By Dr. Carole Weaver In my early 60's, with a lifetime of adventure in travel, single parenting and fund-raising--and a few side trips into musical comedy, I was ready for a new exciting chapter. My kids grown and gone to Hollywood, I aimed at Broadway, or at least auditions for bit parts (the older woman—an extra decked out in colorful rags in Sweeny Todd). Wham! Fate however dealt me two surprises: a new boyfriend-- an art appraiser--and... breast cancer. Complications ensued (read about it in my memoir, SIDE EFFECTS: The Art of Surviving Cancer) especially with the cancer, but, hey, a Cinderella romance ensued even for this aging feminist. One problem: It takes a village, as we all know, to help a cancer patient through treatment. But my village looked more like a ghost town. Family was 3000 miles away. Boyfriend suffered sick people as energy drains. Shrink only interested in "authenticity," not pain. And girlfriends, while valiant, soon became exhausted with the regimen of driving, shopping, calling and, well, caring. A few pieces of art stepped into the breach. The “side effect” I discovered as an antidote to an e-coli infection in the operating room, a nasty reaction to chemo, and multiple surgeries, was how a handful of beautiful objects distracted, comforted, delighted, and ultimately gave me a deep healing perspective which got me through my ordeal. I was no art expert, no art major; didn’t even especially like museums for more than 45 minute visits. I just let my own frame of mind (pun intended) move me toward a statue, a painting, a piece of music, even an object artistically sewn. Most of the individual pieces had something to do with the stage of my treatment. For example, when I was going through chemo, my appetite was horrible. I could barely get anything down. I dreamed of eating clouds. Then I discovered this large Turkish plate-- a reproduction of a fifteenth century ceremonial ceramic. It was gorgeous with the special calligraphy dedicated to the Sultan and his distinctive Tughrah, his signature in the middle. This plate was never meant to be laden with food. It was strictly an object of magnificent craft to be looked at and appreciated. I loved that plate during those days when the Nausea Imp waited next to my cheek. It was the opposite to what I saw at work when people would bring in gigantic sandwiches for lunch; or at the Chinese buffet, the food dangling over the over-burdened plates. The Turkish plate told me my aversion to food was rewarded with grace, with the masterly strokes of the anonymous hands that filled the background of the Tughrah like a movie set or a musical accompaniment I could not hear. Basically, this is the way it worked: If I saw something in my boyfriend’s house that I liked and came back to it to stare, hold it in my hand, and wonder at its creation, I stayed with it for a while. It made me happy. Eventually, I would understand that it did more than that to my physiology. I learned that art can heal.

By Leslie Ferris Yerger, founder of My Density Matters So that my story doesn’t become your story. And so MORE women with breast cancer become SURVIVORS. ‘Do the best you can until you know better, and then when you know better, do better.’ – Maya Angelou Eighteen months ago, I was diagnosed with Stage IV breast cancer after receiving that phone call that we all want to get saying, ‘All good, see you next year’ from the radiologist’s office reporting on my mammogram and ultrasound just one month prior. After learning that breast cancer was in almost every bone of body, I was beyond confused to say the least. How could this have happened? There was much to learn. What I now know, is that mammography finds less than ½ of the breast cancers present in dense breast tissue, and that those of us with dense breasts are 4-6 more times likely to get breast cancer to begin with. Having dense breasts is a higher risk factor than having a mother or sister with the disease. Around half of all women in the world have dense breast tissue; it is completely normal. Therefore, though mammography has saved many lives, it can fail those of us who actually need it the most. Many in the medical industry have known this for years. It is time, now that we know better, to do better. It is those facts, along with realizing there is a better way to detect breast cancer in dense breast tissue that is FDA approved and commercially available but not widely used, that motived me, along with personal reasons, to walk, and walk, and walk. See a description of this technology here. Molecular Breast Imaging, which finds around 400% more cancers than mammography in women with dense breast tissue, was invented at the Mayo Clinic where they are conducting a multi-site, 3000 women trial comparing MBI to 3D mammography. Preliminary results are astounding. Out of 1000 women with dense breasts tested, MBI has found 9, while 3D mammography has found 2. Wow. It is this study at the Mayo Clinic, called Density MATTERS, that I fundraised for while I walked 500 miles from France through Spain, on the Camino de Santiago. Many people ask me WHY I walked the Camino. My answer depends on how much I want to get into it, and how deep of a conversation I really want to have, or if there is time to explain. So sometimes I just say: for the adventure, to do something cool, for spiritual or religious reasons, or even to satisfy the slightly independent wild hare I have always had, or even to fundraise for a great cause. All of these answers are true actually. But my REAL WHY is much more than that. It’s about that thing nobody wants to talk about. It’s about that thing we all dance around. It’s about that 41,000 number. It’s that 41,000 women per year die of breast cancer in the US. Just imagine what the worldwide figure must be. My REAL WHY is about kids without moms, grand kids without grandmas, and widowers without wives. It’s about careers unfinished, potential not met, and dreams not realized. It’s about lives cut short, and all of the hurt that goes with that. To think this happens 41,000 times over every year is heartbreaking. To think that there is a way to detect MANY more breast cancers earlier when they are curable, that is FDA approved and commercially available, but is not available to most women is unfathomable. So this is the REAL reason WHY I walked 500 miles. So there can be more kids with moms, more grand kids with grandmas, and less widowers without wives. So careers can be finished, so potential can be met, and dreams given a chance. The next step is to finish funding the Density MATTERS multi-site study including 3,000 women so that we take one step closer to Molecular Breast Imaging becoming available to all women. This is the technological advancement we all want, need, and deserve to have. Now that we know better, this is a way to do better. Please join me is spreading the word so that women everywhere, including survivors with dense breast tissue, can begin to have access to better additional breast cancer screening methods such as Molecular Breast Imaging. So that my story doesn’t become their story And so MORE women with breast cancer become SURVIVORS Now that we know better, we MUST do better.

By Store My Tumor You know that the standard of care for cancer is simply not enough and if your cancer is not contained early on and actively managed, there’s a high risk that the cancer will recur and progress. What you may not know, and is a vital component to advanced cancer treatment, is that tumor preservation is the only way to customized treatments and strategies that are more likely to work. What many cancer patients do not know and often times find out too late is that a live cancer tumor is required in order to design personalized treatment options. And, how that live tumor is stored is a critical component. If you choose to have your hospital store your tumor, it will NOT be preserved in the right formats. Hospitals routinely discard tumors as medical waste. StoreMyTumor offers a service that can help you collect, process and store your tumors in multiple formats so that you continue to have access for diagnostics and treatment. Don’t let anyone discard your tumors. Your tumor can help you answer tough questions. Preserving the tumor or biopsy in multiple formats is the first step toward developing personalized effective treatments. With the tumor preserved in the right format at the time of surgery or biopsy, you can answer very big questions, such as: Which chemo is my tumor most likely to respond to? Which one of the thousands of drugs out there may work on my tumor? Are there any experimental drug/ treatment/clinical trial out there I should consider? Is there a certain combination that may work better than the standard or one drug? Which immunotherapy drug/ treatment is available for me? Diagnostics instead of guessing There are diagnostic tests that synthesize various data points about your tumor and translate them into specific recommendations that become your personalized cancer treatment roadmap, such as: Genetic testing– checks for hundreds of targets on the tumor and matches these targets to chemo/drugs and experimental drugs designed for that target. Chemo-sensitivity testing– tests which chemo is most effective. This is vital because chemo has toxic side effects. Drug screening / organoids – tests a wider range (100+) of drugs and combination of drugs, including, chemo, targeted drugs, and immunotherapy drugs. Personalized Immunotherapy instead of a wait-and-see approach Immunotherapy is also another area patient consider. It educates your own immune system to fight the cancer cells. Immunotherapy is experimental, typically considered in parallel to drugs and standard treatments, and helps extend time in remission. In summary, here’s what is possible when you preserve your tumor: Bottom line: No two tumors are the alike, and each contains important information critical to the treatment. Tumors are NOT preserved in the right formats by the hospital, and are routinely discarded as medical waste. Don’t let anyone discard your tumors. For more information: call +1 267.702.5501 or www.storemytumor.com Team StoreMyTumor +1.267.702.5501 cs@storemytumor.com www.StoreMyTumor.com Return to the blog.

By Kristie Konsoer Empathy: the ability to understand and share feelings with another. I recently read a blog written by an older woman who had a cancer scare that she had to deal with on her own. Her husband had passed away from cancer and she had had enough of it in her life. Her feelings are understandable. Two mammograms directed her to an ultrasound. The ultrasound triggered a biopsy. Her timeline read very much like mine did. One test after another was given with heightened urgency. Everything was fast tracked for this woman because the doctors were worried about the outcome of tests. She didn’t know how she would do cancer alone. Thankfully, this woman did not have breast cancer. Of course, I am glad it turned out this way for her. She said her experience gave her empathy for people who are alone. Hello? I’m sure this fellow writer is a lovely woman. Supporting someone through illness is hard. Losing him/her to that illness is excruciating. I do not diminish her pain because I know it’s real. I can empathize with her because I have lost my people in my life. Cancer takes too much. I am confused though why empathy needs to be directed toward people who are alone. Is aloneness somehow lesser than togetherness? Do my experiences when I spend time with friends, family, or a group of people give me empathy for people with partners? They do not. I may at times feel a little thankful to be back home and away from some of the stimulation and unwelcome opinions, but I do not have empathy for people in a relationship. It sounds absurd when the shoe is on the other foot. Somehow the comment rubbed me the wrong way. It seemed more bothersome to me that she felt empathy for people who are alone than for people who have cancer. I just kept scratching my head. It felt like pity or that someone was feeling sorry for me. I don’t want someone’s sorrow. Her remarks made me feel like she was saying, “Thank goodness I didn’t have cancer and the double whammy of being by myself!” This is more of an inner reflection than what was likely intended. I guess being on my own is a bit of a touchy subject for me, mainly of how I feel society perceives it as something less. I feel like I’m regularly defending my status. Sometimes I feel forgotten. Having cancer and being on my own really isn’t so hard. For one thing, I am reliant on myself and can organize appointments, etc. in a way that works best for me. I don’t have to check with others when I need to change my plans. I know how I feel and I don’t need to try to convince or explain those feelings to someone else. Sometimes it’s hard. Sometimes I wish I had a little more help and didn’t have to figure everything out. And I do have help. I have plenty of support. I ask for what I need. I feel connected to so many and have nurtured meaningful relationships. Technically, yes, I am doing cancer on my own, but I’m also not. It’s complicated. “Empathy is simply listening, holding space, withholding judgment, emotionally connecting and communicating that incredibly healing message of ‘You’re not alone.’” ~ Brené Brown I am not sure I’ve done all those things in my reaction to what I read. This post itself has been difficult for me to write. I have felt angry and questioned those feelings. However, it is completely okay, in fact it is fine, more than fine, for me to feel anger. I feel misrepresented. I feel there are indirect implications that are at my expense while someone else is expressing gratitude. Gratitude is not gratitude if someone (or another group) is put down in order for another individual to feel grateful. Nor is it empathy. Empathy means a lot to a person whether they have someone at their side or they are on their own. Empathy is a universal yearning we all need and we all have the capacity to give. You are putting yourself in someone else’s shoes. It still isn’t quite the same because at the end of the day you put your own shoes back on. Still . . . there are moments when you almost get it. The important part is that you try to get it. I have beloved friends who try to get it. One of my goals with this blog is to change perspectives on cancer, particularly advanced stage cancer. When I read something that feels a little, “Oh, that poor person has cancer and is alone,” I don’t like anything in that sentence because that feeling of pity permeates whatever sentiment is trying to be conveyed. It doesn’t feel good. What feels good is being welcomed to a group. I’d rather hear a compliment about something amazing I accomplished instead of a question on whether I went with anyone while achieving it. It feels good to be appreciated for my other qualities. It feels good to be included in things. If I’m unable to do something, then I may need to pass, but I appreciate being included. I like it when people remember things about me and respect my thoughts and opinions. I like it a lot when I’m not constantly asked about my health and truly treated like one of the gang. A small bit of thoughtfulness goes a long ways. It is how I believe we all can treat one another respectfully and compassionately. Empathy in action is a lifestyle choice. It’s possible I’m confusing empathy with sympathy, but I don’t think I am. In fact, I think some other people are. I certainly don’t want anyone’s sympathy or sorrow. It belittles and demeans if directed at me because I’m living with cancer. I want an even playing field. Don’t give me something or take something from me because of my health. Don’t give me something or take something from me because I’m single. I didn’t ask for your sorrow or pity. I’ve asked for your encouragement, support, and friendship. These are the things I offer. There is something else you can give me: caramel. If someone were to offer me a caramel, I would not say no. Really good caramels are an entirely different story. It just might be an edible form of empathy. Empathy is feeling as sad for a friend as if the event were happening to you. It’s understanding your friend is in a lot of emotional or physical pain. Empathy is understanding a perspective that’s the polar opposite of yours. Parents and teachers demonstrate empathy every time they know that something that isn’t a big deal at all really is a huge deal to a child. You show empathy to me when you understand that I may cancel plans, not feel one hundred percent, and don’t ask me a laundry list of questions. It means a lot to me when you share something hard in your life rather than me always explaining my latest hurdle that I try to embellish with a little humor thrown in for good measure. Empathy is not making comments along the lines of “It’s too bad you had to get cancer.” Yeah, I just don’t know what I was thinking when I was in the cancer store. It isn’t empathetic to tell someone what he/she feels. Neither is telling someone what he/she needs to do to fix what is deemed not right (health, job, loss, etc.). Empathy is not putting someone down or saying things could be worse or that he/she should feel grateful. The words “at least” aren’t used at all. Please don’t tell me to live life to the fullest because tomorrow I could get hit by a bus. What many people don’t understand is that I’m running from that stupid bus every day. These things seem obvious to me, but I’ve heard them all. Perhaps the intention isn’t to show empathy, but to show something far less kind. I can’t figure it out. And empathy definitely is not knowing what it might be like to have cancer and be alone because you had a scare and everything turned out just fine. You put your own shoes back on and walked on. Empathy is something we all need and we all have the ability to give. At best, we understand what it’s like to be scared, perhaps terrified about our health and our future. We understand all the “what ifs” that run wild in our thoughts. We understand that disease can be a very lonely place to live. We can relate to one another that our upsetting news, event, or circumstance may be completely different from another person’s struggle, but that they are the same in that they are unsettling, frightening, and possibly very lonely feelings. We understand people are doing the best they can with what they have. Empathy connects us to one another. Through empathy we can share with and support one another. I can empathize with those feelings. I am not alone. You are not alone either. Consider replying: Where have you seen empathy alive and well in your life? How do you best handle situations when someone is not empathetic? Here is the link to my site: https://www.kristiekonsoer.com

Survivingbreastcancer.org had the pleasure of meeting Janine Gilarde during breast cancer awareness month last October at one of our Survivors, Thrivers, and Friends event. It was one of our first events in MA and it was a packed house. We know that diet and nutrition are an essential component of managing a cancer diagnosis and preventing recurrence. Our event focused on diet, nutrition, plant based meal plans, meditation, yoga, pilates, and overall health and wellness. It was a natural fit that Survivingbreastcancer.org and Janine crossed paths and we are thrilled to partner with her as a guest blogger for our community! By Janine Gilarde, RN & Healthy Living Coach Originally published on here 4/14/2019. Weight gain, especially during or after cancer treatment, can be unexpected and distressing, but it’s not uncommon. Cancer itself — along with side effects from treatments such as chemotherapy, radiation, and surgery — can significantly impact your weight. It’s never too late to take steps to improve your health. Whether you were overweight or obese before cancer, or gained weight during or after treatment —  managing your weight after a cancer diagnosis is possible. Common Beliefs about Losing Weight Before being diagnosed with cancer, you may have already tried several ways to lose weight or increase physical activity and found the results discouraging. Here are some common beliefs that may prevent people with cancer from pursuing a healthier lifestyle. “I’VE TRIED EVERYTHING AND JUST CAN’T LOSE WEIGHT.” Losing weight is challenging.  You may feel you have “failed” because previous attempts to lose weight have not worked. The truth is that you just haven’t found what works for you yet. Many people find it easier to to lose weight when they have a structured program that offers accountability and support. “THE HARM HAS ALREADY BEEN DONE.” It is never too late to improve your health.  Many studies have shown that people who choose healthy foods and exercise regularly are at lower risk of having the cancer return or of developing a new cancer. In addition, changing to a healthier lifestyle reduces the risk of other medical problems, such as diabetes and heart disease. “I ENJOY EATING AND DON’T WANT TO CHANGE MY DIET.” You can still enjoy the foods you love, but with more balance. Focus on eating foods that are nourishing, while reducing non-nutritional foods that are high in calories and unhealthy fats. Even small reductions or changes to what you eat and drink can help you lose weight slowly over time. Healthy Diet – Healthy Weight – Healthy Lifestyle Nutrition Nutrition is not just about calories – where you get your calories matters. If you want to improve your health, focus on foods that are nutritionally dense. There are some studies that suggest eating this way can help prevent and reverse many chronic diseases, including cancer. Physical Activity Aerobic and strength training exercise can improve your quality of life, help reduce fatigue, lessen muscle loss, and prevent the gain of body fat.  Physical activity is also important for weight management. Behavior Change Support For many, being overweight or obese is more complex than simply eating too much and exercising too little. It’s important to get support when you are trying to lose weight. There are many studies showing that working with a weight loss specialist/wellness coach can help you make healthy lifestyle changes and stick with them over time. More information about Janine and her healthy tips can be found on her website.

Jan. 21, 2019| By Diane Mapes / Fred Hutch News Service Original article published on FredHutch.org here. Study reveals how blood vessels in the bone marrow protect dormant tumor cells, suggests a way to kill them in their sleep. Fred Hutch translational researcher Dr. Cyrus Ghajar talks about the spread of breast cancer tumor cells during the third annual Northwest Metastatic Breast Cancer Conference in October 2018. Video excerpt by Connor O'Shaughnessy / Fred Hutch News Service Researchers at Fred Hutchinson Cancer Research Center in Seattle may have found a way to essentially smother cancer cells in their sleep, preventing them from ever waking up and forming deadly metastatic tumors. The work, led by translational researcher Dr. Cyrus Ghajar, has also turned on its ear the longstanding belief that chemotherapy can’t kill dormant disseminated tumor cells — cancer cells that escape early on and hide out in other regions of the body — because those cells are in a “sleeper state.” They’ve stopped growing so chemo, which blindly targets all fast-growing cells, healthy and otherwise, doesn’t work. That’s not quite the case. “It’s always been assumed that dormant cells cannot be killed by any kind of chemotherapy because they’re not dividing,” said Ghajar, who runs the Laboratory for the Study of Metastatic Microenvironments at Fred Hutch. “But what we’re showing is that’s not true. They’re relying on survival signaling in their microenvironment, in this case specifically from blood vessels within the bone marrow. And if you can take away that signaling, you can sensitize them to chemotherapy.” Ghajar’s paper, published today in Nature Cell Biology, is the culmination of more than four years’ work and proposes both a paradigm shift in how we view dormant disseminated tumor cells — and a new therapy to potentially slay this sleeping giant. Although it’s still early days, Ghajar and his team slashed the metastatic relapse rate in his mice by more than two-thirds. Rebecca Seago-Coyle, a 43-year-old IT project manager and breast cancer survivor who worked with the team as a research advocate, said she loved Ghajar’s innovative approach — and his inclusiveness. “One thing I love about Cyrus is that he makes room for patients,” she said. “We always have a seat at the table. I’m not metastatic, but I still have that fear that the cancer could come back. Thirty percent of early stagers go on to become metastatic. If we could lower that number, that would be huge.” The nonlinear path to metastasis Cancer doesn’t just spread because a primary tumor has reached a certain size or stage. Disseminated tumor cells, or DTCs, can break off before a tumor has even formed and travel to distant sites in the body where they lie dormant until something “wakes them up” and they start the deadly process of metastasis, or cancer spread/colonization. One common hideout for these sleepy creeps is the bone marrow. Dormant tumor cells have been found in the bone marrow of breast cancer patients at the very earliest stage of the disease — DCIS or stage 0 — and Ghajar said they’re mostly likely present in other patients with early-stage disease, as well. Past research has shown an association between DTCs in the bone marrow of cancer patients and metastatic recurrence — and not necessarily just bone metastasis. “Patients with breast cancer cells in the marrow recur more often than patients who don’t have cells in the bone marrow,” said Ghajar, who collaborated with a cadre of Fred Hutch researchers as well as scientists from the University of Colorado Anschutz Medical Campus and the University of California, San Diego. “And tumor cells in the bone marrow predict metastasis in a variety of different sites. They even predict metastasis in cancers that never get bone mets.” Why disseminated tumor cells snuggle up to the bone marrow microenvironment where they go dormant is still a bit of a mystery, although we do know that dormant blood stem cells hang out in the same place. What wakes the sleeping cancer cells up and starts them growing again also remains a huge question. But Ghajar said there’s scientific evidence that “if you can successfully remove disseminated tumor cells, you can prevent those patients from having mets.” And that has become the focus of his work. Breast cancer’s ‘long tail’ For this research, Ghajar and his team focused on the most common type of breast cancer, estrogen-receptor positive (or ER+), which comes back as metastatic disease five or more years after treatment in up to 17 percent of early-stage patients. In comparison, the metastatic recurrence rate for all breast cancer patients is thought to be between 20 and 30 percent. “There’s this long tail in ER+ breast cancer where patients will go for years and years without any kind of problem and then five, seven, 10, 15, 20 years later, they have a recurrence,” Ghajar said. Unlike some early-stage cancers, metastatic disease is incurable. Patients with stage 4 disease are in treatment for the rest of their lives. And while some patients live with their cancer for years — or even decades — when their treatment stops working or they run out of options, they die. Ghajar’s finding, if it holds true, could reduce the number of early stagers who go on to become metastatic, effectively snipping off breast cancer’s long tail. “We’re not trying to treat a primary tumor or trying to treat mets,” he said. “We’re trying to treat DTCs, for which there are no current therapies.” Teri Pollastro, 58, another research advocate who worked with Ghajar, went from DCIS, or stage 0, to stage 4 years after her initial treatment. She believes her advanced cancer was a direct result of awakened DTCs. “That’s exactly what happened to me,” she said. “They stopped treatment and the stuff that was quiet and sleeping came to life.” Uncoupling dormancy and chemo resistance Ghajar said work he did as a postdoc in the lab of Dr. Mina Bissell at Lawrence Berkeley National Laboratory, as well as research done at the Hutch by Dr. Pete Nelson, led him to question the conventional wisdom of DTCs surviving chemo due to their paused cell cycle. “We’ve seen evidence that quiescent cells respond to chemo,” Ghajar said. “They seem to sense when you dump chemicals on them. And there’s been other evidence that architecture — the microenvironment — may be more important than the cell-cycle state in terms of the response to chemotherapy.” Tumor microenvironments are the noncancerous cells and molecules surrounding tumor cells; they're often co-opted by the cancer to help it grow. To pursue this scientific question, Ghajar and his team looked at how DTCs behaved in two preclinical models: mice with breast cancer and organotypic cultures, i.e., human blood vessels and bone marrow tissues growing in a dish. The researchers first dosed mice with chemotherapy, then looked for DTCs in their bone marrow. The only tumor cells that survived were those that were nestled close to the microvasculature, the tiny blood vessels of the bone marrow. They then seeded the organotypic cultures with human breast cancer cells. The tumor cells surrounded by blood vessels grew dormant; those without blood vessels continued to rapidly divide. The team then treated the tiny tumor environments with chemotherapy to determine whether DTC survival was coincidental, or something else. “When we added increasing doses of chemotherapy, we noticed that without blood vessels, the breast tumor cells died,” he said. “And with the blood vessels, the breast tumor cells didn’t die. So maybe the blood vessels were protective.” To find out, Ghajar and his colleagues used a growth factor to wake up the dormant cells, then treated them with chemotherapy. Conventional wisdom held that the awakened DTCs would be killed because they were now active and rapidly dividing. But that’s not what happened. “It didn’t matter at all that we had woken them up,” he said. “The chemotherapy had no effect because the blood vessels were there.” Silence the signal, kill the cancer The researchers then went about trying to determine what it was about the blood vessels that offered protection to both active and quiescent cancer cells. In collaboration with Peter Nelson’s laboratory at the Hutch, they used RNA sequencing to a look at the genes that were being activated or expressed in the organotypic cultures both with and without the blood vessels. They then used protein analysis or proteomics to discover what, exactly, was being secreted and deposited on the surface of the various cells that might result in this protection. Eventually, they found the answer. “The main thing that was being enriched when blood vessels were present — as opposed to when they weren’t present — were molecules that bind integrins,” Ghajar said. Integrins are proteins that, among other things, help with cell signaling; they integrate signals from the outside of the cell with the inside of the cell. Humans produce different types of integrins, and there are also several existing molecular inhibitors, or “off-switches,” for them. The research team screened these integrin inhibitors to see if any would interrupt the blood vessels' protective signaling and found two that did just that. They then combined integrin inhibition with chemotherapy and tried it out on the preclinical model of human bone marrow — to great effect. “When we interrupted signaling from those two integrins, we started sensitizing cells to chemotherapy,” Ghajar said. “Chemo on its own would kill one third of all the single cells in our culture. But when we combined integrin inhibition and chemotherapy, we killed over 90 percent of the single cells in our cultures.” What’s more, the team was able to kill the DTCs without first waking them up, showing that cell division was not necessary to get chemo’s toxic attention. Once the researchers moved onto mouse models with this new combo therapy, they were able to reduce the reservoir of DTCs in their bone marrow by 94 percent. Further, by following the mice for a number of months, they determined their odds of metastatic recurrence were greatly reduced. “With only chemo, over 70 percent of the mice relapsed with mets,” Ghajar said. “But when we used the combo only about 22 percent of them relapsed with bone mets. We were able to save a lot of mice from relapsing with breast cancer metastases using this approach.” Next steps for the science The big question, as always, is “Will it work in humans?” “Oftentimes, you have something that looks beautiful in a mouse, but when you try it in a human, it never works the same,” Ghajar said. “But we really tried hard to mitigate that by the models we used.” Ghajar said his next step will be to make human versions of the molecule he used for integrin inhibition and then test them to make sure they’re safe in people. Once that’s established, the research can move toward a clinical trial that tests the new combo therapy on cancer patients. Although cautious about getting ahead of the science (a clinical trial could be three to five years away), Ghajar does believe his research demonstrates that dormant cells can be killed by chemo without waking them up, which is significant in and of itself. “No matter what happens with regard to the specific molecules we’ve discovered, that concept is going to endure,” he said. Could this potentially help patients currently living with metastatic breast cancer? Ghajar said it’s too early to draw any conclusions about that. “We’re trying to find a way that we can augment therapy up front to kill the roots of metastasis before they arise,” he said. “Would this possibly be a way to eliminate the cells that are going to seed the second met or the third met or the fourth? There’s potential, but it’s not something we trialed experimentally.” Pollastro, the patient advocate living with metastatic disease, said she’s optimistic, despite the nascent stage of Ghajar’s work. “Everything starts in a mouse model, doesn’t it?” she said. “I’m very hopeful. And that’s a great next question for him to investigate. Wouldn’t it be wonderful if that worked?” Funding for this research came from Fred Hutch, the Cuyamaca Foundation, a Department of Defense Era of Hope Award, Breast Cancer Research Fund, National Breast Cancer Coalition’s Artemis Project for Metastasis Prevention, Susan G. Komen, the National Institutes of Health/National Cancer Institute and the Fred Hutch/University of Washington Cancer Consortium. Diane Mapes is a staff writer at Fred Hutchinson Cancer Research Center. She has written extensively about health issues for NBC News, TODAY, CNN, MSN, Seattle Magazine and other publications. A breast cancer survivor, she blogs at doublewhammied.com and tweets @double_whammied. Email her at dmapes@fredhutch.org. Are you interested in reprinting or republishing this story? Be our guest! We want to help connect people with the information they need. We just ask that you link back to the original article, preserve the author’s byline and refrain from making edits that alter the original context. Questions? Email us at communications@fredhutch.org Return to reading more blogs

Sponsored by Store My Tumor Written by Robyn Stoller Today, most people with cancer receive a one-size-fits-all approach to treatment meaning they receive the same treatment as others who have the same type and stage of cancer. However, research has now shown that each person’s cancer is unique, and each tumor may contain information critical to treating that cancer. Although still in its infancy, precision medicine is beginning to change the way cancer is treated. Here are 5 facts you need to know about precision medicine and cancer: 1. Precision medicine helps to personalize cancer treatments. The National Institute of Cancer defines precision medicine (also known as personalized medicine) as “an approach to patient care that allows doctors to select treatments that are most likely to help patients based on a genetic understanding of their disease.”[1] 2. No two cancers are exactly alike. We now know that just as no two people are exactly alike, no two cancers are alike. Using this knowledge, precision medicine aims to treat cancer by targeting mutations that allow cancer to grow and spread. To identify those mutations or genetic changes that drive a particular person’s cancer, we test DNA from their tumor(s). This is known as “molecular profiling” and “genetic sequencing”. This testing may also help patients avoid treatments that are ineffective, unnecessary and potentially harmful. 3. Precision medicine is transforming the way some cancers are treated TODAY. Several cancers are already benefiting from precision medicine treatments. Today, oncologists can prescribe targeted therapies to cancer patients whose tumors have certain genetic mutations. For example, Trastuzumab (Herceptin®) or lapatinib (TYKERB®) may be given to a woman whose lab tests show that her breast tumor has too much HER2. Everolimus (Afinitor) may be used for women who have gone through menopause and have advanced hormone receptor-positive, HER2-negative breast cancer. As a result, patients are experiencing better outcomes with fewer adverse effects compared to standard chemotherapy. Please note: At this time, not all mutations can be matched with known treatment options. 4. Immunotherapy is already helping to save lives. One of the most promising areas in cancer research and precision medicine today is “Immunotherapy“ which uses the body’s own immune system to prevent, control and eliminate cancer. Credited as the first therapy ever proven to extend the lives of patients with metastatic melanoma, immunotherapy is changing the way some cancers are treated today. In fact, immunotherapy offers such great promise that one day we may have a new kind of doctor called immuno-oncologists. 5. StoreMyTumor is the first step to personalized medicine. Your tumors contain critical information needed to personalize your cancer treatments. When live cancer cells and tissue are stored properly, additional and more effective cancer treatment options may become available to you. Personalization is a process. It starts with having access to the cancer cells, then testing the tumor to identify the best drug(s) that will kill cancer cells. StoreMyTumor, the leader in tumor collection, processing and storage services, connects you to cutting-edge technologies that are beyond standard treatments. To learn more about personalizing your cancer treatment, schedule your FREE consultation today with our Patient Advisor! [1] https://www.cancer.gov/about-cancer/treatment/types/precision-medicine

By Bria Mackay, South Wales Joanne Mackay was a vibrant and caring woman who lived with nothing but love to give to those surrounding her. Her zest for life, love for others and faith in a higher power outweighed all obstacles that she faced. This is the story of her battle with breast cancer and how her vision of creating a support network for Breast Cancer patients came to fruition. In the year 2000 the Mackay family were settling back into sunny beachside life after a year of living in England. Brad Mackay had just finished a successful NRL (Rugby League) career and hung up the footy boots for a more laid-back family lifestyle on the beautiful shoreline of Stanwell Park, Australia. Joanne, a former midwife and nurse was focusing on mothering her two children Angus, 7 and Bria, 5. She was expecting her third child later that year. On the 22nd of December 2000 the family was blessed with the delivery of Tully. Things were blissful in the Mackay household until one morning whilst breastfeeding Tully, Jo noticed an unusual lump in her left breast which caused her concern and she immediately phoned to make an appointment with her local doctor. Intuition told her that something was not right. It was late February and Tully was not even nine weeks old. The doctor arranged tests to be conducted immediately and on Tuesday 6th March 2001 Jo received a phone call that would forever change the lives of the Mackay family. Joanne was diagnosed with stage IV aggressive breast cancer at the prime age of just 36 years old. “It’s now just over three weeks since I was diagnosed with breast cancer and had a mastectomy on my left breast. My first chemo session was eight days ago and since then I have felt tired, sick and lethargic. That is just the physical side! Emotionally I cannot begin to express the roller coaster ride I have been on since that horrible Tuesday afternoon that the breast surgeon rang me with the news. One minute I’m living in my perfect world, Stanwell Park in summer with the sound of the waves crashing on the shore, the parrots squawking, the sea salt air, my two oldest children playing happily, my gorgeous husband about to become a fireman and me, mother for the third time to little angelic Tully…then a freight train from out of nowhere hits me at 100 miles an hour and completely wipes out my picture perfect world.” (exert from Joanne’s diary entry on 25th March 2001). Joanne bravely underwent a double mastectomy and had multiple rounds of chemotherapy. It was during this treatment that Jo became aware of the various struggles other breast cancer patients around her were facing. Whilst she had an abundance of support from her dedicated friends and family and was in a comfortable position financially, Joanne’s heart broke for the women she met who did not have these things. Jo began speaking about the idea of a foundation; one that would work at a very hands on level. She wanted to be able to provide women with the support that she felt so lucky to have. Jo had met single mothers who had to give up work to undergo treatment and therefore could not afford to pay their utility bills or buy groceries to provide for their children. She met one woman who had just moved countries with her husband and didn’t have her immediate family nearby for support. She met women who did not have the means to afford the gap payment of their chemotherapy. Another woman she met had to catch a public bus to and from treatment as there was no one close to her who could drive. All these things broke Joanne’s heart. She wanted to create a centre for women who needed extra support. She dreamt of the day that she would be well again so that she would be able to dedicate the rest of her life to caring for this community of women. Tragically, Joanne lost her battle on the 11th of July 2002 surrounded by her family and loved ones. Joanne was survived by a group of passionate women whose goal became realising her vision and so in her honour the Joanne Mackay Breast Cancer Foundation (JMBCF) was created. JMBCF, otherwise known as Jo’s Helping Hand has since been supporting the breast cancer community in New South Wales, Australia. For over sixteen years the foundation has operated entirely off kind donations and has been run solely by a small and dedicated team of volunteers. The Directors include Joanne’s mother Maureen Eades, close childhood friend Leanne Reed and as of 2019 her daughter Bria who took on the role at the age of twenty-two. JMBCF’s mission is to ease the burden placed on one’s life after the initial diagnosis of Breast Cancer. Patients are referred to the foundation through many oncologists and nurses working across four different hospitals in Sydney, Sutherland Shire and Wollongong. JMBCF offers transportation for patients, cleaning services for their homes, premium quality wigs and financial aid to cover excess treatment costs, utility bills and groceries bills etc. Until recent years the foundation provided patients with prosthetic breasts however this has since become a service covered by Medicare. The foundation has to date supported over 1,300 women and their families, averaging a total of 81 women each year since it was founded in 2002. The Foundation has always worked as a small charity allowing them to form individual relationships with each patient. Incredibly, Joanne’s Mother Maureen personally phones and writes to each patient regularly throughout their personal journey. In recent months the foundation has undergone a re-brand with the intention of gaining more awareness and expanding their network to support breast cancer patients Australia wide. The Team are working hard at launching new fundraising events and forming partnerships with other breast cancer organisations. Jo’s Helping Hand will be carried throughout decades to fulfil her inspiring legacy. For more information please visit: https://www.joannemackaybreastcancerfoundation.org/

Wildfire Magazine Interview With Director Paula Mozen, June 2018 Issue A few months after I was first diagnosed with ILC breast cancer, I was speaking with a film friend and she said, “ well you know, YOU should make a film about this, you have the film awards and now you have the breast cancer credentials.” And I said absolutely not. It was a shocking diagnosis for me and I just wanted to get it over with and move on with my life. The last thing I want to do is get involved with a film, a project that I knew would take several years. As a documentary filmmaker, two of my previous documentary films that garnered international attention, were no rewind and 3 girls I know…These documentaries viewed health and societal issues through the lens of diverse female experience. The topics covered included teenagers and HIV and young women coming of age as they are dealing with teen pregnancy, coming out gay to their friends and family and living with AIDS. As I dealt with my breast cancer, the film idea came up again and again and I kept rejecting it. I didn’t think I would be an interesting subject and I didn’t want o make a personal film. I prefer to be behind the camera, not in front of it. As I got more distance from my diagnosis, I began to read more articles about breast cancer in the general population, and see more mention of diverse survivors who connected online and at conferences. I became aware that each breast cancer diagnosis is unique to the individual in terms of the chemistry of the tumor, how it interacts with each person’s unique body and how individual circumstances influence access to treatment, choices and longevity. “One size does not fit all” when dealing with each individual’s circumstances and cultural context. Each person’s breast cancer situation is unique. Breast cancer patients are often asked to make their own choices in terms of treatment. The moment the diagnosis is received, each person must gather information and make life-altering decisions under extreme emotional duress, all in a relatively short period of time. Individual circumstances are unique and yet, breast cancer is an equal opportunity disease. It doesn’t care if you’re rich or poor, black, white, Asian, or brown. It doesn't care if you live in the North, South, East or West, in the city or in rural isolation. It does not discriminate. It was at this point, as I was realizing all of this, that I knew I wanted to make a film. Hearing and seeing truthful stories from articulate and resilient women who have traveled the road before would be invaluable for navigating the treatments and keeping hope alive. Knowledge is power, the successful prevention and treatment of breast cancer depends on this. The film would have a purpose and that is what motivated me to finally take on the project that eventually lead to the film LIFE INTERRUPTED. I wanted to include multiple stories, multiple perspectives to simultaneously show the uniquely personal aspects and universality of the disease process. I also wanted to use my own experience to connect with other women-we were, after all, sisters by way of our experiences with breast cancer. I wanted to connect with women who were, in my opinion, underrepresented in the media portrayal of breast cancer: women of color, rural women and younger women. Eventually, I made the film I wish I could have see when I was diagnosed. LIFE INTERRUPTED is an open and honest film about some of the most deeply personal aspects of a breast cancer diagnosis. Waiting in doctor’s offices, taking off my clothes to be poked and prodded and waiting for test results to make life saving/life altering decisions, took up most of my time during my diagnosis. This is not unique to me and my experience. After diagnosis, we focus in on what needs to be done. In my case, I think I disassociated from my breasts in order to “get the facts” and put information together to make intelligent decisions. I did not feel I could get all emotional about it I am as vain as the next person - believe me - but for that moment in time, when I was going though two separate breast cancer diagnosis and finally the mastectomy, I was dissociated from my breasts and my inhibitions. As the director of the film, and so I became one of the patients depicted in the film. I would not ask anyone else to do what I myself would not do in front of the camera, that just did not seem ethical or fair. It may affect the ability to show the film in more places but I do think that if you are doing a film on breast cancer, you kind need to be able to show breasts (in this case mine). These are true stories after all. My mom was diagnosed with metastatic breast cancer at age 65. Although she had yearly mammograms, they failed to detect her tumor. I believe this failure over time lead to her being diagnosed with MBC. She had a lumpectomy as part of her diagnosis but she never had a mastectomy. Her cancer had already spread to her stomach and bones, it was not warranted for her situation. Her disease influenced my checking of my own breasts on a monthly basis which lead to me finding my first lump, which I found 2 months after a clean mammogram. We both had very dense breasts, which I believe played a big role in the failure to detect our individual tumors. My decision to have a bilateral mastectomy was made for the following reasons combined: I was diagnosed twice within five years, I was the daughter of a breast cancer survivor, I was premenopausal and ILC is known to jump to the other breast. Though I was only diagnosed with breast cancer in my right breast, both times, I decided to go with a bilateral mastectomy. In the film, there is another survivor whose story is told; Debi. As it turned out, Debi and I both had our fathers be very present during our cancer “journeys.” There was an instant connection between Debi and I, the way we both felt about our Dad’s as support systems. I felt very fortunate to have my Dad through both diagnoses and all the treatments. He is caring and has a background in biochemistry so has a scientific and logical mind. He also spent 12 years prior with my mom after her metastatic breast cancer diagnosis. My dad was very experienced with the whole breast cancer realm, including patient advocacy and partnering with one’s doctor to make the best choices for your own situation while keeping in mind quality of life issues. I will always be appreciative of the time and energy he spent helping me navigate my choices and treatments. He was THERE for me and I will always be grateful for the time and energy he spent helping me navigate my choices and treatments. We are currently launching the film via festivals and community screenings. In 2018, the film screened seven times in three countries (Germany, United States, Switzerland) for over 2500 people, received BEST DOCUMENTARY FEATURE AWARD from Long Beach Indie International Film Festival and was nominated for a Dolores Huerta Award. Most importantly, as the filmmaker, I was able to attend most of the screenings and meet with dozens of breast cancer survivors, caregivers and family members who told me what a positive impact the film had on them, a moving and humbling experience for me as both a survivor and filmmaker. AND WE ARE JUST GETTING STARTED… In 2019 we will continue with screenings and collaborate with community organizations to bring screenings to many more people, providing HOPE for survivors as it promotes understanding and education to everyone about what it truly means to survive breast cancer. Our ultimate call to action is: · Take responsibility to advocate for one’s own health. · Get exams and diagnostics when appropriate · Make decisions from knowledge rather than fear. · Instill hope · For people who aren’t personally diagnosed, to support survivors in their lives and to support research and programs that directly benefit survivors. Finally, I hope to use this film to start a foundation to provide young survivors financial resources to help them make it through their diagnosis and treatments. Putting a huge hole in the pocketbook is a well-known and experienced side effect of any breast caner diagnosis. If you would like to see a screening in your area or want to find out more about the film, please click here For more information about the film including trailer, press, awards and more click here Note: This piece has been updated & republished with permission from WILDFIRE Magazine, the 2018 “Body” issue (Vol 3, No 3, Copyright (c) June 2018 by Wildfire Community LLC). More information available at wildfirecommunity.org.

Published by Sponsor Store My Tumor Only by recognizing that each patient is different, oncologists can begin to design tailored and effective treatments, but this requires the patient’s tumors (cancer cells and tissue) be preserved alive. StoreMyTumor helps patients collect, process, and preserve their tumors alive (for all indications). Because: FACT: Two people with the exact same cancer diagnosis can and do respond differently to the exact same treatment regimens. Each person is unique and so is their cancer. FACT: Up to 50% of cancer patients do not respond to traditional treatments and are forced to explore advanced diagnostics and personalized treatments that requires your tumor. FACT: When you match the RIGHT targeted therapy or chemotherapy to the RIGHT tumor, tumors can shrink and hopefully the cancer goes into remission or at least remains stable. FACT: A new class of treatments called Immunotherapy (cancer vaccines) awaken and stimulate your immune system to actively fight the cancer cells with and with out toxic side effects. FACT: To potentially benefit from personalized treatment options, you need tissue from your specific tumor. This tumor tissue can only be collected at the time of biopsy or surgery. StoreMyTumor preserves patients’ tumors in multiple formats so that the preserved tumor is compliant with most advanced diagnostics and treatments. The process StoreMyTumor can work with any hospital or cancer center. The patient seeks this service before the surgery. StoreMyTumor obtains the patient’s consent and sends the patient a collections kit with detailed instructions for the surgeon. Once the tumor is packed and the kit is received back, StoreMyTumor processes the tumor and preserves it. Patients then work with their oncologist and StoreMyTumor and instruct StoreMyTumor to coordinate parts of the tumor sent for diagnostics and parts for immunotherapy, thus allowing them to maximize their potential therapeutic and diagnostic options. What is a preserved tumor used for? Advanced testing: Tumor is tested to identify the drug or combination that will and rule out drugs that will not. This is important to identify the idea drug-cocktail from day one as opposed to trying to learn. Personalized immunotherapy: Tumor is used in preparing cellular immunotherapies that awaken and stimulate the immune system to fight the cancer. There are different types of immune-therapies including: Vaccines and T-cell therapy. Bottom line Patients must make this decision before the biopsy or surgery or ascites drainage. Every tumor is unique and contains information critical to treatment, but tumors are not preserved in the right formats by the hospital and are routinely discarded as medical waste. As the disease advances, standardized treatments are often not enough. Having the tumor preserved is the only way to testing it and using it to create more customized treatments and strategies that are more likely to work. It is a process, and this is personalized medicine at its best. StoreMyTumor is the trusted tumor preservation service leader for cutting edge cancer centers worldwide. Team StoreMyTumor +1.267.702.5501 cs@storemytumor.com www.StoreMyTumor.com

At survivingbreastcancer.org a 501(c)(3) non-profit, we seek to offer community, support, education and health and wellness assistance for breast cancer survivors and their caregivers. A topic that frequently arises in our community is the issue of partners, boyfriends, girlfriends, fiancés, husbands, family and friends "divorcing" (literally and figuratively) themselves from the breast cancer diagnosed patient. This divorce/broken relationship rate may run as high as 50% or more according to breast cancer thriver, Abigail Johnston. The reasons are many, but selfishness and being overwhelmed, i.e., lack of understanding of the role of a caregiver, appear to be the leading factors. One of our Breast Cancer community guest bloggers eloquently posted the following: “Our relationship started to spiral downward, and very quickly. In fact, deep, down inside I knew as soon as a month after my diagnosis that “forever” wasn’t going to happen. But I held on. Even after he laughed at me and called me pathetic when I had trouble getting into the car a week after my 10-hour mastectomy surgery, drains distending from my sides, I held on. Even after our fight because I had to shave my head when my hair wouldn’t stop falling out, I held on. Even after sitting through a 5-hour chemo, crying, because a fight had gotten so bad that he shoved me into the car door, 10 minutes prior to walking through the cancer hospital door, I held on. Even after he told me he would rather not spend New Years with me because I wouldn’t be any fun due to a chemo infusion I had a few days before, I held on. In retrospect, in the beginning, I do think he cared. However, ultimately, it was too overwhelming for him. Cancer is messy. It’s dark and scary and forces you to face your own mortality. Want to know a secret? It’s like that for you AND the people around you. It is, indeed, something that not everyone can handle and you know what? That’s okay. However, over the past two years, I’ve learned that I would rather surround myself with people who CAN handle it. I would rather be with a man who understands that I’m worth more than a phone call, two days before a surgery, telling me that he no longer wanted to be in a serious relationship because the past 6 months had been too hard on him and he was too young to be going through such a trying ordeal.” Feelings of fear and helplessness When a couple faces an illness like cancer that threatens their entire way of life, there are bound to be feelings of anger, fear, helplessness, bitterness, and exhaustion. While they wade through these feelings, they are also faced with new roles they have to fill (or can’t fill), financial uncertainty, and a complicated future including many trips to the oncologist, surgery, possible overwhelming financial obligations, etc. Partners may struggle with their new roles and feel inadequate—or overwhelmed. If there were underlying problems in a relationship before an illness, the added strain may prove to be too much. As partners face the reality of their mortality, what they really want in life and what they’re willing to give up come into sharp focus. According to recent studies (all credited below CB) it seems like women were less well-supported by their partners than men were while undergoing treatment for serious illnesses. The study found that couples were far more likely to separate if the female partner was the one being treated. The effect of divorce on health risks is also well researched, but less understood is how health, or the lack of it, may affect the risk of divorce. Another study (CB) of older couples finds that marriage is more likely to end in divorce when the wife is ill than when the husband is ill. That study finds the risk of marriage ending in divorce when a spouse falls ill is higher when that spouse is the wife. Illness can stress marriage in a number of ways. One way that spouse illness can stress a marriage is when the healthy spouse is the primary caregiver and may also have to take on sole responsibility for supporting the household. Another stressor can be differences about quality of care. A third study (CB) found that wives are generally less satisfied with the care they receive from their husbands, probably because - and this applies to older men in particular - men have not been raised to be caregivers in the same way as women and may feel uncomfortable when thrust into the role. Serious illness is a life or death experience that can make people stop and think about what is important in their lives. A fourth study (CB) found a significant gender difference in divorce following illness of a spouse. They were interested in people who were married at the start of the study period, and because they wanted to examine the effect of falling ill during that period, they excluded marriages where a spouse was already sick at the beginning of the study. Age was tied to an increased chance of getting a serious illness, with husbands experiencing higher rates than wives. While the onset of illness in the husband was not linked with raised chance of divorce, illness in the wife was linked to a 6% higher risk of being divorced before the end of the study period. This was a significant gender difference. A cancer diagnosis brings physical and emotional challenges, requiring both excellent medical care and a strong personal support system. When a couple chooses to divorce or separate during this time, managing the personal loss can present another hurdle. As difficult as this can be, there are strategies that can help you cope. Does the blame rest with a Cancer Diagnosis? It can be tempting to blame a separation or divorce on cancer, but most experts agree that it’s far more likely that the stressors related to the disease simply highlight weak areas that already exist within a relationship. The intensity of emotional and physical stress during this time magnifies patterns of behavior within relationships, as couples confront changing roles and responsibilities. The caregiver may need to step up to take over tasks that the patient previously handled, which can be a difficult transition; both partners will need to learn to manage and express feelings of fear, resentment, anger, anxiety and grief that arise; and, financial stressors may develop, especially if the patient is unable to work or if outside help has to be brought in to handle household or childcare. In the end, solid marriages may even be further strengthened by the true partnering of spouses in together facing the threat that the cancer poses to their relationship. While some troubled marriages improve, with cancer refocusing the partners on what is truly important in life. In other teetering marriages, a cancer diagnosis represents the final blow, leading to separation, as this additional set of fears and issues simply overwhelms one or both partners. In some cases, couples may make it through the treatment phase together, but find that the survivorship phase presents an entirely new type of stress that highlights underlying problems in the relationship. For some survivors, a cancer diagnosis inspires the desire to make healthier choices in their lives, and that may include ending an unhealthy relationship. A fifth study (CB) indicates that issues that arise in a relationship during cancer can make patients aware of problems and inspire them to make changes. They may recognize, they now have a different direction in life, but the other person isn’t really interested in this new direction. Like any other crisis, if one person feels like he or she has developed or changed, and the other person hasn’t grown, they can outgrow each other. Navigating your way Whatever the underlying causes of a divorce or separation, employing strategies (CB) to cope with the new reality and ensure your own well-being is essential. Work to gain perspective and to recognize that this is what was happening in this situation, this is how you feel, and this is how you can feel. Focusing on the future during the treatment phase will also benefit you physically. While it’s true that the timeframe for recovery— physical, emotional and spiritual—varies depending on the type and stage of cancer and the treatment received, letting negative emotions about the end of the relationship take precedence isn’t going to help your healing process. And if you’re not able to move forward on your own, then it’s time to reach out for professional help. Look for help If you’re facing a separation or divorce, your personal network can be invaluable—family members, friends, your faith community or even work colleagues can provide social support and practical help. A cancer support group like survivingbreastcancer.org and others or individual therapy can also help you cope—not just as a person with cancer but also as a person without a partner. Look for services or groups that can tailor support to your situation and provide insight. The end of any marriage can be frightening, depressing and challenging for the former partners. The addition of a cancer diagnosis, which comes with its own fears, threats, issues and concerns, dramatically compounds the enormous challenges that result from separation or divorce. For the cancer patient whose spouse has left, the attention, involvement and support of loving family and friends can play an important and significant role in their cancer care and quality of life—providing for the patient’s physical, emotional, medical and practical needs. Steps to take to minimize the threat of divorce/breakdown of relationship after a breast cancer diagnosis. Communication, as always is the key. Talk to your partner. Express yourself. • Find some time for each other. Schedule time if you have to. • Start somewhere. Find a comfortable place. • Talk as often as possible. • Be reassuring. • Consider outside therapeutic help. • Write it down. Use texts, emails, etc to help extend the conversation. It is understood that Breast Cancer is typically a heinous diagnosis, resulting in some form of the following: surgery, chemo/hormonal treatments, and radiation, and the myriad side effects associated with all of the above. Generally it is not good for relationships, but good relationships can be made stronger by sharing hardship. As our previous guest blogger stated: "Cancer is messy. It’s dark and scary and forces you to face your own mortality. Want to know a secret? It’s like that for you AND the people around you. It is, indeed, something that not everyone can handle and you know what? That’s okay." We’d love to hear your stories associated with loss of friends, companions, family members and loved ones following your breast cancer diagnosis. The following links/ articles were reviewed to assist this blog. Special call out to all of the various doctors, therapists and journalists involved in elevating this conversation. • First Comes Breast Cancer, Then Comes Divorce - Beth Gainer ... bethgainer.com/first-comes-breast-cancer-then-comes-divorce • Divorce after breast cancer | Cancer Survivors Network • Cancer Hard on Marriages - WebMD www.webmd.com/.../cancer-cause-divorce-women • Breast Cancer And Divorce: The Struggle To Embrace Hope After ... blog.thebreastcancersite.greatergood.com/breast... • Divorced due to Breast Cancer? ~ Pink Lotus Power Up pinklotus.com/.../divorced-due-to-breast-cancer • Cancer and Divorce - Cancer Fighters Thrive www.cancerfightersthrive.com/cancer-and-divorce • Breast Cancer and Divorce treato.com › Conditions › Breast Cancer • Divorce is a more likely end to marriage when wife is ... www.medicalnewstoday.com/articles/290583.php • You and Your Partner - breastcancer.org • www.breastcancer.org › … › Sex and Intimacy

All too often we hear the story of breast cancer survivors whose loved ones couldn't cope with the diagnosis, treatment, surgery, radiation, side affects, scarring etc., and were so overwhelmed that they left the relationship. What follows is a brief descriptive characterizing the role of a care giver and the value it represents to the patient. This precedes the narrative of breast cancer survivor Krystle Hansley, whose relationship with her loved one fell apart due to the onset of Breast Cancer. In the future we will follow up with a more extensive Caregivers Guideline. Characteristics of care giving There are many characteristics of life as a caregiver.  The support that one provides to a cancer patient/survivor includes many of the following: emotional, physical, intellectual, financial, social, spiritual, nutritional, and motivational aspects to name just a few.  But you are never alone.  There is help and assistance everywhere.  I found the following links to be quite helpful in coming to terms with my role as a caregiver. https://www.cancercare.org/tagged/caregiving http://www.breastcancer.org/community/acknowledging/caregivers https://www.cancer.org/treatment/caregivers.html From diagnosis onward the responsibilities associated with caregiving kick in.  There are meetings and discussions with your oncological and surgical teams.  Options and alternative courses of action are proffered and weighed. Decisions have to be made in short order so it’s best to prepare yourself ahead of time by performing as much due diligence as you can. Do your research on the various options as spelled out by your team. Once a course of action is agreed upon and plotted take particular care to stay on top of developments, I.e. scheduled appointments, pain/emotional management, medications, coordinating and communicating information to the extended caregiving family, and helping with chores. At all times be aware that you are there to assist the patient.  This isn’t about you.  Involve yourself with the patient’s emotional issues.  You do not need to be a medical professional.  Common sense and responding through the lens of caregiving should provide you with enough tools to deal with the myriad emotions that arise, such as fear and depression/sadness.  There are many support groups that you can reach out to, including hospital care groups, psychiatrists, social/media pages, #survivingbreastcancer.org. Guest Blogger Krystle Hansley, At the start of the summer in 2016, I was in the “prime” of my life. I had a prestigious research fellowship working on a HIV vaccination project at Tulane University; I was entering my last semester of graduate school, and I spent my weekends strolling down the lively streets of New Orleans. Everything was perfect, or so it seemed. Little did I know that a storm was coming. Within a few weeks, everything would change -- forever. On July 15, 2016, while sitting on the same bed where I had spent countless hours studying some of the world’s deadliest diseases, I received a phone call that would throw my whole world into disarray. That day, at the ripe age of 27, I was diagnosed breast cancer. One of my very first phone calls was to my then-boyfriend. We had been together for a year, spent holidays together, and even discussed what we would name our future children. I imagined that he was going to be my primary support system; compassionate, understanding, and an impenetrable presence. A minute into the phone conversation, he hung up on me, frustrated at the notion that I might not come home to North Carolina to be treated. That should have been my first red flag, but I had seen The Fault in Our Stars and I knew we would be okay. He even promised that he would never leave me. That means something, right? Unfortunately, this isn’t Hollywood and I wasn’t Hazel Lancaster. Our relationship started to spiral downward, and very quickly. In fact, deep, down inside I knew as soon as a month after my diagnosis that “forever” wasn’t going to happen, but I held on. -Even after he laughed at me and called me pathetic when I had trouble getting into the car a week after my 10-hour mastectomy surgery, drains distending from my sides, I held on. -Even after our fight because I had to shave my head when my hair wouldn’t stop falling out, I held on. -Even after sitting through a 5-hour chemo, crying, because a fight had gotten so bad that he shoved me into the car door, 10 minutes prior to walking through the cancer hospital door, I held on. -Even after he told me he would rather not spend New Years with me because I wouldn’t be any fun due to a chemo infusion I had a few days before, I held on. In retrospect, in the beginning, I do think he cared. However, ultimately, it was too overwhelming for him. Cancer is messy. It’s dark and scary It forces you to face your own mortality. Want to know a secret? It’s like that for you AND the people around you. It is, indeed, something that not everyone can handle and you know what? That’s okay. However, over the past two years, I’ve learned that I would rather surround myself with people who CAN handle it. I would rather be with a man who understands that I’m worth more than a phone call, two days before a surgery, telling me that he no longer wanted to be in a serious relationship because the past 6 months had been too hard on him and he was too young to be going through such a trying ordeal. I WAS worth more than that and just to be clear; YOU are worth more than that. You are worth someone who will lay on the bathroom floor with you when the chemo starts to kick in, but your nausea medications don’t. You are worth someone who will parade you around a college basketball game with your bald head like a full moon shining. You are worth someone who brings you your favorite snacks during chemo, even if you end up hating them after (it’s the thought that counts). You are worth someone who tells you they will not leave you, and means it. The situation with my ex devastated me. It broke me into a million little pieces. In fact, it thrusted me into a dark depression; one I thought I’d never get out of. But you know what? Two years later, I’m still here. Thanks to people who didn’t give up on me, and still don’t. Thanks to friends who broke into my apartment when I was so sedated on Oxy that I couldn’t get off the couch, much less communicate with anyone for 24 hours. Thanks to my family and closest friends who WILL sit on the bathroom floor with me when I think I’m dying. And last, but definitely not least, to a newfound Faith in God and the blessing that He bestowed upon me when He removed my ex from my life. I still have “those” days; those days when I wallow in self pity, but at the end of the day, I know a brand new one is coming. So, I pick myself off the floor, straighten my crown, and keep it moving. I haven’t done a health update lately so here is the latest after my appointment with my oncologist today: As I’ve previously mentioned, neither one of my oncologists want me to carry a baby due to several factors including my hormone status and BRCA mutation. My BRCA mutation not only gave me a higher chance of breast cancer, but also, a much higher chance of ovarian cancer (mine is 40%, the normal population is around 1%) Ovary removal is recommended for BRCA+ mutants. After careful consideration, I’m contemplating getting mine out sooner rather than later. Sooner being May of this year. If I decide to do this, I will be giving up the chance to ever conceive naturally. I’m asking that you all please pray for guidance because this is a huge decision and one that would change my life, forever.

By Dr. Paula Gordon. Canadian women should be outraged. The Canadian Task Force on Preventive Health (CTF) released its latest guidelines for screening for breast cancer for women at average risk. They advise against mammography for women aged 40-49, against women doing breast self-examination (BSE), and against doctors doing breast exams. They recommend women age 50-74 have mammograms every 2-3 years. A 2014 study of screening in Canada showed 40% fewer deaths among women who had screening mammograms than women who didn’t, but the CTF deliberately chose to ignore observational studies done with modern mammography equipment, in favour of Randomized Control Trials (RCTs) from the 1960’s to 1990’s, which show only a 15-20% mortality reduction. The only measurable outcome of a RCT is how many women die of breast cancer, so the CTF ignores three other significant benefits of early detection of cancer: the ability to avoid mastectomy, lymphedema and chemotherapy. How can the CTF not recommend annual mammography starting at age 40, if it saves the most lives, and allows more women to have less aggressive treatment? The answer is they focus on “harms”: the number of women who are recalled for additional tests after screening, and “overdiagnosis.” About 10% of women need additional tests after screening. The CTF uses the pejorative term, “false positive.” That term implies that a cancer was diagnosed, when none was present. This is not the case: women are recalled when there is a potential cancer. This causes anxiety for many women, but it’s transient, and studies show that it doesn’t harm women long-term. The CTF gives undue weight to overdiagnosis in the harms-to-benefit discussion. Overdiagnosis is the theoretical possibility that a woman will be diagnosed with breast cancer and treated for it, but die of something else (like a heart attack) before she would have died of cancer. The rate of overdiagnosis can only be estimated. Experts estimate it at 10% or less. The CTF says that most women age 40-49 would choose not to be screened. From my thousands of conversations with women during my career and in published research, when told that mammograms can prevent breast cancer death, and allow them to have a lumpectomy and avoid chemotherapy if cancer is detected early, most women choose to be screened. The CTF calls breast density an emerging issue. We’ve known about it for 40 years! Having dense breasts is a higher risk than having a mother or sister with breast cancer. Mammography is 96% sensitive in fatty breasts but only about 50% sensitive in the densest breasts. And when cancers go undetected by mammography, they grow larger and can spread by the time they are found. The CTF has not acknowledged the harm of not offering supplementary screening for women with dense breasts. The CTF says there’s insufficient evidence to recommend supplementary screening for women with dense breasts because of their insistence on RCTs. An RCT of screening ultrasound is underway in Japan but it will take at least 7-10 years before it can prove mortality reduction. We have observational data from multiple studies showing that ultrasound finds an additional 3-4 cancers per thousand women. Finding these cancers earlier will allow less aggressive treatment AND reduce mortality. With convincing observational data available, women shouldn’t have to keep dying prematurely until the Japanese RCT is complete. The CTF exaggerates the “harms” of screening, but they don’t mention the harms of not screening. Yaffe calculated, using a model based on CISNET, that in Canada approximately 4,000 more woman can be expected to die of breast cancer in the next decade, if the CTF guidelines are followed, rather than starting screening at age 40. The CTF refuses to consider evidence other than RCTs. The Canadian taxpayer is funding this misadventure that will lead to loss of life, and unnecessary suffering for women who develop breast cancer and are denied early diagnoses when cancers are small, confined to the breast, and most successfully treated. Annual mammographic screening starting at age 40 saves the most lives, albeit with inconvenience and stress of recalls and the theoretical possibility of over diagnosis. Supplementary screening for women with dense breasts can detect early cancers missed on mammography, saving more lives. All women and their family doctors deserve to have all the facts, and the option of shared decision-making, to decide whether the harms outweigh the real benefits. Instead of protecting women from screening, it’s time to start saving women’s lives.

Guest Blogger, Katerina Gmitter, Founder of EcoThriver.com How green and clean is your cleaning routine? Did you know that conventional cleaners can introduce hundreds of chemicals into your home? Did you know that there is no FDA approval needed on many of the chemicals in cleaning products? Due to trade secrets companies do not need to disclose their full ingredient list. This allows hundreds of chemical compounds to be included in one ingredient, fragrance or parfum. Why does it matter? Many cleaning supplies and household products can cause irritation of skin, eyes, or throat, cause headaches, cancer, and other health problems. Many products contain volatile organic compounds that are harmful and when inhaled. This includes air fresheners, fabric softeners, scented laundry detergent, ammonia and bleach (found in many cleaners including dishwashing detergents). Did you know there are ingredients used in the U.S. that are banned in European countries due to their toxicity? This January I celebrate 9 years of cancer survivorship! When our family first decided to go “eco” and “nontoxic” I was beyond overwhelmed. I just finished treatment including a double mastectomy and 6 months of chemotherapy. I met with a nutritionist (helpful) and a cancer survivorship “guru” (not helpful) who literally was on my living room floor simulating how to give myself a coffee enema. That is when I delved into my own research on how to eliminate household toxins, live a cleaner and greener life, how to reduce my personal risk of recurrence and raise healthier kids. By going green with your cleaning routine, you are improving your indoor air quality, your health, your lungs, your energy. Toxins from conventional cleaners (like formaldehyde) get into the air, sit on surfaces (including glassware and dishes) and are absorbed through your skin. Cleaning was actually one of the later healthy changes we made because I felt it was so overwhelming how to decide what to choose. I grew up with conventional store-bought cleaners and their smell told my brain the house was clean. My brain used to recognize the smell of bleach, Windex and Pledge as “clean”. Now my brain recognizes that clean doesn’t have a scent, and if it does it is a lingering vinegar scent or the scent of fresh lemons. How do you start greening your cleaners? Terms like “natural” and “safe” are overused and greenwashing is a large problem. Here are some steps to follow: 1. Read ingredients; if ingredients aren’t listed do not buy it! Products claim to be safe and natural and they just aren’t. 2. Cleaners fall into 3 categories: worst, better, best You can use this guide to help you make educated choices: https://www.ewg.org/guides/cleaners 3. Avoid fragrance in all your cleaning products (all products really!) If you really want a smell to your products you can add some lemon essential oil, lavender or grapefruit. 4. You can make your own cleaners! Here is a great resource: https://www.womensvoices.org/take-action-with-womens-voices/green-cleaning-parties/green-cleaning-recipes/ Had I known how it easy it was to make my own products, I would have started sooner! My Green Cleaning Arsenal includes white distilled vinegar, peroxide, washing soda, and castile soap. I make a fantastic dishwasher detergent and laundry detergent! Vinegar and water is used to clean my floors, counters, and more. I have started teaching eco-cleaning classes as well! Empowering other women to live a cleaner and greener life is my passion. The past 9 years of survivorship has brought out the best and worst of life. I have learned that healing is not linear and that small changes can have a large impact. Here's to making at least one small change that may lead to more! Happy clean and green cleaning! Resources: https://www.cbsnews.com/pictures/ewgs-hall-of-shame-of-toxic-household-cleaners/ https://www.lung.org/our-initiatives/healthy-air/indoor/indoor-air-pollutants/cleaning-supplies-household-chem.html https://www.sciencenews.org/article/household-products-make-surprisingly-large-contributions-air-pollution #survivingbreastcancer #breastcancer #eco #ecofriendly #greencleaning #cleaningsupplies #nontoxic

By Michelle Stravitz, Co-Founder, 2Unstoppable As I moved beyond active treatment and into that murky post-treatment phase, I attended many classes and webinars on a variety of topics – chemo brain, the emotional rollercoaster of survivorship, nutrition and healthy living, emotional well-being, and more.  Do you know that every single one of them told us to exercise?  It really amazed me. The more I looked into it, the more I realized that exercise has been shown to improve cancer outcomes in many ways.  Regular exercise has been demonstrated to significantly lower recurrence rates and increase survival rates for women with breast cancer.  Exercise helps fight so many side effects that I learned about and experienced throughout treatment, and many that I didn’t even realize until after treatment was over – including lower bone density, lost muscle mass, new feelings of anxiety (even PTSD), tight tissue in my arms and chest area, balance, notable chemo brain, potential heart damage, and lingering fatigue. In one class I attended, I learned something about our muscles that truly shocked and mobilized me: We normally lose about 3-4 pounds of muscle mass over 10 years of aging; we lose the same amount of muscle mass in just 6 months of chemotherapy! That fact alone got me to barre or another exercise class on many a morning! … and never mind the emotions that kicked in after treatment! The more I learned, the more I decided to make physical activity a priority in my life – finding what worked for me, but trying to address each of the different side effects.  My personal routine includes active yoga, barre, cardio exercise classes, brisk walking, and even a bit of running.  I’ve also tried belly dancing, cardio drumming, and Qigong.  And I can’t say I regretted a single time that I dragged myself out of bed or out of the house to exercise.  It has helped me tremendously, from fighting fatigue and chemo brain to building back muscle and confidence. And truly, if exercise only fought the cancer-related fatigue … that would certainly be enough.  Seriously, “you had me at fatigue.”

We, at survivingbreastcancer.org, continuously seek ways to provide health and wellness activities for those diagnosed with breast cancer and today we turn to an organization providing so much camaraderie and wellbeing to the breast cancer community, the Wellness Warriors. The Wellness Warriors support those who have been diagnosed with any type of cancer, though approximately 50% of their members are those who have been diagnosed with breast cancer. We were most fortunate to share exhibit space with the Wellness Warriors of Boston at the 2018 CelebrASIANS Benefit Fashion Show (benefiting the Boston Asian Breast Cancer Community) in Boston and then they graciously hosted an exhibit table at our Greater Boston Breast Cancer Awareness Event. Needless to say we were inspired by their mission, contribution to the Breast Cancer Community, their sense of adventure, fun and accomplishment. Before we jump into what their organization is all about, I want to provide some brief background. For anyone who has had their lymph nodes removed, developing lymphedema is a real concern (See our blog on Lymphedema). A shocking statistic reads that 30% of those who have had their lymph nodes removed will develop lymphedema during their lifetime. While it has been argued that repetitive motion could be a cause of developing this non reversible side effect, a group of researches set out to do a study and investigate if an activity such as dragon boat racing would help those diagnosed with breast cancer, get moving, exercise, and use their upper bodies to build strength and increase mobility. In a case study out of the University of British Columbia, the findings were one of the first to "provide quantitative evidence suggesting that dragon boat racing and other vigorous upper-body exercise are actually safe activities" (Harris, S.R., et al. J Surg Oncol. 2000 Jun; 74(2):95-8). Without further adieu we have raided their website (with their permissions of course) to present their Mission, and the reason you may wish to reach out to them to join their community. We are all in this together as we seek to improve the lives of those diagnosed with breast cancer, as well as their caregivers and support team. We are also looking to do a podcast with this terrific group soon. What Follows are excepts from the Wellness Warriors Website: Wellness Warriors of Boston https://wellnesswarriorsboston.org Our Mission Our mission is to provide new opportunities for cancer survivors to heal – both physically and emotionally – by being active participants in their own recovery and part of a mutually empowering dragon boat team. In addition, we are working to raise awareness within the metropolitan Boston survivor and medical professional community of the benefits of paddling for cancer recovery, wellness, and a healthy lifestyle. We accomplish this through education, outreach, and by being an inspirational presence of strong and confident cancer survivors. “Dragon boating has helped me make friends with my body again after the punishing effects of cancer treatment. The Wellness Warriors have helped me figure out who I am post treatment.” Who We Are Some of us are receiving chemotherapy, radiation and other cancer-fighting strategies, while others have completed treatments, but are still working through the cancer experience. For others still, cancer is a distant memory. We are a diverse group committed to dragon boating as part of our self-care after cancer diagnosis. Why We Paddle On or off the boat we are united as a team. We support and encourage each other. Not only is dragon boat paddling good for our health, it’s a lot of fun. We are excited each week to join our friends on this paddling journey being coached by our intrepid leader, Coach Peter. He teaches that by working together, nothing is impossible. When we’re tired, we can keep going. We all work together to tap our inner reserves and come off the water feeling stronger. We cherish the views from the middle of the Charles River. What a spectacular place to see the setting sun reflected on the river and buildings of the Boston skyline. We love the warm temperatures, longer daylight hours, and the evening breezes. Even the river is warm. In the early summer, ducks and geese drift by with their babies in tow, and an occasional fish jumps high in the water. We savor our accomplishments – learning to paddle better, harder or faster. Our experiences on dragon boats help make us stronger. We appreciate the support and encouragement of other dragon boat teams. In the summer months, we have friendship races up and down the river to practice our starts and build our endurance. Nothing cheers us on more than a “Great race!” from a competing team. We relish the exhilaration of flying across the water when we paddle in sync with each other. Coach Peter’s “You’re doing well,” is music to us all. We treasure the sense of being alive, using our muscles and building our strength. No matter where we are on the cancer journey or in our athletic ability, our rise to the physical challenges of dragon boat paddling makes us this team of thrivers. Each time we are on the water we are reminded that we are vital and alive, and we become aware of the rewards of teamwork and personal accomplishment. Please join us on this adventure of wellness. Your Wellness Warriors teammates will support you in living the best life possible after cancer. We are grateful to family and friends who give us this time and are there to support us – not just at dragon boat competitions – but every day, rain or shine. We paddle for other cancer survivors and caregivers to pass on the HOPE that has been given to us. We want to show them there is a lot they can do, even as they work through their own cancer experience. If you feel that this activity suits your fancy please feel free to visit their website and say we @survivingbreastcancerorg highly recommended them! Sending Hugs, The SBC Team

By, William Laferriere, Survivingbreastcancer.org board member Hello darkness my old friend.... I’ve come to talk with you again, Because a vision softly creeping, Left it’s seeds while I was sleeping. Fools, said I you do not know, how Silence like a cancer grows… Paul Simon, Art Garfunkel, The Sounds of Silence While hosting an exhibit booth recently with survivingbreastcancer.org founder Laura Carfang at the CelebASIANS Breast Cancer Awareness benefit in Boston, MA, I met a survivor who approached with the plaintive cry that “I am so lonely”. I walked around the exhibit table, hugged her and said that she had come to the right place, exemplified by our raison d'etre @survivingbreastcancer.org, where we attempt to empower breast cancer survivors from day one. I suggested that she join our Fb group and introduce herself and enjoin our community of Survivors. Loneliness is a complex and unusually unpleasant response to isolation, and ergo, a lack of companionship. A great Beatles song, Eleanor Rigby opined: All the lonely people, Where do they all come from? All the lonely people, Where do they all belong? The affects of loneliness are felt by many of our vaunted breast cancer community. Early on at the September, 2018 Living Beyond Breast Cancer Conference in Philadelphia, PA an elderly woman approached our exhibit table and talked at length about her diagnosis and long term treatment and survivability, but then said she mostly came over for hugs and an embrace from Laura and myself. We gladly obliged and she asked us what we we @ survivingbreastcancer.org were all about. I gave her the impromptu response that “We look to inject positivity into the fabric of a heinous diagnosis”. At a white water raft trip last summer in the Poconos, along with the Staten Island Cancer Tamer gang we shared a communal experience of rafting, zip lining and Soul Re-engineering’s Claudia and Jim’s incredible Shamanic, Akashic Lakota chanting/readings/cleansing on the waterfront. At the end of the day we performed a group hug. One of the survivors, currently a second time stage 4 BC diagnosis at the age of 74, held onto me for a prolonged hug and told me that we had just made her so incredibly happy. We’ve also met survivors whose spouses couldn’t handle the impact-fulness of a BC diagnosis and treatment; many verbalized that their family and friends couldn’t handle either. One woman contacted me through our website Caregiver Consultation Platform and informed me that her spouse had an affair while she was in the hospital having her surgery. He proceeded to leave her for the other woman shortly thereafter. I suggested that by just reaching out she was halfway back from the despair of loneliness and invited her to join us as well. Laura and I have discussed these, and other similar stories of loneliness, and despair, and how valuable community, embracing, and hugging were and how these consistently contributed to enhancing the health and wellness of a survivor. Studies (credit below) have found that part of the reason for this loneliness is because the person with breast cancer is experiencing situations and emotions that few others can understand. Experiencing loneliness, especially chronic loneliness, may aggravate the cancer. In fact these studies “have determined that rats who were isolated experienced increased incidences of breast cancer. The tumors were significantly larger than in the rats who were not isolated. The researchers suggested that people who experience high degrees of loneliness may also experience greater degrees of breast cancer as well.” Therefore, lonely women could be at greater risk of breast cancer returning or exacerbating. Scientists have shown the stress and anxiety caused by ‘social isolation’ can speed up the growth of potentially deadly tumors. Other studies have shown that social support and friendship can boost a woman’s chances of recovering from breast cancer, and that the lonely and depressed are more vulnerable to a host of serious diseases. Warner (credit below) identifies the relationship between loneliness and decreased immune functioning as well as increased inflammation, all of which may negatively impact attempts at treating breast cancer. Even after a person goes into remission, loneliness continues to linger. Mary Rosedale (credit below), in her research talks about survivor loneliness of breast cancer survivors. “Their experience of loneliness included several themes such as emerging consciousness, in which women talked about the ongoing feelings of loneliness despite others being around and transcending time, where family and friends often moved on from the breast cancer experience whereas the women were still dealing with it. Often this would happen after the first year, when people assumed that the women have moved on.” Misunderstanding “was another theme that focused around how even those closest to them misunderstood how breast cancer changed their lives. One other important theme was withholding truth, which discussed how these women would censor what they say, and not communicate what they are really thinking or feeling. Withholding truth was a form of protection from having to hear feedback from others; feedback that is often hurtful, such as confirming a fear or having others feel sorry for them.” So, what can be done for those who are currently experiencing or have experienced breast cancer and loneliness? The process of connecting to others who are experiencing similar conditions is a common thread among support/self-help groups. The powerful component of these groups is the ability to be authentic, to reveal one’s fears, desires, hopes, and concerns to others who “get it” because they have similar experiences. In those groups, it’s okay to say, “I am scared about a relapse,” because there are others in the room who are scared as well. The point at which a person can become authentic, vulnerable, and truly connect with others is the point at which loneliness begins to disappear. Support groups are an excellent way of doing that, but certainly paying attention to feelings of loneliness and making deliberate attempts to be authentic, vulnerable, and to connect to important loved ones is also a great strategy. In closing a look at loneliness through the eyes of a poet: I shiver melancholia, entombed with my winter blues in the dark dreamless hollow of my frowning igloo. Draped in decor of dispirited drear I wear a wistful woebegone fog, an overcoat of overcast moods sown of sneering sunless, scentless days. I weep wall to wall in the long light-less nights alone with my lonely longings~ my psyche withers a little more each dull day, I shrivel. I shiver sadness, my colorless tears cry out loud for color; yearning for watermelon sunsets, pink sands and swirls of marigold kisses, for rainbows to color my lackluster laughter and fireworks to celebrate in my mirthless eyes, for Sol’s warm hands to tenderly undress and caress me and lay bare my soul straitjacketed by winter blues... Susan Ashley January 4, 2018 Please see the below links for blog contributions. • The Harmful Connection Between Breast Cancer and Loneliness ... www.psychologytoday.com/blog/web-loneliness/... The researchers suggested that people who experience high degrees of loneliness may also experience greater degrees of breast cancer as well. You can get a summary article here on the study . • Cancer And Loneliness: The Vicious Cycle | The Breast Cancer ... blog.thebreastcancersite.greatergood.com/cancer... And cancer sends a person to a unique place—suddenly everyday matters seem unimportant when forced to consider your own mortality. Cancer tends to focus a person on what’s truly important, and that may mean that relationships that worked before cancer no longer work during or after cancer. • The Loneliness of Cancer | HuffPost www.huffingtonpost.com/lisa-masters/the... The Loneliness of Cancer. ... Even though I write about breast cancer now being treated as a "chronic disease" again, today's reality says that this cancer will kill me. I push those thoughts to ... • Loneliness and breast cancer - 'Breast cancer treatment left ... www.goodhousekeeping.com/uk/news/a579443/breast... Loneliness and breast cancer - Battling breast cancer in rural Cumbria left me isolated and lonely. A teacher and mum of two is calling for more emotional support for those affected by breast cancer. • Loneliness may sabotage breast cancer survival ... - CBS News www.cbsnews.com/news/loneliness-may-sabotage... Loneliness may impede long-term breast cancer survival, a new study suggests. In the years after treatment, women who don’t have strong social ties are more likely to have their cancer return or ... • Loneliness May Sabotage Breast Cancer Survival - WebMD www.webmd.com/breast-cancer/news/20161212/... MONDAY, Dec. 12, 2016 (HealthDay News) -- Loneliness may impede long-term breast cancer survival, a new study suggests. In the years after treatment, women who don't have strong social ties are ...

By Guest Blogger, Abigail Johnston In January of 2017, at the ripe old age of 38, I felt a lump in my left breast. I was tandem nursing my almost 4-year-old and almost 2-year-old at the time. I started taking herbs and saw my lactation consultant since I’d already had a few clogs. I always had an overabundance of breast milk, so much so that I donated over 25,000 ounces to a milk sharing group during my 4 years of nursing and pumping. My lactation consultant thought it was nothing but since the herbs weren’t working, she wanted me to see my PCP. My PCP is super chill and tandem nursed her kiddos, so she was not too concerned. Her comment was that she was 95% sure that it was nothing but since my mom was then a 14-year breast cancer survivor and I’d never had a mammogram, she sent me for a mammogram and a diagnostic ultrasound. Since we were expecting some difficulty with my dense and milk filled gigantic breasts (seriously, I went from barely a B to at least a DD while nursing and I’m 5’2”), she told me not to let the radiologist do a biopsy if there was any suspicion but to call her for a referral to a specialist. I didn’t know what to expect at the mammogram appointment but I certainly did not except to drench the machine in milk. Also, it HURT!!! The tech wasn’t very happy about milk everywhere but seriously, that crazy machine HURT!! I pumped before the scan and pumped again during a break and we got some pictures. Tech didn’t have a poker face, so I knew something was up. After the diagnostic ultrasound, the radiologist came in and wanted to do a biopsy right then. Since my PCP had already told me to call her after the mammogram, I explained that and they freaked. I was taken to three different people, including a social worker before they finally let me leave AMA. It was after office hours at this point and I left a message with my PCP’s answering service on the way home. It was a Thursday. She called me back that Friday morning after having looked at the scans and the report. I think the only explanation at this point for the fact that I was not freaking out was that I was in denial. I was convinced that everything was fine and went to the appointment with the surgeon the following Monday without trepidation. In hindsight that was pretty naive but I am thankful for a few more months without the weight of cancer in my life. The surgeon did the biopsy in her office that day, also not what I was expecting and we left with some amount of concern to wait for the results. I leaked milk from the biopsied area (at around 10 o’clock right outside the aureola on my left breast) for about a week and my kiddos thought that was pretty funny. The crazy bruising wasn’t as funny and the anxiety even less. On March 8, 2017, we got the results of the biopsies. The suspicious lymph nodes were just full of milk but the lump in my left breast was breast cancer. Invasive Ductal Carcinoma which was ER/PR+ and HER2-. I later found out I am BRCA- but then so was my mother. At that point, we met with a medical oncologist and a radiation oncologist and started the process of drying up my milk. It was tremendously difficult and abruptly weaning both Boys was just plain awful. I felt like I was walking around with a bomb inside me. I was limping at this point, favoring my right leg — I’m not a complainer and I simply didn’t bring It up. In hindsight, that wasn’t the smartest move. We decided to do a lumpectomy and my surgery was on April 11, 2017. The surgeon was able to get clear margins and I was considered node negative since only one of the 4 sentinel nodes had some trace cancer cells. Trace cancer cells means less than 200. We hoped I would just need radiation and again waited for the oncotype results. Still naively hoping we were in the clear. Original staging was 2b. Oncotype score came back in the high side of the gray range and so we had to adjust our thinking to include chemo. Original plan was 4 rounds of AC and then 12 of Taxol. I started chemo and in the haze of the day after the first chemo treatment nicknamed the “red devil,” my medical oncologist called to say that something was wrong with my blood-work (he didn’t say tumor markers then) and we’d need to do more tests. Still naive, I didn’t get upset or exercised and I went in for a bone scan and CT scans within a few days. Took nearly a whole day and when we got the call the next morning that we needed to come in, didn’t matter what time, just come, and a sense of doom began to settle over us. The weight of all that was and all that might be was stifling. The next day, June 22, 2017, we went to my medical oncologist’s office to find out that the cancer had spread, not through my lymph nodes, but through my blood to take up residence in all of my bones. That limp I mentioned earlier, turns out I had a 5-cm tumor in the middle of my right femur. My organs were and are clear of mets so far. My husband had insisted on coming to my appointment and we both cried and cried and cried. Life as we knew it had already shifted and now it had taken a dark turn. About a week later, on June 30th after having multiple MRIs and skeletal studies, an Orthopedic surgeon put a titanium rod inside each femur secured by 4 screws each. We also did some additional genetic testing and found out that I’m positive for the ATM mutation. I kept going with AC but we decided to leave Taxol for later. I did 10 days of radiation on my legs and my back (big lesion at L2) in July as soon as I was healed enough from the surgery. I had a full hysterectomy on September 18, 2017 and I started Ibrance and Letrozole in August, 2017. For now, all of my mets have shrunk and I’m getting more and more limber each day. I’ve added yoga to my routine, which is really helping with flexibility. In October 2017, we finished closing up my office and moved to Miami to live with my parents for the help and support. I’ve been able to access disability benefits and I’m trying to figure out what’s next. Becoming educated and keeping up on research as much as possible has become a little like a full-time job! I’ve added acupuncture, chiropractic, supplements, diet changes and medical marijuana to my regimen. I like to say that we’re combining the best of Eastern and Western medicine the best we can. Recently, I’ve developed heterotopic ossification in each thigh, which basically means that I have bone growing inside each of my thigh muscles. None of the bone pain I’ve been managing prepares me for this much pain. We’re working on building muscle to cushion the growing bone and there may be more surgery in my future, once the ossifications stop growing. My very first thought in June when we got the news was that I wanted to spend as much time as possible with my children. That’s what I’m doing. I’m spending time with my family and creating a new life and memories for as long as we have. Our focus is living in the present and working to maximize the joy of the time we have. I’ve got boxes started for both Boys and I’ve been working on letters and cards and mementos. I worked with a nonprofit recently called Thru My Eyes to create a video for my children to watch after I’m gone. I’ve also started a box for my husband to stash important reminders and letters. Thinking about leaving my kids sometimes leaves me paralyzed but it also clarifies things. While I’m still able, I get out of bed each day and spend as much time as I can with them. When I can’t get out of bed because of all the side effects I deal with daily, we get lots of snuggles and cuddles. This is our life now, in all it’s beautiful mess.

Guest Blogger: Lucy Wright Before I faced cancer I always naively believed that a survivor was someone who defeated something and that was that! I have now come to realize there is so much more that comes with being a survivor, whether it be mentally or physically. I want to share something with you that made me want to write this piece today. I was in hospital waiting to see my plastic surgeon and a lady came and sat next to me. We got talking and people who know me know I am very open about my journey. This lady told me about her sister who passed away from lung cancer and like many others, she said I was lucky to still be here and survive the disease. When this was first said to me not long after my treatment, I didn't think much of it but now I am 20 months on from my last chemo and I find this hard to digest!! Surviving something like cancer is not lucky. I am of the belief that it's the outcome of treatment and how positive you are. But there is nothing lucky about having to endure chemo, face life changing surgery and radiotherapy. Yes, I am clear of cancer but I had to face the toughest time in my life to get to this point and that was not due to luck. I have never been lucky, as I also lost my mum and dad within 9 days of each other when I was of only 17/18 (both sides of my 18th birthday). When cancer patients finish treatment, it is not the end, this is just the beginning for a survivor! Not only do you have to get over the physical effects of treatment, whether it be chemo, radiotherapy or surgery but you also have the turmoil of dealing with the effects cancer has on your mental state. There is always the "What if's''. My mental state is pretty positive, maybe not sane but I manage to keep my thoughts on track. When I have a moment of "what if my cancer comes back, what if I die, how will Nevaeh (my daughter) cope if I am not here, will I ever think how I used to?" My Macmillan nurse told me it is normal to have these thoughts and taught me a great way of dealing with this: If the thoughts enter my head, I need to take a minute and visit my demons. I have to let myself have the minute but then put them in a box and forget about them until next time they creep up. This technique really works for me, I might look like a crazy lady for a few minutes but what's new! I find I constantly worry when I get a cough or an ache! Could this be my cancer returning or a new cancer? It never stops, the checking of my breasts (I can now say breasts) and I am mentally exhausted but I just plod along. Survivors will always be over vigilant when it comes to their health. Before my diagnosis, if I got a cough I would think it's a cold, now I contemplate whether this could be a symptom of a cancer! We just have to channel this in a healthy way and not drive our state of minds into darkness. When you have faced death, your whole world shifts and your outlook on life changes for the better. This could be the people you associate with, how you deal with certain situations and just living your best life. You will cut people out, you will want to face your fears and just appreciate every minute you breath this air on earth. Being a survivor also means annual check ups, which in turn you have to deal with Scanxiety. Although everything might be fine, the worry of something showing up weighs heavy on your mind and also your body physically. I get no sleep for many nights leading up to my scans, which I am graced with 50 shades of dark circles under my eyes. The future for a cancer survivor can be masked by negative thoughts but on the flip side we want to make the most of the second chance we have struggled to fight for. It's an ongoing battle that we have to live with for the rest of our lives but I will always fight, as will many others! So to be a survivor, it's not luck, it's proof that something was sent our way to kill us but determination, strength, grit and positivity prevailed. Much love Lucy You can follow Lucy on IG @lifeorjustlucyisms Or through her website: Www.lifeorjustlucyisms.co.uk

Guest blogger Laila (@2sweaterpuppies on Instagram) gives you a glimpse into what it’s like to be only 28 years old and fight breast cancer. She’s a scientist. And, no joke, she finished her PhD in cancer research less than two years before she learned she had cancer. Laila Roudsari is not your typical badass, she’s next level: brains, beauty, and ingenuity. She’s a realist so you won’t find sugar-coated smiles or bubblegum optimism here. Instead, she details the important stuff: an almost missed diagnosis (everyone told her she was too young to have breast cancer), the science behind treatment options (because this is a comfortable space for her, unlike many fellow survivors, so she’s leaning in to shave the jargon off the science-speak), how-to’s on making it through tough treatments, and lifestyle changes she’s employed to live a balanced, happy life after cancer. Imagine your approachable doctor friend, who studied your disease, sat in the chair next to you, having undergone the treatments herself, and shared her notes with you. This is Laila’s space. She’s about advocating for yourself and your health first and foremost, and she does that by sharing the honest details about treatments and support (because how else will you know what to expect), spreading awareness about breast cancer in women under 40, getting real about which organizations are making a (scientific) difference, arming women with knowledge about the disease so they feel confident making treatment decisions, oh and advancing breast cancer medicine. Laila is a vibrant, enigmatic, kind soul who now researches cutting-edge technologies to advance what we know about tissue regeneration. So basically… a full-time badass whose proper title is Dr. Roudsari. For a healthy dose of real talk that informs and inspires, 2sweaterpuppies can be found here: Laila’s Story Laila’s pre-cancer bio: I was born in Charleston, South Carolina and I love the coast. I'm half Persian, half Southern. I have 1 sister, 2 brothers, and 2 awesome parents. I went on to do lots of schooling to earn my PhD from Duke in Biomedical Engineering. I'm now a researcher at a biotech company working on growing lungs for people with chronic lung diseases. Oh yeah, and I have 2 cute sweater puppies (actual dogs, not boobies) named Pharah (plott hound/pit mix, age 3) and Willa (wheater terrier, age 5) and a super cute boyfriend (who is also a former cancer researcher), Joe. Laila’s cancer bio: Diagnosis in January 2018, double mastectomy with reconstruction in February 2018, axillary node dissection February 2018, 6 cycles TCHP chemo regimen March-June 2018, 25 rounds radiation August-September 2018, continued HP infusions every 3 weeks until February 2019, daily Letrozole pills and monthly Goserelin injections for 5 years. ​ Stats: stage 2 invasive carcinoma, HER2+/ER+/PR+, BRCA negative Push Until You’re Certain: Trust Your Gut A technician at an imaging clinic spent less than 5 minutes looking only at the breast with the mass, then told me nothing was there and that I had nothing to worry about. I never saw the radiologist himself. It didn’t make sense to me. If nothing was there, why did I feel a distinct mass? I know I’m young and my breasts are dense but there must be another way we can see it. I even asked the technician about getting a mammogram or doing a biopsy. She annoyedly reassured me that, “You can’t biopsy something that’s not there.” She was certain we had taken the necessary precautions. I called my gynecologist later that day. She also insisted I was fine. She read the radiology report aloud to me and explained we were being cautious by having it imaged. I spent the weekend tormented. The only clear memory I have is holding Joe and crying together face to face. Somehow, I knew already that they were wrong and I had cancer. We researched the 2 best university hospitals in the area, found the breast clinics, and wrote down the phone numbers for calls first thing Monday morning. I worried I was being crazy and overreacting but I knew I had to do more. Wisdom from the unwise: I knew the genetics: I’ve always been worried about breast cancer. I'm a cancer researcher. I did an internship at the #1 cancer center in the world. I shadowed a genetic counselor there and learned all about the BRCA mutation. After that summer, I was inspired to have my family tested since my aunt had breast cancer very young. She tried but her insurance wouldn’t cover it since she was cancer free for more than 10 years. Every year I talked to my gynecologist about it but nothing ever came of it. I tried to be proactive, but I wasn’t proactive enough. I had first-hand exposure: In 2017, I saw a high school friend who was 28 get diagnosed with breast cancer. I didn’t check myself. I also attended the funeral of my Farsi school teacher who died from breast cancer. I still didn’t check myself. Not once in all of 2017. So here are my messages to all of you: Check your breasts every month, trust your gut if you do think something is wrong, and fight for yourself. Find your rescue radiologist, and don't be stopped by the rude NPs with years of experience who can't be bothered to spend more than 5 minutes on a diagnosis call or the technicians who question why you need a second opinion. You're your own best advocate. The scariest part of all of this is that I could still be walking around thinking I was cancer free. And so many young women do. Dear Pinktober: Message From A Survivor Scientist What do I think of all the pink in October? As a patient, I feel very fortunate to have a cancer that’s so visible; a cancer that so many people know about, talk about, and recognize. But I think our focus needs to be not just on wearing pink. As a scientist, I believe that raising money for research should be the number one priority. And I’m writing today to convince you that you should feel the same. Research is what will advance detection and treatment and that is what will ultimately end cancer. Make your pink mean something by making sure your focus is on ending cancer. Here’s an example of a game changing advancement in breast cancer treatment. You may have heard of the term ‘HER2 positive.’ I am HER2 positive. For those of us that have HER2 positive disease, that means our cancer is very aggressive. It used to mean your chances of survival were a lot lower than women that were HER2 negative. Recent advances in cancer research have led to the development of targeted chemotherapies for HER2. What does that mean? That means the cancer cells have a lot more HER2 receptors on their surface than normal cells (picture a bunch of baseball gloves on the outside of my cancer cells, orange cups in the pic below). These HER2 receptors send a lot more signals to the cells to grow out of control, which is why it makes our tumors aggressive. Scientists have developed drugs that bind to the HER2 receptors to prevent the cells from further growth (picture baseballs that get caught in the baseball gloves, yellow squares in the pic below). Your First To Do List Alright breasties, I made you your first post-diagnosis to do list. Reflecting back, there are a few things (6 to be exact) that really helped me right after getting diagnosed and I’m here to share those with you. 1. Share your news on social media. Of course, you’ll tell your closest friends and family, but I could not have dreamed up how much support I got from sharing my news on social media. I was inundated with supportive messages, to the point that I even felt a little overwhelmed by the desire to reply to everyone. It cast a little ray of light on me when I was at my lowest point. Don’t get me wrong, I still had plenty of anger and I was more devastated than I had ever been, but it helped. People I didn’t know very well shared with me ways that I had impacted them in their lives. It was incredible. It also led to an outpouring of cards and gifts. I mean, who doesn’t want to get presents in the mail every day? I really do mean every day, enough to cover the walls of my bedroom with cards. People sent lotions, flowers, baskets, blankets, and jewelry; the list could go on. When I felt like my whole world was turned upside down, my support system was bombarding me with positive things to push out the bad. And it kind of worked. I would caution that some people will try to tell you what treatments you should or shouldn’t do, and share (very unhelpful) stories of relatives or friends who died from cancer. But all of that will be outweighed by the love you will receive. A community I didn’t know existed rallied around me, and for that I am forever grateful. A few of our favorite Instagram posts: These are my dreams, my wildest hopes for my life. This is me, here today, speaking them into existence. This is what I am manifesting. First, I'm a survivor. I never have to fight cancer again. I'm a lead scientist involved in the first engineered lungs going into a person. Once I accomplish that, I become a leader in breast cancer research. In this role, I make real treatment changes, getting treatments into the clinic faster. I work to disrupt the focus of academia on publishing and onto moving findings past the bench to the bedside. I start a company to culture patients' own cells to advance personalized medicine. I seek out causes of breast cancer in young women and once discovered, I push for awareness about these causes. I travel the world to form global partnerships with cancer researchers and improve the state of cancer detection and treatment worldwide. Through this, I gain a deep understanding of other cultures. I use this travel to experience life to the fullest, exploring the wonders of the world to feed my thirst for adventure. I use my knowledge of science to empower women with breast cancer to make informed decisions about their care. I change the way people envision a scientist by mentoring women in STEM. I have a family. I raise strong, smart, children who are open-minded, good people. I master yoga and salsa. I play the cello to feed my artistic side. I live a fully balanced life and I am happy. Inspired to speak my dreams aloud. You should try. It was such a good way to bring back the excitement I used to have about my future. For so long as a cancer patient, I've been afraid of planning ahead, refusing to even think about what I'd be doing in a couple months. I was afraid that if I made plans, I'd be let down if the cancer took my life away before I could do those things. But I'm here right now. And I want to try to live as though I've gotten the one miracle I wish for every day, the assurance that I'm going to get to live out all of my dreams. Pic taken the day before my mastectomy. I am a scientist and I chose biomedical research so I could #movemountains to offer patients treatments when they otherwise didn't exist. A mass was found in my breast in January, a week after my 28th birthday. I got an ultrasound and was told it was nothing by several medical professionals. #imovedmountains to get diagnosed with stage 2 triple positive breast cancer. I had a double mastectomy in February and #movedmountains by freezing eggs after so I can have kids one day. Then came chemo - 6 rounds of one of the toughest regimens. I didn't start moving mountains when I started chemo - my family and friends #movedmountains for me. My parents and boyfriend shaved their heads to become my baldie crew. They made countdowns to tear off the wall and checklists to help me track my food, meds, and side effects. My co-workers and friends made me meals. I ended up #movingmountains by going to the gym for 5 hrs a week, even if I was barely moving my legs on a stationary bike. I also #movedmountains by tossing aside the scarves and hats and putting my bald head and smile out there for the world to see. And then radiation. 25 doses I finished this September. #imovedmountains by going to work every day to do the science I love. Now #imovemountains by helping other breasties through their journeys, sharing tips for what helped me. #imovemountains by striving to enjoy my life and really live it to the fullest (I'm on an endless #cancermoon). This has been the hardest year of my life but I've come out still smiling, still me. I have big plans for how I want to continue moving mountains and impacting breast cancer. I didn't intend to have to move these mountains, but I have. As a former cancer researcher, I can do a lot to help other young women by forming bridges between patients and the medical field. Maybe this is what I was meant to do. So what did we tell you? Badassery on another level. Laila has clearly found her calling and we can’t wait to watch her journey continue to unfold. #longlivelaila

This weekend, as you head out to the grocery stores to stock up on Thanksgiving delights, your shopping list will most likely contain the traditional provisions: turkey, stuffing, sweet potatoes, creamy green bean casserole, cranberry sauce, and pumpkin pie... By all means, Thanksgiving is about the traditions we’ve formed around the table. Don’t get me wrong, I always look forward to splurging on my aunt Minnie’s chocolate chip cookies and helping myself to seconds (let's be real, even thirds) helpings of the thanksgiving feast. This year, I wanted to share some new ideas for how we can celebrate the holidays with a healthy spin as we continue to fuel our bodies and steel them against breast cancer! First, let’s look at the science behind a healthy diet: Data is emerging from the American Institute for Cancer Research that a plant-based diet can lower the risk of breast cancer, particularly for those tumors that are not fueled by hormones. The big winners of a plant based diet are fruits and veggies high in beta-carotene like -Yams -Tomatoes, -Bell peppers, -Grapefruit and -Cantaloupe as well as cruciferous vegetables which are nutrient rich in vitamins C, E, K, minerals and offer good fiber such as -Cauliflower, -Collard greens, -Kale, -Turnips, -Rutabaga, and -Radishes. But can food really be thy medicine? YES! And that is because of the magic that happens inside our bodies after we enjoy a meal. For example these cruciferous vegetables provide sulfur-containing compounds, called glucosinolates. During the digestion process (i.e., the magic) the glucosinolates become active compounds that not only prevent the growth of cancerous cells but can encourage the body to destroy cancer cells! According to the NCI, these compounds help prevent cancer in the following ways: They help protect cells from DNA damage. They help inactivate carcinogens. They have antiviral and antibacterial effects. They have anti-inflammatory effects. They induce cell death (apoptosis). They inhibit tumor blood vessel formation (angiogenesis) and tumor cell migration (needed for metastasis). Ok, so now onto the yummy stuff! This Thanksgiving should definitely be the one where you have fun and play around with some delicious plant-based entrees and sides, not only because of the salmonella outbreak in turkey this year, but reaping all of the benefits from a whole-food plant based diet to assist in kicking cancer's butt. Imagine after your thanksgiving meal being refreshed and energized instead of cozying up on the couch for a nap and football! After clicking through Pinterest and some of my favorite blogs, I am excited to share with you what William and I will be cooking up: Click on the links below for recipes: Green Beans and Fennel with Tarragon Pumpkin Curry Soup Mushroom Vegan Loaf Roasted Brussel Sprouts Maple Brown Butter Sweet Potatoes Warm Kale and Apple Salad Roasted mashed turnips with garlic Honey Roasted Carrots

Where We’ve Been Survivingbreastcancer.org kicked off breast cancer awareness month in historic Philadelphia. It was the first time we were exhibiting at the Living Beyond Breast Cancer conference and we cannot wait to return next year. We met amazing men and women, attended sessions to learn about the newest treatments and latest research and had some deep dive conversations about yoga, meditation, and the power of writing to heal. With our focus on health and wellness, it was no surprise we became fast friends with several organizations who are helping those diagnosed with breast cancer (check out Wellness Warriors, 2Unstoppable, and Casting for Recovery to name a few). One of the highlights from the conference was meeting Charlotte Matthews, a breast cancer survivor, poet and faculty member who runs workshops to illustrate the power of writing as a tool to help those diagnosed with cancer by sharing their stories. I highly recommend checking out her latest publication Truth: Voices of Women Changed by Cancer and our exclusive interview with the woman behind the typewriter. Thanks to RedSparks Films, the below trailer launches Matthew's project based on one of her poems about her diagnosis with stage 3 breast cancer at the age of 39. A powerful conversation arose when speaking with a woman about breast cancer and the number of times we said “if only I had known” or “I wish I knew that ahead of time”. This sparked our interest as the organization StoreMyTumor which offers a private option to those who want to preserve their live tumor cells! This enables you to go back to your original tumor and have access to the information in the event you need genetic sequencing or customized vaccines. Personally, I did not know about this option at the time of my diagnosis, in fact, when I found out I had breast cancer, it never occurred to me what happens to my tumor (tissue) once they remove it. Feel empowered and ask your medical care team, what happens to the tumor post biopsy or post-surgery? It’s important to know where your tissue goes and how it is utilized, after all, it is yours! On the Road Again What started off as a small get together in the Boston area with survivors, caregivers, and friends, has quickly become one of our Signature programs. Our Survivors and Friends Meet and Greets. While the name of the program is consistent, each city we visit takes on their unique personality! In Philadelphia, we hosted a Sunday Brunch. We were thrilled to have medical oncologists and researchers from Temple attend as well as collaborators from the Philadelphia/Wilmington FB group partner with us to host a celebratory brunch. Highlights include survivor stories and meeting the face behind the blog BeautyThroughtheBeast, Chiara! Next Stop: Chicago There is no better way to say “Cancer didn’t win” by checking off a buck-list item running a marathon! Yes, going to the infusion center week after week, daily rounds of radiation, or the hours of bedrest recovering from surgery certainly have similar qualities of a marathon, but the joy (and pain) one endures in putting in the long hours of training and completing a marathon is like no other! And that’s exactly what these breast cancers thrivers did! An open house was held for our Chicago-Based breast cancer Survivors and Friends meet and greet in the home I grew up in. We were honored to have women from all over the Chicagoland area attend, donate, and exhibit their breast cancer products (Thank you Medical ID Fashions and Complete Shaping). Additionally, we got to connect with amazing women like Maira Luisa who is the founder of Courage for the Soul who provides scarves to those who are undergoing chemotherapy. The next morning these brave souls were off to run 26.2 miles and celebrate life one step after the other! Special shout out to Nicole Mancini (BC Survivor) who never left my side the entire race, ensuring that as we started together, we would finish together! Talk about a fabulous teammate! Cancer didn’t know who it was up against, that’s for sure! Finally, the energy in Chicago continues to be vibrant. After I had left town, I was thrilled to see the Chicago community gather for the release of Ginger The Movie Back to Beantown Taking a Look at Breast Cancer Disparities: We know that breast cancer is pervasive, but did you know that black women are 43% more likely to die of breast cancer than white women, according to the Breast Cancer Research Foundation . Other disparities include those who identify as LGBTQ. While more research is needed, according to the Young Survival Coalition, this population tends to engage in more breast cancer risk behaviors such as smoking, alcohol consumption, and obesity. Continuing to press the conversation forward, have you ever considered the role culture plays in a breast cancer diagnosis? What if English was not your first language? Do you have access to translators to explain to you your pathology report? Would your culture be accepting of your diagnosis or is it something you keep close to the vest and never talk about? How does a culture, gender, race, identity and a diagnosis impact cultural norms and expectations? A blog specifically on these topics is forthcoming as it cannot be summarized or taken lightly. Themes include selfishness, divorce, lack of support, depression, anxiety, fear of finding out you have cancer so better to not get screened. Here are highlights from two powerful events this October, the Audre Lorde Brunch, and the Asian Women for Health Fashion Show (CelebrASIANS): SurvivingBreastCancer.Orgs’ Survivors and Friends Meet and Greet Half meet and greet, half speaker’s bureau, half fundraising, half building local community support, I don’t actually have a name for what we did, but all I can say is that it was a huge success and give thanks to our sponsors at Benchmark Independent Living for hosting us! We heard survivor stories, information from plant-based advocate, Abby Power, and were led on a guided meditation and introduced to “Laughing Yoga” from Soul-Re-engineering’s Claudia Gallo. The next day, we gave thanks to mother earth and sang and chanted in the Lakota native American language because the universe is powerful and we want to stay in its positive grace. Between Paint Night at Tufts Medical Center and wonderful conversations with community members, we concluded breast cancer awareness month with a fundraiser at Club Pilates at Assembly Row. Building strength, toning and stretching are great exercises post-surgery and can help prevent lymphedema if you had your lymph nodes removed. It was a fun day raising awareness and being grateful for what our bodies CAN do! Where We Are Heading If you’ve gotten this far I’m thrilled because you will definitely love where we are going next and how you can get involved and join our community! Here’s a sneak peak of things to come for 2019: Survivors and Friends Meet and Greets are heading to Atlanta! Stay tuned for dates and details. (More locations coming soon!) Survivingbreastcancer.org will be launching our podcasts where we share survivor stories, meet with leading medical professionals, share inspirational meditations, affirmations, and tools for assisting the caregivers, plus more! Interested in being a guest on our PodCast, we’d love to hear from you. Contact William to schedule time for us to connect. While we love our 1 day meet and greets, the power of our community needs more than just a few hours. Stay tuned as we plan our first Survivingbreastcancer.org Retreats! Looking for something in particular? Let us know, these retreats are for YOU! ***Click Here*** to complete a quick survey so we can be sure to meet the needs of our community members. Thank you to everyone who believes in our mission! We were energized by what October has brought us. We will be strategizing, reflecting, and reenergizing during the upcoming holiday season and cannot wait to hit the road again in 2019! If you haven’t done so already PLEASE show your love by subscribing to our YouTube Channel and follow us on Instagram @survivingbreastcancerorg XO, The SBC Team

Guest Blogger, Cora (@boobambassador on Instagram), weaves a delightful yarn dealing with the myriad issues of Breast Cancer. What follows is a collection of, and/or excerpts of, blogs that may help one navigate the rough waters of that most heinous diagnosis. You can find her blogs and vlogs here: Scared is what you’re feeling. Brave is what you’re doing.” Emma Donoghue Scared is what you’re feeling. Brave is what you’re doing.” Emma Donoghue I’m human. Contrary to beliefs that I’m a Super Warrior chick (which I kind of am), I still struggle with a lot of things these days. Not sure if it’s post cancer angst, old age, menopause, or just the way the fecking stars are aligned. Which ever…..it’s been a funky week for me, and I needed to get that off my “foobs”/chest. I woke up this morning with the thought that…..holy shite….it’s already half way through the year. Winter is coming!!!!!Reference to Game of Thrones for those of you that don’t watch it. But seriously…..I almost had a panic attack. Like….Christ on a bike…..I’m NOT ready for another Winter ALONE!!! My hopes for even a second date have been dashed….the dude has dropped off the face of the earth. Hopefully he hasn’t dropped off the face of a cliff in the White Mountains (which was the last text I got from him over a week ago as he set off to go hiking ). More likely, he met someone closer to where he lives….which is perfectly fine and TOTALLY understandable. Just wish he had the balls to drop me a text, and not just disappear. So…..back to the drawing board I go. Man, is it EXHAUSTING!! I may have to just throw in the towel, and join the Nunnery, because at this rate, I’m a born again virgin anyway!!! Plus another upside would be that there would be more help with schlepping in the wood!!!! LMArseO!!! Not EVER going to happen. Now I know what your thinking. Cora…..be positive. Don’t wish or worry your life away. To which I would answer….tell me to be more positive than I already am 98% of the time…..and I will punch you in the head. Not literally. Figuratively….but there may be a wee slap if you were in front of me. Just a gentle one, because I love you. And I work VERY hard at not worrying too much….but sometimes it gets the better of me. Like when I was in the shower this morning doing my self Breast exam (#Buddy2buddy)….low and fecking behold….Louise had what felt like a lump on the medial aspect of my foob. Can you say PUKE!!! Which I almost did. But after poking and feeling the shite out of her pretty much ALL day (in between patients of course)…..I have come to the conclusion that it is just a wrinkle in my implant that when in a certain position, feels like a small lump. Menopause Ain’t for Sissies…. Holy crap….it happened again!! Not AS bad as the first time….but still disconcerting none the less. And in the bloody car AGAIN! I just got the heating fixed today. Should have left if stuck on arctic freeze instead!! Figured this would be an appropriate time to share the FB post I wrote about the first time I experienced one of the joys of being a woman, to the people out in Blog land. Enjoy So….a funny thing happened to me on me way to work this morning. Not funny “ha ha”, but funny “weird”! There I was, driving along, minding me own business, when all of a sudden…..me ears are on FIRE!! I mean….hot enough to fry a bloody egg..on fire !!! And I’m thinking…WTFeck! Am I having a reaction to my cancer fighting drug Tamoxifen (cause that’s the only medicine I’m taking).?? And that makes me panic slightly because then I’m up Shite creek without a paddle…or a way to fight my cancer. So I get to work, and start to take off me jacket & gloves (‘cause of course it’s cold enough outside to freeze the balls off a brass monkey ), and I recoil in fear and slight disgust at what I’m seeing in front of me!! I have this “rash” spreading up from me hands towards me shoulders . So now I’m thinking….Christ on a bike…..What. The. Feck. Is. Going. On!!!!! I solicit an opinion from my nice coworker….who upon taking one look at me….ever so briefly….steps back away from me. Which I don’t blame her…..because I looked slightly hideous. Or contagious. Or a combo of both . So….I’ll try to cut this ramble short, and say I made an appointment with a wonderful nurse practitioner in the clinic where I was working. But by the time I got in to see her…..my hideous bubonic plague like “rash”, had subsided to a rosy glow. Kind of like when you have something wrong with your car, and you go and tell the mechanic “there’s a clunk & a rattle”, and they look at you like you have ten heads and say “yah….right!” And the car behaves perfectly FINE for him. That’s how it was for me. BUT….we think we figured it out. It was most likely NOT a bad reaction to my cancer fighting drug (thank the Sweet Jesus!!!! ), but more likely a side effect of it…..my first HOT fecking FLASH!!! Welcome to almost 50 Cora!!!! Me Mum never told me about THIS!!! SO….if you are in my company, and all of a sudden me ears are glowing and hot enough to warm your hands on a cold day, and I develop a rash that spreads from my hands up to my shoulders….DO NOT BE ALARMED!!! Do not run in the opposite direction fearing for YOUR skins integrity. I am NOT contagious. I’m just having a fecking HOT FLASH with accompanying HEAT RASH!! #welcometomenopause #sideeffectsofcancertreatmentscansuck #thejoysofbeingawoman Ps…..not sure this post will help my dating prospects too much….what do you think. LMArseO. Carry on tribe. Hope you are having a lovely evening. I’ll shut up now Dating at 50….. With a Breast Cancer Diagnosis and Foobs to Boot…… Dating at any age can be interesting. But dating when you’ve turned 50, is like biking up Cadillac Mountain on a 3 speed. Slow and painful THEN you add the extra layer of breast cancer boob/foob stuff…..well then shit gets real! PLUS….when you live at the end of the universe, chance meetings are, well….few and far between. So Match, or some such dating site is what we are left with. And let me tell ya…..I would rather be back at the Sisters of No Mercy getting beaten across the back of the head with a bible (true story)……than be on those sites. BUT…spending the rest of my days on this earth without that special man in my life, is NOT an option, so here I am. Cyber dating, and sucking at it. Not that I haven’t met some VERY nice men on Match. Over the past 5 yrs (with a hiatus of a few years because of the cancer thing), I’ve been on approx 10 dates. First dates mind you. No one was horrible, but they were not “second date worthy” in my mind. That’s sounds pretty harsh once it’s written down…..but what I mean is that as nice as they were, I just didn’t want to waste anyone’s time (including my own) on pretending there was something there. I’ll know it when I see it. And at this time, I haven’t. Seen it. Cancerversary…… Yes, There Is Such A Thing Cancerversary , like a cancer experience, is unique. It is a milestone defined by you. It could be the day that a loved one was diagnosed. It might be your own last day of treatment. Or it might be several important dates that occur throughout someone’s cancer journey. I’m on the last day of several that have caused me some angst this year. And they probably will for some years to come. April 21st, 22nd, and 23rd will ALWAYS stand out in my mind, as the days leading up to one of the most challenging of my life. Not THE most challenging (because I’ve had worse), but it’s definitely up there in the challenging scale. On a scale of 0 to 10……we are talking about a 7. My family dropping off like flies, that’s a 10. My husband divorcing me (at the same time as my house renovation was going on), that’s a 9. I guess, because of all those other challenges, cancer was a WEE bit easier for me to handle. April 21st, 2015 I found my lump, or more accurately, my lump found me. Jumped right out at me when I went to free the girls at the end of a trying day. Wasn’t there in the morning when I put me bra on. April 22nd, was the day I got in to see my surgeon. I remember seeing her face when she examined me. I think we both knew it wasn’t just my “usual” cysts, as she performed a biopsy in her office. April 23rd, was the day she called me with the results. It didn’t come as a surprise. I think instinctively my body and mind knew, and were preparing to go in to fight mode. I remember her voice, and how very sad she sounded as she gave me the news. I actually felt worse for her than I did for myself. She had done EVERYTHING possible over the years that she had been monitoring my lumpy, bumpy, cyst filled Boobs, to NOT let me get to this moment. I wanted to reach down the phone, and hold her hand to let her know that this, this devastating news, did not break me. We formulated a plan for me to come in the next morning (even though it was her day off), and we would come up with my plan of care. I also remember the feeling’s and thoughts that swept over me when I put down the phone and sat in my kitchen, alone. I believe the words “OH fuck” popped in to my mind first. Actually it was more like “FUCK, fuck fuck fuck fuck!” Then, it was like a sucker punch to me guts……how am I going to tell Sean that yet another sibling is so very sick. Now THAT almost broke me. Backstory for those who don’t already know, parents….dead. Brother, Gabriel…..dead of a heart attack at 44. Sister, Stephanie…..dead of a diabetic coma at 53 (after surviving a breast cancer diagnosis at 50). Brother, Stephen…..barely alive after being on life support in January of 2015. You get the picture, right. But the thing was, my brother Sean had JUST left Ireland for a 4 day vacation to France with one of my cousins. And I sure as shite, was NOT going to ruin that for him. My cancer would still be there on Monday when he got home. And I would have a concrete plan of action by then also. So, I waited until then to tell him. In the meantime, as I sat there with my thoughts and my kitty cat, I knew I needed my friends. I knew I couldn’t bare the burden of this news alone. So my friends Chandra, Stephanie, and Tamara came to my home and “circled the wagons” so to speak. They wrapped me in as much love and comfort as they could. I’m not sure they know how MUCH that meant to me. I needed them SO VERY much that night. And as always. They were there for me. As was my friend Dave and his new girlfriend Jen, who had been diagnosed with breast cancer the year before me. I called Dave to let him know the news, and even though I had not met Jennifer, she wanted to come with me to my Drs appointment the next day, to help me navigate through all the information that would be coming at me. Her act of kindness is what has inspired me to reach out to newly diagnosed women……to be their “Jennifer” at such a devastating time. To pay it forward to the breast cancer community. I’m writing this blog post at approximately 3am. Sleep has eluded me over the past 3 days, but I know it will get better once Tuesday comes. In the meantime, I will sit with the pain (as the Buddhists teach), because trying to deny its existence will make it come out sideways. I won’t wallow in it. I’ll just let it wash over me, and then continue my journey forward. So if you happen to see me today, and I’m slightly out of sorts, a hug would be appreciated. But just knowing that my tribe has always had my back through this shit storm…….that’s been priceless. And healing. And what’s given me the strength to get through it. I think I might be able to get some sleep now……maybe.

What are you reading these days? If you are an avid reader, you probably have a running list of your must read books already cued up. However, if you have been diagnosed with breast cancer or recently found out that you carry the BRCA gene, your reading list may have turned into scouring the internet for answers, reading cancer blogs, medical journals, and the like. The search for information can be overwhelming, perhaps generating more questions then answers, and leaving you feeling lost and alone. When I was diagnosed with breast cancer at 34, this was my reality. At Survivingbreastcancer.org we are pleased to be able to offer our readers content drawn from real experiences and further disseminate resources and information because we all know "Knowledge is Power". Today on the Blog, if you are looking for a good read from someone who has been there - this is what you've been waiting for! Understanding BRCA: Living With The Breast Cancer Gene by Clarissa Foster BRCA (pronounced ‘bracka’) stands for BReast CAncer susceptibility gene. There are two BRCA genes – BRCA1 and BRCA2. These genes function as tumour suppressors, helping to prevent the formation of cancer. When either of these genes carries a mutation, a woman has a high risk of developing breast and ovarian cancer, and men with these mutations are also at increased risk of breast and prostate cancer. Mutations in these genes have also been associated with a small increased risk of several additional types of cancer. At the age of 35, I was found to carry a harmful mutation in the second breast cancer (BRCA2) gene and statistics suggested that I had a 45-85% chance of developing breast cancer and a 10-30% risk of developing ovarian cancer during my lifetime, which is much higher than in the general population. Finding out that you carry a BRCA mutation is hard, and if this happens to you, you will have a great many questions that you will feel desperate to find the answers to. I felt overwhelmed and scared of the future that lay ahead. I desperately wanted to connect with other women who were going through the same thing as me and to find answers to my many questions. I looked for a BRCA support group locally, but there were none. I also looked for a book but none seemed to offer what I was looking for. I was eager to meet with the consultants that I had been referred to, but this process takes time and it was frustrating waiting for these appointments. I hoped they would be able to answer all of my questions but, in reality, even the consultants didn’t have all the answers as we do not yet fully understand the BRCA genes and their impact. I felt very frightened, alone and frustrated that there seemed to be so little help and support and I wanted this to change. I decided, therefore, that once I had come through my own journey, I would write a book with the aim of helping others. This book aims to improve your understanding of BRCA gene mutations and the various ways in which a carrier can manage his/her mutation, including screening, risk-reducing surgery and chemo-prevention, with reference to relevant research. In the last part of this book, I share with you my own personal journey of undergoing risk-reducing surgery, including the removal of my ovaries and fallopian tubes (known as a bilateral salpingo-oophorectomy, pronounced oo-for-ek-tuh-mee) and the removal of my breast tissue while retaining my nipples (known as a bilateral, nipple-sparing mastectomy). I detail, openly and honestly, the emotions I felt before, during and after my surgeries, along with the physical experience of undergoing these operations and the surgically-induced menopause which follows the removal of both ovaries. I will share the effect, if any, that these operations have had on my body image, identity and sexual functioning. This book aims to answer the many questions that I personally had, including those that you may feel are simply too uncomfortable to ask. I felt anxious about so many things but, having come through my own journey, I realize now that I needn’t have worried anywhere near as much as I did. I really wish I had known then what I know now; it would have spared me a lot of fear and anxiety. If you have been found to carry a BRCA gene mutation, I hope that by sharing my journey with you, you will see for yourself that this journey, albeit very tough, may not be as terrifying and as insurmountable as you may be feeling right now. You will get through this – I did and you can too. And, while I appreciate you may not be feeling this way now, you may even be nicely surprised by the positive ways in which this journey may change you as a person. I am an Advanced-level Human Biology teacher and have experience of teaching both GCSE and Advanced-level (A-level) Human Biology. I also have experience of medical writing and have drawn from both of these skills throughout the writing of this book. My desire to help others has inspired me not only to write this book, but also to set up a website to offer my support to women and men worldwide who have been found to carry, or who believe they may carry, a BRCA1 or BRCA2 gene mutation. This blog was taken from Clarissa Foster’s new book Understanding BRCA: Living with the breast cancer gene is now available on the Hammersmith Health Books website. #BRCA #breastcancer #BRCA1 #BRCA2

A few months ago, Dr Charley from Cancer Tamer (cancertamer.org) contacted me at Survivingbreastcancer.org about teaming up and participating in a rafting trip scheduled for August, to celebrate life. Little did I know that a day on the river would change my life! Invitations went out to breast cancer survivors, thrivers, caregivers and advocates. The rafting trip served as a bucket list item for many participants, regardless of age. The itinerary read: Meet at location at 10am Rafting from 11-4 (lunch included) BBQ afterwards Simple. Straight forward. It sounded good. My caregiver, William, and I signed up. We made the 5-hour drive from Boston to central Pennsylvania and within minutes of being ensconced in the mountains, we heard the rippling sounds of water rushing by. After an introductory session we began buckling up our safety vests and our adventure began! 25 inexperienced thrivers and caregivers (though William would argue he is experienced) jumped into the rafts, paddles at the ready, final instructions received. We entered the water, and the current moved us quickly downstream. The river carried us away from our launch site and there was no turning back! Within minutes of starting our rafting journey we hit our first section of rapids. Our guides say it was a class two, but by the size of the waves splashing directly onto me, it felt like much more! The air was warm, the water refreshing, and women between the ages of 30 and 80 were splashing one another, smiling, and giggling like we were all 13 years old again and on a summer camp adventure! The beauty of the trip was the absolute judgment free environment. Though we all came from different walks of life, breast cancer unified us, and we established a strong bond that day on the river. The trees lining the riverbed provided fresh air for us to breathe in hope; the clouds above provided shade and coverage from a hot sun and protected us along our journey. The river was high from several weeks of rain, and cradled us as we cascaded over the ebbs and flows of the Lehigh river. The River derives it’s name from an old Lenape descriptive and means “where the forks are”. As you navigate this beautiful river you get to choose one fork or another for safe passage. As breast cancer survivors and thrivers we too get to choose from various “forks” in our medical care, nutrition options and exercise regimentations. I know how strong rivers and currents can be, the power of water, waves and rapids at the beck-and-call of mother-nature. And there we were, just as powerful as the water that carried us, fierce, strong, and courageous women who are not letting treatment nor a first or a second diagnosis of cancer defeat us. What stood out was the vibrant community forming; the immediate friendships that developed and the camaraderie and spirit these beautiful women showed. The power on the water that day was magical – breast cancer thrivers enveloped by mother-nature - two force that are undefeatable. Want to join us at our next event, check out our upcoming events for breast cancer awareness month! Hope to see you there! Xo, --The SBC Team