric Associates

Jacob S Kriteman, MD Paula Heimberg, MD Ian F Sklaver, MD Erica N Goldstein, MD Heather Archibald, NP
Available 7 Days A Week ACCEPTING NEW PATIENTS

Womens Health & Medical Arts Building 83 Herrick Street, Suite 1003 Beverly, Massachusetts 01915
Tel: 978.927.4980 Fax: 978.922.9115
Suzanne F Graves, MD Eric Sleeper, MD Sheryl R Silva, MD Elizabeth M Monaco, MD Lauren Parker, NP
www.gardencitypediatrics.com
Proud Supporter
Know-how is supporting the

Peoples United Bank is a proud supporter of National Breast Cancer Awareness Month!
of the fight against Breast Cancer
communities where we live and work.
DAN BENNETT
Republican Candidate for State Representative
for Danvers, Middleton Precinct 2 and Peabody Ward 5 P-2 and Ward 6 West Peabody.
2012 Peoples United Bank | Member FDIC |
Equal Housing Lender
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To reconstruct or not to reconstruct its one of the toughest questions a woman faces following a mastectomy. Heres the information needed to make an informed decision.
By Jeff Schnaufer
CTW FEATURES
fears about reconstruction debunked

Breast Cancer Care and Research Fund in Los Angeles, developing a mentoring program for newly diagnosed patients so they can speak with trained, educated survivor mentors. It has been 24 years, and as the result of my experience, I always remind women that a diagnosis of breast cancer is not an emergency, Rakoff says. They
or the suggestion to have a second opinion, Rakoff recalls. Within four days of my diagnosis, I had a simple mastectomy with no reconstruction. At the age of 44, Michele Rakoff disAfter the surgery, Rakoff began invescovered she had breast cancer. She recalls being not well-informed by her tigating the possibility of having reconstruction, educating herself. She decided surgeon about her options for breast to have breast reconstruction six months reconstruction. I was rushed into making a quick deci- later. That was in 1988. Today, Rakoff serves as executive director with the sion and was not given the opportunity
RECONSTRUCTION, Page S48
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RECONSTRUCTION
Continued from Page S47 have time to get a second opinion, do research and speak with well-educated advocates who can share their own experiences. Reconstruction is one of the toughest decisions a woman faces following a mastectomy. According to a Colombia University study, fewer than one in four women with invasive cancer opt for the immediate reconstruction of their breast. More than one in three with early stage cancer got the procedure. The biggest predictor of whether a woman got reconstruction was insurance coverage. Ultimately, its a personal decision. But many fears can get in the way of making the best choice. We asked a few experts to weigh in on the validity of these fears.
Fear #1: I have to decide right away because reconstruction can only be done immediately following the mastectomy.
Incorrect, says Dr. Christy Russell, a spokesperson for the American Cancer Society and associate professor of medicine at the University of Southern California. They can always have a delayed reconstruction. One can do a delayed reconstruction. But if one
can get it together and really make a decision upfront, theres some economies of scale, so to speak, says Dr. John Link, author of The Breast Cancer Survival Manual, 5th Edition (August 2012, Holt Paperbacks) and director and founder of Breastlink Medical Group, a comprehensive breast cancer treatment group in Orange, Calif. There are a variety of types of reconstruction, he says. One is a silicone implant. The second type is where fat and skin are brought in from somewhere else to create the new breast. The third option is a hybrid of both. When the breast implant is put in after the mastectomy, it eliminates an added surgery, Link says. In our practice, 90
percent of women have immediate reconstruction. Those women who deny it are more likely to do it because of age or underlying health issues like pacemakers, severe obesity, diabetes or heart failure.
Fear #2: If I have to have radiation or chemotherapy, I cant have reconstruction until it is over.
Each person receives different treatment and depending upon that treatment, a decision should be made with discussions between the woman and her health care team, Rakoff says. Women should be informed that radiation does have an effect upon the skin and
RECONSTRUCTION, Page S50
District Attorney Jonathan Blodgett is proud to support breast cancer awareness month.
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RECONSTRUCTION
Continued from Page S48
VISIT US ONLINE
at the end. There should be no guilt about trying to become as whole as possible.
can limit the reconstructive choices.
106 LIBERTY ST. DANVERS | 978-777-5727 | WWW.PORTSIDEMARINE.US
Fear #3: It is too dangerous to have reconstruction when you have an aggressive form of cancer.
No, Russell says. Even if women are dying of breast cancer, they deserve to have any type of body they want. You just have to make sure a patient is healthy enough to go through the surgery.
Fear #6: If my cancer comes back, it will be easier to detect if I dont have reconstruction.
Absolutely incorrect, Russell says. Women who get a recurrence on the skin, it looks like a mosquito bite in the skin. Its very, very easy to detect. Local recurrences occur less than 10 percent of the time, Link says. When they reoccur, they are almost always on the surface.
have chosen not to have reconstruction and are beautiful, sexy women, Rakoff says. I know several who were diagnosed in their 20s, married after breast cancer and had children. They and their partners feel they are lovely, wonderful women.
Fear #4: If I dont have reconstruction, Fear #7: My partner wont be as Ill never feel like a woman again. attracted to me if I dont have There are many women of all ages who reconstruction.
I have a lot of patients who have not had reconstruction and they are still functioning normally sexually, Russell says. Many of them said the fact that they developed a life-threatening illness changed the relationship both emotionally and sexually. It was a wake-up call to the Fear #5: Reconstruction is a vanity decision I should just be grateful my marriage. My advice is to know how you use your body sexually before you go into cancer is gone. these surgeries. At the same time, Russell points out that Absolutely not, Russell says. This is all about doing everything you can to try to the breast is a sexual organ. A mastectomy even out the chest wall, not only for physi- will deaden sexual stimulation in the skin cal appearance but to even out the weight over the removed breast. And getting a new breast from reconstructive surgery on the chest and stop back problems. will not improve sexual stimulation, either. Following a mastectomy, Russell says There is always an adjustment period women with large breasts get very unbalanced. They start leaning in one direction. after breast surgery, and discussions can help, Rakoff says. Many couples find The whole process of being treated it helpful to get professional counseling. for breast cancer is difficult enough, Your partner should love you for who you Link says. Theres no reason a woman are. shouldnt try to feel good about herself
BREAST CANCER
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From the mouths of
survivors
CTW FEATURES
Supporting those who are touched by this disease, remembering those who have been lost and rallying for a cure.
By Lisa iannucci
Tara Mullen, 38, is a married mom of two daughters, ages 8 and 5. She was diagnosed at age 35 for ductal carcinoma in situ after her doctors found a cyst in her breast. Ductal carcinoma in situ (DCIS) is a noninvasive breast cancer with abnormal cells contained in the milk ducts. In situ means in place because the cells have not left the milk ducts to invade nearby breast tissue. Due to my family history of breast cancer, they were keeping an eye on it and I was getting an ultrasound every six months, she says. A few months later, the fluid-filled cyst turned into a solid mass. I didnt hear anything after the doctor told me that I had breast cancer, Mullen says. The doctors performed a lumpectomy, and a few months later, more cysts were found. They werent in the lymph nodes, thankfully, but I opted for a double mastectomy in May 2012, she says. Mullen went through radiation treatment and a chemotherapy shot in her stomach every three months. I never had a choice to stop going and never had time to really think about it, Mullen says. I broke down at the end of radiation when it all hit me at once and my radiation oncologist said, I was waiting for that. I worked in the oncology department, so when I heard the news, my first thought was, What stage is it? Did it metastasize? she says. I thought about my kids, they were small and I didnt know whether it had spread or not. And all of the surgery was a pain. Mullen says she couldnt care less that she lost her breasts. I just wanted them off me, she says. I didnt want to have to worry about it anymore. You can get them reconstructed. There are more important things than breasts. What I hated
Meet Tara Mullen
was the fact that I couldnt care for myself and all of a sudden I was shut down completely with drains in me. Mullen needs more reconstructive surgery, but she says her health is good. Meridith Stevens was diagnosed with inflammatory invasive ductal carcinoma on Oct. 26, 2011. It had spread to some of her lymph nodes. I followed through on a suspicious lump in my left breast and then other topical changes that were apparent, she says. I dont remember exactly when it was, but I think my suspicions started in early August. I had felt a hard lump in my breast, perhaps an inch away from my nipple. I noticed it by chance, either adjusting a bra or showering. Prior, I had not been good about selfexaminations because I had cystic breasts and I blew off self-examining because I figured Id always be feeling lumpiness, so I might as well leave it up to the experts to determine the differences. This time, it was different though. It was more solid than I had ever felt. I was in complete disbelief because, for goodness sake, I had just had a clear mammogram in April. There was no way the lump could be anything serious. As time went on, the lump got harder and bigger and began to swell, and Stevens nipple began to discolor and invert. The skin over the lump and neighboring area started turning red and swelling, too. She was treated with two rounds of chemotherapy and a mastectomy and then radiation. Next July, I will have the right breast removed and the first of my reconstruction surgery for both breasts, she says. Physically, besides having a higher blood pressure than at the start, residual fatigue from chemo treatments, and having to lose weight and get in condition, Im otherwise healthy.
Meet Meridith Stevens
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Wenham Museum Join Us in the Fight Against Breast Cancer

Wenham Museum is collecting donations for the American Cancer Society, during the month of October.
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Honor a Breast Cancer Survivor

On Tuesday, Oct. 23rd in this special Salem News feature
JENNIFER BLACK
SHES A SURVIVOR I Love You! McKayla
KAREN SMITH
We love you, Mom!
ANN JONES
Survivor!
MARY WHITE
We love you. Bill and Joe
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BREAST CANCER
Barbara C. Unell finished her radiation treatments for breast cancer in 1998 and assumed shed be given help on getting back in the swing, as she called it. She was looking for follow-up care for side effects and guidance for rebuilding her health. When it wasnt offered, her frustration led her to form Back in the Swing USA (www.backintheswing. org). The Back in the Swing mission is to educate and empower health care professionals to provide care for the (post-breast cancer) consumer, Unell says. The organization also helps women develop a personal survivorship care plan. New is The Back in the Swing Cookbook (Andrews McMeel, 2012) by Unell and Judith Fertig. The book features nutritious recipes, luscious indulgences such as celebration chocolate cake, and anecdotes and health tips to get readers back to their full lives.
AWARENESS
Back in the swing of living

Spiced Blueberry Applesauce Muffins
Prep time: 10 minutes Cook time: 16 to 18 minutes Some of our favorite flavors come together to celebrate taste, textureand great health. Make a batch, individually wrap the muffins well, andfreeze for up to three months. You may prefer golden flaxseed because itdoesnt have the horse food flavor, some say, and the color is better inthe final product. Ingredients 11/4 cups whole-wheat flour 11/4 cups old-fashioned rolled oats 1 teaspoon baking powder 1/2 teaspoon baking soda 1/4 teaspoon salt 1 teaspoon ground cinnamon 1 tablespoon milled flaxseed 1 cup unsweetened applesauce 1/2 cup buttermilk
Makes 12 to 15 muffins
THE EMOTIONAL WEIGHT OF FOOD

When Patricia DImperio was undergoing treatment, she had chemotherapy on Fridays. By Sunday at home, I would be horribly sick on my living room couch when my daughter would come home with a small bag of Doritos she got with my husband. DImperios family, knowing she could stomach almost nothing, thought the snack would be a special treat. Doritos were one of the few things that went down easily, according to the chiropractor. I cherished every last crumb. Maybe it wasnt the best snack; still isnt as far as nutritionists are concerned. But for DImperio, theres comfort in certain foods. It takes us to a place where we are OK, she says.
Line 12 muffin cups with paper liners. 2. In a large bowl, combine the flour, oats, baking powder, bakingsoda, salt, cinnamon and flaxseed. 3. In a medium bowl, combine the applesauce, buttermilk, brown sugar, oil and egg. Stir the applesaucemixture into the flour mixture until just moist. Fold in the blueberries. 4. Fill the muffin cups equally, about two-thirds full. 5. Bake for 16 to 18 minutes, until a toothpick inserted in the centerof a muffin comes out clean.
Nutrition:
2 tablespoons grapeseed oil or canola oil 1 large egg, beaten 3/4 cup fresh or thawed frozen blueberries Directions 1. Preheat the oven to 375 degrees.
1/2 cup firmly packed brown sugar
Calories: 144 Total fat: 3.5 g Saturated fat: 0.5 g Carbohydrates: 26 g Protein: 3.5 g Dietary fiber: 3 g Sodium: 94 mg
Think ink.
October is breast cancer awareness month.
Think Pink in October.

Supporting Breast Cancer Awareness Month.
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BREAST CANCER
AWARENESS
All eyes on breast cancer awareness during fashion event

Cheryl leCesse
STAFF WRITER
IF YOU GO
WHAT: Illusions, a magical fashion event to help make breast cancer disappear WHEN: Thursday, Nov. 1, at 6 p.m. WHERE: Danversport Yacht Club, 107R Elliott St., Danvers TICKETS: $75, available online or at Lorraine Roy Designer Collections, 30 Maple St., Danvers INFO: 978-774-0 825 or www. lorraineroy.com
Lorraine Roy Designer Collections is bringing pink to the catwalk. On Thursday, Nov. 1, the Danvers shop and fellow sponsors will present Illusions, a magical fashion event to help make breast cancer disappear, at the Danversport Yacht Club. Because were a womens store, we decided it would be nice to do something that primarily affects women, said owner Jeanne Hennessey. Unfortunately, we all know so many people who have been affected by breast cancer. The fashion show will benefit the Breast Oncology Program at the Mass General / North Shore Cancer Center. We wanted to give to breast cancer, but we wanted to remain local at the same time rather than give to Avon or Susan G. Komen, Hennessey said. We wanted to make a difference in our own neighborhood. She added: Ive had relatives whove been treated so wonderfully there. Its nice to give back when you know people who have benefited from all of their expertise and compassion. In addition to professional models showing off Lorraine Roys dress collections, 12 local breast cancer survivors will make their way down the catwalk, modeling a series oftrench coatsthat will be raffled off throughout the evening. Hennessey said the survivors range in age from their
30s to their 70s, and each will be recognized with a short story about their cancer fight. Among the survivor models will be Noreen Forlizzi of Danvers. Forlizzi, now 57, was diagnosed with breast cancer when she was 32. She celebrated her 25th anniversary in June. I was very lucky. I never had a problem, she said. Forlizzi found a lump while doing a breast exam on herself. A registered nurse in the outpatient oncology ward at St. Elizabeths in Brighton at the time, she was aware of the possibilities. She made an appointment, and doctors determined the lump was cancer. With two young children at home a 5-year-old son and 3-year-old daughter she opted for a bilateral mastectomy with breast reconstruction. I wanted the most assurance I could get, she said. It turned out to be a great decision. A neighbor of Hennesseys, Forlizzi is very familiar with her charitable fashion shows, although
Illusions will be the first in which she will be an active participant. She said shes looking forward to it. This a whole new experience for me, so it will be fun, she said. Hennessey said the event has been met with tremendous response so far. Weve already sold more than a few hundred tickets, she said. In line with its magical theme, Illusions will feature four magicians donating their time to entertain, as well as raffle prizes, cocktails, and dueling piano players from Bostons Howl at the Moon nightclub. We wanted it to be fun, upbeat, and interactive with the audience, said Hennessey. Rather than having separate baskets up for grabs, ticket holders will have the chance to win raffle tables, each worth around $500. Themes include books, golf, and a Fifty Shades of Grey table, featuring gray accessories and handbags. A separate Hocus Pocus board will offer guaranteed prizes to those who play. Women in the area are jumping on board, she said. People want to help. Lorraine Roy holds a fashion show every year, each for a different charity.Sponsors include the Danvers Butchery, Peoples United Bank and East Boston Savings Bank. Paulas Salon does the hair styling for the models, and The Makeup Artist provides the makeup. Hennessey said raffle prize donations are still being accepted, and sponsorships Lorraine Roy Designer Collections owner Jeanne Hennessey. are still available.
ETHAN FORMAN/Staff Photo
and friends present
To benefit The Breast Oncology Program at MGH North Shore Cancer Center
A magical fashion event to help make Breast Cancer disappear.
Thursday, November 1, 2012 at 6pm Danversport Yacht Club Tickets: $75

Includes: Cocktails & Magic Dinner Howl at the Moon Piano Road Show Fashion Show
Visit our website at www.LorraineRoy.com or call 978-774-0825 for ticket purchases, sponsor opportunities and more information
The Mass General/North Shore Cancer Center Breast Program in Danvers is a program providing the highest quality breast cancer care in the area with a multidisciplinary team consisting of breast surgeons, radiation oncologists, medical oncologists, geneticists, breast radiologists and pathologists. Patients are offered access to the latest national and regional clinical trials at all stages of disease. Monies donated to the program help support participation in these clinical trials, as well as the education of breast cancer nurse practitioners and access nurses. Thank you for your support in helping to make breast cancer disappear! Sincerely, Jeanne Hennessey, President Lorraine Roy Designer Collections
30 Maple Street, Danvers, MA l 978-774-0825 l www.LorraineRoy.com
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* MLS DOLLAR VOLUME DATA 2003, 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011 Data includes all single family, condominium, multi-family and land sales in Beverly, Danvers, Essex, Gloucester, Hamilton, Ipswich, Manchester, Rockport & Wenham, MA. This representation is based in whole or in part on data supplied by our MLS Partners. These entities neither guarantee nor are responsible for data accuracy. Data maintained by MLS may not reflect all real estate activity in the market. 2012 Coldwell Banker Real Estate LLC. Coldwell Banker is a registered trademark licensed to Coldwell Banker Real Estate LLC. An Equal Opportunity Employer. Equal Housing Opportunity. Owned & operated by NRT LLC.

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The Salem News

For local leaders, the power of pink prevails

Tinti, Quinn, Grover & Frey, P.C. Attorneys At Law

Mayor Kim Driscoll

Doctors take a risk adapt approach

To the many breast cancer patients and dedicated researchers:

Beverly M. Shafer, M.D.

PLASTIC & RECONSTRUCTIVE SURGERY

Annual walk/run honors Danvers native

A new era in breast cancer diagnoses and therapies

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Supporting Breast Cancer Awareness Month

I refuse to let this disease be what defines me and my family

What has been the hardest part so far, and why?

Liesl Voosen Fields during her chemo treatment in late 2011.

Better healing through food

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Why healthy eating is important for breast cancer recovery

Hereditary gene means a greater risk of breast cancer for some

Ovarian cancer at any

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Surgeon explains the breast reconstruction process

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Survivor sets sights on half-marathon goal

October is Breast Cancer Awareness Month

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