Breast cancer spreads most often during sleep, unexpected findings from researchers indicates

Research findings have unearthed "potential implications for the timing of biopsy and treatment of metastasis-prone cancers."

That's one conclusion from the authors of a study published some time ago in the journal Nature that decided "the metastatic spread of breast cancer occurs predominantly during sleep."

The findings, according to a story by Megan Brooks online in Medscape Medical News, were "unexpected."

Nicola Aceto, PhD

Brooks quotes Nicola Aceto, PhD and professor of molecular oncology at the Swiss Federal Institute of Technology  (ETH) Zurich, Switzerland, as saying, "This has not been shown before [and] we were surprised, indeed."

Harrison Ball, a PhD candidate, and Sunitha Nagrath, PhD, of the University of Michigan, Ann Arbor, also are quoted, to the effect that "this finding is astounding."

In addition, Brooks' piece quotes Dr. Marlene Myers, clinical professor of medicine at NYU Langone's Perlmutter Cancer Center in New York City, regarding clinical implications: "The most obvious is that the time of day [that] treatment is administered may influence efficacy."

She adds, however, that the benefits of treatment someone at night would need to be weighed against the downsides of interrupting a person's normal sleep-wake cycle. 

More information on research can be found in "Rollercoaster: How a man can survive a partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

Major U.S. panel drops longstanding mammogram recommendations from 50 years of age to 40

"All women should start getting regular mammograms at age 40, an influential advisory panel said, in a stark revision of standard medical advice."

That paragraph in a recent online "breaking news" short by The New York Times led to a story by staffer Roni Caryn Rabin indicating that women shouldn't wait until 50, as had been advised since 2009.

The new advice, the piece says, "comes as breast cancer diagnoses rise among younger women and mortality rates among Black women remain persistently high."

Troubling trends in recent years, the article continues, "include an apparent increase in the number of cancer diagnosed in women under 50 and a failure to narrow the survival gap for younger Black women, who die of breast cancer at twice the rate of White women of the same age."

Dr. Carol Mangione

The story quotes Dr. Carol Mangione, immediate past chair of the I.S. Preventive Services Task Force, as saying that " we don't really know why there has been an increase in breast cancer among women in their 40s, but when more people in a certain age group are getting a condition, then screening of that group is going to be more impactful."

The new recommendations, the Times piece goes on, "covers more than 20 million women in the United States between the ages of 40 and 49."

Breast cancer has remained "the second mosts common cancer in women after skin cancer and is the second leading cause of cancer deaths, after lung cancer, among women in the United States," the story notes. 

One possible reason for the increase in younger women, it is speculated, might be postponement of childbearing — or not having children at all. At least that's the opinion of Rebecca Siegel, senior scientific director of surveillance research at the American Cancer Society. "Having children before age 35," the Times story says, "reduces the risk of breast cancer, as does breast feeding."

More information about screening recommendations can be found in Rollercoaster: How a man can survive his partner's breast cancer, a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

Docs push back on women who want flat chests rather than post-mastectomy reconstruction

Although some women prefer flat chests after a mastectomy, many surgeons fight them and push for reconstruction.

According to a story by Fran Kritz in The Washington Post some time ago, "several of those who sought the procedure say they got pushback — and outright denial — from their doctors when they brought it up."

Dr. Deanna Attai

The article focuses on Dr. Deanna Attai, an associate professor at UCLA's David Geffen School of Medicine, who surveyed nearly 1,000 women who'd had a single or double mastectomy without reconstruction. Her study found that almost three-quarters said they were satisfied with the result.

Kritz's story quotes Roshni Rao, chief of breast surgery at Columbia University Medical Center in New York, as having "seen more patients requesting to go flat after mastectomy, likely as they feel more power to make this decision."

Attai has noted that there's more awareness now that the process of reconstruction has risks: "Women who opt for reconstruction, whether a breast implant or their own tissue (called autologous reconstruction) could face multiple surgeries, post-surgery recovery, a 10 percent risk of infection which can get in the way of chemotherapy or radiation schedule, and, occasionally, implant recalls and removals."

Roughly 22 percent of the women in Attai's study, the Post story reports, "said a flat closure option was either not initially offer by their surgeon, or was not supported by the surgeon, or the surgeon intentionally left additional skin in case he patient changed her mind. That extra skin would require further surgery if the woman did not change her mind about the flat closure."

More information about the choice between flat-chestedness and reconstruction can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

Actor Sam Neil must take chemotherapy rest of life to ward off recurrence of lymphoma

After fighting it for months, actor Sam Neill, star of Jurassic Park movie franchise, has finally revealed that he has been diagnosed with blood cancer.

Sam Neill

According to a recent story by Lee Moran on the HuffPost website, Neill says he's being treated but is in remission. There's now "no cancer in my body," he's quoted as saying. 

He will, however, need chemotherapy treatment each month for the rest of his life, he admitted to the Guardian in an interview.

Moran's piece says the 75-year-old was diagnosed with angioimmunoblastic T-cell lymphoma "after experiencing swollen glands while promoting Jurassic World Dominion last year."

His revelations most likely came because his memoir — Did I Ever Tell You This? — was just released.. Writing it, the HuffPost story quotes him, "was a lifesaver" that gave him "a reason to live."'

Neill is back to work, with his next television appearance scheduled for Apples Never Fail, a limited upcoming Peacock series co-starring Annette Bening.

More information about treatments and disease can be found in Rollercoaster: How a man can survive his partner's breast cancer, a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

Left Edge Theatre's 'Pass Over' elicits laughs, shock as it depicts Black fears, hopes

Here's my latest theatre review:

https://localnewsmatters.org/2023/05/03/review-left-edge-theatres-pass-over-elicits-laughs-shock-as-it-depicts-black-fears-hopes/

FDA gives providers 18 months to implement new standards on mammograms and dense breasts

The Federal Drug Administration has established national mammogram standards to protect women with dense breasts.

According to the headline on a recent story by David Ovalle in The Washington Post, "almost half of women over 40 have dense breast tissue, which is tied to a higher risk of breast cancer — and also makes it harder to detect cancer."

The article notes that the new FDA standards require mammogram providers "to inform women with dense breast tissue that their cancer screenings may be difficult to interpret and suggest that they consult with their doctors about the need for additional tests" — such as MRIs or ultrasound.

Providers must implement the new regulations, which are expected to save lives by helping women detect cancer earlier, within 18 months.

The new standards are a minimum, but states can still require more severe language.

Breast cancer, Ovalle's story says, "is the most common cancer among women, after skin cancer, and the second leading cause of cancer deaths among women overall."

The American Cancer Society estimates, the piece continues, that in 2023 almost 300,000 women will be diagnosed with invasive breast cancer, and almost 44,000 will die from it.

Dr. Hilary Marston

Dr. Hilary Marston, the FDA's chief medical officer, claims in a statement that the "action represents the agency's broader commitment to support innovation to prevent, detect, and treat cancer," the Post article reports,

Currently, according to JoAnn Pushkin, executive director of the New York-based Dense Breast-info, a resource website that aims to teach patients and health-care professionals about dense breasts, some states tell women only that they have dense breasts, "really not enough to raise a red flag."

Pushkin in 2005 had a mammogram that showed no cancer, but an ultrasound shortly thereafter did. Because her breast cancer wasn't detected years earlier, she had to undergo eight surgeries, eight rounds of chemotherapy, and 30 rounds of radiation.

"Someone should have told me," the Post story quotes her saying about the greater difficulty detecting cancer in  people with dense breasts. "When I'm denied this information, I have effectively been denied an opportunity for early-stage diagnosis."

JoAnn Pushkin

The National Cancer Institute cautions that women with dense breast have a higher risk getting breast cancer.

Additional information on mammograms and dense breasts can be found in Rollercoaster: How a man can survive his partner's breast cancer, a VitalityPress book I, Woody Weingarten, aimed at male caregivers.

Actress Sharon Stone opens up about having to surgically remove tumors bigger than her breast

After receiving a Courage Award from the Women's Cancer Research Fund earlier this month, actress Sharon Stone revisited having had "gigantic [tumors] bigger than my breasts" removed in 2001. 

A recent story by Anthony Dominic on the ET (Entertainment Tonight) website indicates that the 65-year-old actor insisted women shouldn't "ever feel compelled not to get a mammogram, not to get a blood test, not to get surgery because it doesn't matter. I'm standing here telling you I had a one and a half and more tissue of my breasts removed and none of you knew it."

Stone had opted to half one breast removed, and half of the second, ending with reconstruction that resulted in an unauthorized breast enlargement, before learning that her massive tumors had been benign.

Sharon Stone

The Basic Instinct star, speaking at the fundraising event at the Four Seasons Beverly Wilshire in Beverly Hills, admitted that "those mammograms are not fun," but also said that the "mammogram machines that your taxpayer dollars pay for don't work if you don't walk up and put your breast up in that machine and let them slam that thing down."

She recalled that she'd gone into the hospital saying, "'If you open me up and it's cancer, please take both breasts,' because I am not a person defined by my breasts. You know, that might seem funny coming from me since you've all seen 'em."

During her plea for donations, she wiped tears from her eyes and noted that she'd just lost "half my money" via "this banking thing," an apparent reference to the Silicon Valley Bank collapse. It's been a tough time in the world for everyone, she added, specifying her own difficulties — including the death of her brother Patrick to a heart attack last month at age 57. 

Stone, who'd received an Oscar nomination in 1996 for Casino, had originally revealed in her memoir, The Beauty of Living Twice, that not only had she had the breast surgery but that she'd suffered a stroke in 2001.

Multiple sources reported that Stone was being honored for raising awareness about breast cancer. At one pint, she honored survivors in the audience by asking them to stand up and be recognized.

For more information on diagnoses and reconstruction, check out Rollercoaster: How a man can survive his partner's breast cancer, a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

Sexual problems plague women after cancer diagnosis, but little is being done, docs report

Despite a wave of new research around cancer treatment and sexual health, women say their issues are still being dismissed.

That long subhead sits under the headline "When Cancer Upends Your Sex Life" on a story by Catherine Pearson in yesterday's editions of The New York Times.

The article states unequivocally that "cancer can devastate a woman's sexual function in countless ways, both during treatment and for years down the road."

Chemotherapy, it elaborates, "can cause vaginal dryness and atrophy…but it can also prompt issues like mouth sores, nausea, and fatigue."

Surgery such as "a hysterectomy or mastectomy can rob women of sensations integral to sexual arousal and orgasm," the piece continues, and "pelvic radiation therapy can lead to vaginal stenosis, the shortening and narrowing of the vagina, making intercourse excruciating, if not impossible."

In addition, Pearson's story says, "sadness, stress, and body image issues can snuff out any sense of sexual desire."

The article cites a 28-year-old Stage 3 breast cancer patient who "developed vaginal dryness so severe that her skin began to deteriorate and was covered in small, paper cut-like tears. Urinating was comfortable; sex agonizing" — but when she told her oncologist about the pain "and how her libido had evaporated almost overnight," he responded dismissively.

That, Pearson indicates, is not unusual.

Dr. Elena Ratner

The Times piece quotes Dr. Elena Ratner, a gynecologist oncologist with the Yale Medicine Sexuality, Intimacy, and Menopause Program," to the effect that "the damage that is done is not only physical…From the diagnosis to the fear of recurrence to how they see their bodies, they feel like their whole sense of self is different."

What can be done?

Physicians need to ask female patients abut sex more often —much as doctors ask male prostate patients. 

Until that occurs, the story maintains, the issue will remain the same. 

Pearson quotes Sharon Bober, psychologist and director of the Dana-Farber Cancer Institute's Sexual Health Program, as saying that such questioning must become routine — "so that it's not something special or different, and it's not based on a health care provider's perspective about whether someone is sexually active."

A 2020 survey of 391 cancer survivors found, according to the Times piece, "that 53 percent of male patients were asked about their sexual health by a health care provider, while only 22 percent of female patients were asked the same."

Dr. Jamie Takayesu, a radiation oncology resident physician at the University of Michigan Rogel Cancer Center and a lead author on the study, reportedly said "the research was inspired by her own nagging sense that she wasn't asking female patients about sex often enough, and she suspected her colleagues weren't either."

The reasons, she hypothesized, were that physicians might be more inclined to focus on quality of life issues with men because prostate cancer has a high survival rate; that there are "more formalized tools" to assess sexual function in men; and that "many cancer doctors…[get] little to no training in how to talk about sex," the story says.

Possibilities for more help lies in the proliferation of multidisciplinary sexual health programs — at least in large hospitals or urban cancer centers.

Online communities and advocacy groups also can be helpful resources.

The Times story also quotes Dr. Laila Agrawal, a medical oncologist specializing in breast cancer at Norton Cancer Institute in Louisville, Kentucky, to the effect that "the number of women affected by sexual health concerns after a cancer diagnosis is huge, and the need for the women to have access to medical care for sexual dysfunction after cancer is enormous…I really want women with cancer to know that sexual health problems are treatable medical problems, and they can get better…I just want to offer that out as hope."

More information on women's sexuality and disease can be found in Rollercoaster: How a man can survive his partner's breast cancer, a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.