breast cancer – watercress words by Dr Aletha

How families can face cancer with confidence and hope-a book review

Together they wrote this book to help cancer patients navigate the journey with both personal and professional guidance. Joining them are other families dealing with cancer who candidly share their experiences and what they have learned along the way, both positive and negative.

After You Hear It’s Cancer

A Guide to Navigating the Difficult Journey Ahead

By John Leifer with Lori Lindstrom Leifer, MD

Dr. Lori Leifer, a radiation oncologist, was well qualified to author a book about cancer. As a physician who treats cancer with radiation, she has extensive training and experience managing patients diagnosed with this devastating disease.

(Note: the photos and graphics are for illustration and are not associated with the book. The book links are affiliate links for possible compensation to this blog.)

But her professional expertise expanded to a new level when she found a lump that turned out to be cancer. Then she and her husband John faced the daunting task of confronting cancer as a patient and patient’s spouse.

chance of developing breast cancer by age 70-National Cancer Institute — Source: National Cancer Institute (NCI)

They turned this life changing experience into another chance to help the people she has spent her career caring for. Together they wrote this book offering personal and professional guidance to help cancer patients navigate the journey. Joining them are other families dealing with cancer who candidly share their experiences and what they have learned along the way, both positive and negative.

Cancer- the difficult journey

Their guidance follows the same journey cancer patients follow. First there is a diagnosis, followed by treatment option review and planning . Then there is the active treatment phase which may involve some combination of surgery, radiation, and chemotherapy.

Finally, there is life after the treatments. Each phase has its own issues to navigate, which they explain with advice that is specific and understandable.

A mammography on left and a Magnetic resonance image (MRI) on right. Breast imaging technology has changed over the years. Note MRI’s enhancement ability to confirm diagnosis.
Mitchell D. Schnall, M.D., Ph.D. University Of Pennsylvania
Creator:Unknown Photographer, Public domain

Navigating the journey

In part I, Diagnosis and Treatment Planning, they review how doctors diagnose and stage cancer, and how that influences treatment. They discuss when and why to get a second opinion, how genetic testing can help, selecting doctors and facilities, and considering a clinical trial.

This image shows a triple-negative breast cancer cell (MDA-MB-231) in metaphase during cell division. Tubulin in red; mitochondria in green; chromosomes in blue. A better understanding of how mitochondria play roles in tumor cell division may provide new therapeutic targeting strategies to stop tumor cell growth.National Cancer Institute \ Univ. of Pittsburgh Cancer Institute
Creator:Wei Qian-public domain

Part II, During Active Treatment, they advise on the practical aspects of paying for cancer care and how caregivers fit into the treatment plan. Other vital topics include pain control, managing side effects, and the importance of nutrition and exercise. They also review why and why not to consider complementary therapies.

There are different subtypes of women’s breast cancer. Knowing which subtype is important for guiding treatment and predicting survival. This graphic was created for the Annual Report to the Nation on the Status of Cancer, 1975-2011, published in 2015. Source:
National Cancer Institute (NCI), public domain

And in part III, After Initial Treatments Are Over, they acknowledge the challenge of cancer survivors, and what to consider when treatment is not effective. Sometimes patients and families must face “difficult decisions,” with guidance on when to stop curative treatment and use hospice care.

Guidance

All along the way the Leifers advise readers to “ask questions” and each section concludes with a list of specific questions to ask.

The book ends with a list of Resources such as advocacy and support groups, websites on cancer treatment and research, foundations and other nonprofits, government websites, and professional associations.

Some of these are

Recommended for “those who hear its cancer”, their families, and friends

I recommend this book to any families currently navigating this “difficult journey.” Others wanting to understand and support friends and co-workers with cancer will find the advice useful.

Since cancer is common and likely to strike any family, everyone should consider reading it proactively. Finally, this general approach to diagnosing, treating, and living with a serious illness can be applied to other diseases that are potentially life threatening.

Read the Prologue here.

About the authors

I received a complimentary digital copy of this book from NetGalley in exchange for a review. The book was published in 2015 by Rowman and Littlefield.

You’ll be happy to know Dr. Lindstrom is still practicing at the University of Kansas Cancer Center; listen to her discuss her approach to cancer care .

John Leifer is a senior health care executive, consultant, academic, and writer, including four novels. He is also an accomplished photographer.

“In this chilling prequel to 8 Seconds to Midnight, the most devastating terrorist attack ever recorded on American soil begins and ends without spilling a single drop of blood. Four jihadists, armed with nothing more than a briefcase and a pen, walk nonchalantly through the country’s busiest airports, killing time and killing people. A deadly mist, laden with a universally lethal virus, trails close behind them. Their goal: foment a global pandemic. Their vision: Armageddon, where only the Chosen Ones – those loyal to the United Islamic State – survive. The job of stopping them falls squarely on the shoulders of one man, Commander John Hart, but will he be in time?” (Amazon links and promo text)

exploring the HEART of health

I thank NetGalley and the publishers for asking me to review this book, and especially the Leifers for sharing their story.

The Leifers’ books are also available from Bookshop.org. Visit my online shop at this link.

Bookshop.org is an online bookstore with a mission to financially support local, independent bookstores. They believe bookstores are essential to a healthy culture and they are dedicated to the common good. Bookshop.org donates a portion of every sale to independent bookstores.

Celebrating Life after Cancer

Celebration of Life Mural-The mural was created to honor those surviving the disease of cancer. The mural’s tiles are inscribed by cancer survivors and represent the continuous flow of life.

by Aletha Cress Oglesby, M.D. February 21, 2021January 27, 2023

5 steps to understand statistics on cancer, COVID-19, and other health risks

But numbers need context. Statistics help us understand what has happened before, what is happening now, and what may or will happen in the future. And not only what, but how and why. Then we can act to change the outcome. And sometimes those outcomes involve life or death.

Recently I reviewed a journal article about breast cancer, and as most medical articles do, it started with statistics. You’ve been hearing and reading a lot of statistics about COVID-19 the past year; every television news report about the pandemic starts with the numbers -how many new cases, how many total cases, how many vaccinated, and unfortunately how many deaths.

Before the pandemic you probably weren’t too familiar with the medical science of epidemiology which uses lots of statistics.

Epidemiology is the branch of medical science that investigates all the factors that determine the presence or absence of diseases and disorders.
National Institutes of Health

Health data doesn’t help us much if it just ends up in medical journals or textbooks. Physicians and other healthcare clinicians use it to counsel patients and make medical recommendations about preventive care, and diagnosis and treatments of diseases.

How doctors use statistics to help patients

You might say we use them as “talking points” to convince people to do things we believe will help them and to avoid doing things we think might hurt them. You’ve seen the same thing happen when public health officials make recommendations about COVID-19 suppression. So a doctor might

recommend you do something -get a mammogram or wear a mask

a mammogram image — a mammogram revealing a breast cancer image source- National Library of Medicine, Open-i

caution you against doing something -smoking cigarettes or gathering in crowds

No Smoking sign with pumpkins — Ask your doctor about ways to help you stop smoking.

encourage a behavior-wearing sunscreen or keeping 6 feet distance

all based on knowing the epidemiology of breast, lung, and skin cancers, and COVID-19 based on statistics.

Breast cancer incidence and risk

So getting back to the breast cancer article, I think many women overestimate their risk of getting and dying from breast cancer. According to the article, in the

past 5 years, 2.3 million cases of breast cancer

in women have been diagnosed in the United States (breast cancer does occur in men but the number is so low it does not change this total significantly)

The mortality rate for breast cancer is 20 deaths/100,000 women. The most recent number for deaths in 1 year is 42,000. (United States)

The majority of women have NORMAL BRCA.

COVID-19 by comparison

Since the onset of the pandemic there are been

27 million cases of COVID-19 (February 2020-February 2021)

diagnosed in both men and women in the United states. (And many experts suspect that thousands of cases have gone unrecognized.)

The current mortality rate for COVID-19 is approximately 134/100,000 people. The current number of deaths in the past year is 460,000. (These numbers are compiled by Johns Hopkins University and are current as of the published day of this post)

WHO, the World Health Organization, reports that 2.3 million new cases of breast cancer occurred last year, while in less than a year there have been 105 million diagnosed cases of COVID-19.

Did these numbers surprise you?

Did they cause you to change your mind about something?

Will you change behavior based on these numbers?

What does it matter?

Healthcare professionals use statistics to understand and predict health risks, then counsel their patients about maintaining health and preventing disease, disability, and early death. One way they do so is with screening tests, like mammograms, to detect early breast cancer when it is easier to treat. successfully.

a female physician talking to a male patient

Public health professionals do the same thing, but apply the knowledge to large populations of people, such as infants, children, adolescents, pregnant women, or the elderly. And sometimes to an entire neighborhood, town, state, or nation, as we’ve seen happen with the SARS-CoV-2 pandemic, recommending masking, social distancing, handwashing, and vaccination.

But when health, especially public health, becomes politicized these “talking points” can be used to

inflame rather than inform
manipulate not motivate
confuse rather than comfort
cause panic instead of instilling peace.

And this is more likely to happen when we don’t understand the statistics and reasoning behind the recommendations. I believe much of the misinformation that has been shared on social media is not intentional, but from misunderstanding of the message that was intended.

The Data Detective: Ten Easy Rules to Make Sense of Statistics

This is the title of a new book by Financial Times columnist Tim Harford in which he tries to answer the question

Why do we believe what isn’t true?

In an interview by Erica Pandey, Harford encourages us to be curious and open-minded, and ask the right questions with a desire to understand. When you read or hear some new and perhaps disturbing information about the pandemic, cancer, or any other hot topic, ask yourself if the teller is trying to make you smarter or trying to win an argument. (AXIOS Today podcast February 5, 2021)

(This is an affiliate link, meaning it may pay a commission to this blog is a sale occurs.)

If we can toss aside our fears and learn to approach them clearly—understanding how our own preconceptions lead us astray—statistics can point to ways we can live better and work smarter.
The Data Detective listing on Amazon

My 5 guidelines for making sense of information

RECOGNIZE any bias, inconsistencies, contradictions; does it confirm what you already know? If not, why not? What is it trying to make you believe?
RESEARCH other sources and other media, what do they say about the topic, and are they credible ?
REVIEW all the information you find trustworthy; do you have all the information you need to make a conclusion?
RECONSIDER when new information becomes available or circumstances change; if significant, you may need to start the process all over.
REMEMBER almost everything is subject to reinterpretation; as the numbers change, so may the conclusions. Statistics give us a chance to learn and understand, but aren’t the best way to prove a point or to win arguments .

final thoughts-Know Your Chances

(an affiliate link)

How to see through the hype in medical news, ads, and public service announcements

be a healthy skeptic. That doesn’t mean you have to be a cynic, simply disbelieving all the health messages you hear.
Instead, it means approaching messages critically: looking out for—and seeing through—common tactics used to exaggerate the importance of health problems or actions you can take to address them.
These tactics include emphasizing unimportant outcomes, avoiding numbers, or presenting statistics in ways that make them seem more important than they really are.
Know Your Chances: Understanding Health Statistics, by Steven, Woloshin, Lisa M. Schwartz, and H. Gilbert Welch. © 2008 by the Regenets of the University of California. Published by the University of California Press. (Read free at this link)