B y Maria Montanile The left breast decided to tease the right,  “I’m still here! Still in sight. You are empty, not an issue, while I am full of breast tissue!” The right one yelled, “I’m not a cripple! You think you’re better because of a nipple!” “I have one, yes, you have none, seems to me that I have won…” Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetup s Free Events

B y Gina Capobianco Growing from cancer. I am not the person I was at diagnosis. Cancer tried to take my life. It made me sick. Took me to the depths of a dark place, But I emerged from the darkness. Fought back against the cancer. Like a flower growing from dark soil I have bloomed. I am a different person. Stronger, more reflective. Cancer’s poisonous grip did not strangle me. I took root and grew. My will to live fought cancer’s will to kill. Now, I have a chance at life. I see so many options. New directions I can follow. My roots grow strong in the dark soil. A beautiful bloom replaces the darkness. With each breath I grow stronger, More resilient. Ready to truly live for the first time in my life. I have grown, Become the flower I was always meant to be. About Gina Capobianco: I have stage 4 metastatic breast cancer. I was treated with chemotherapy. The treatment was successful. I am now being treated with targeted treatment. I was 50 years old when I was diagnosed. A mammogram a few months before my diagnosis was normal. So, the diagnosis was a shock. I have the best medical team and support system. Writing has helped me through this battle. I wrote poems and journaled throughout treatment and continue to write. I also struggle with depression and anxiety, which made my cancer battle even more difficult. Writing helped in this area. I learned I have a fight in me. I know I am not finished fighting, but learning I have the ability to fight has made me stronger. Now, I hope to help others fight and live. I can be reached at ginacapobiancoauthor@gmail.com . Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetup s Free Events

B y Jill Rackham In October 2020 my breast cancer diagnosis changed my life forever. But having some amazing nurses there most definitely helped me hold it together. So a big thank you to Linda, Beth, Alison and Lorraine. Throughout all this you have definitely helped to lessen my pain. Through the dark times my mind felt all over the place. Your words helped me to stop over thinking things in such haste. You have given me injections, treatment, wound checks and blood tests. You have completed my pre-ops and made me laugh when I didn’t feel my best. When the words of the surgeon or oncologist felt surreal or confusing. You helped me understand and then often we found things amusing. Four lots of surgery was advised to be had. Each time one of you visited me on the ward – this made me feel less sad. You have helped me adjust to my new “normal” life. And helped me overcome medication side effects which caused such strife. Your outstanding care has certainly seen me through. You each are like an Angel and I truly want to thank you. Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetup s Free Events

B y Susan Thomas What my body has endured over the last 9 months has been incredible.  Chemicals have been injected into me – killing everything in its path, including every single body hair. Every single one.  Depleting me of my self-confidence, my energy, my light.  The nausea and constant tiredness. The brain fog.  The tears. The rage. The anger. The sadness.  The silent tears and the constant pushing myself to take another step forward. Hiding the pain on some days.  My gums have bled, my stomach has ached, and my heart has broken, over and over again.  The endless procedures, MRIs, and CT scans. Veins have collapsed, my arms have felt like pincushions and my hands and feet have tingled and legs have cramped.  The fears that came with surgery and the further disappointment and heartbreak of having to return to surgery. The countless doctor visits and overwhelming task of medical bills, follow ups and admin.  Then the final chapter of this journey – driving daily for radiation treatment, lying there feeling overwhelmed breathing through a snorkel whilst this huge machine moves around you – and feeling no pain – wandering if anything is actually happening. Is the cancer truly gone…?  Slowly my body is recovering, my light is returning. My hair is growing. I am learning that who I am is not who I see in the mirror. I am more than that.  I am grateful.  I am grateful for my amazing children, my husband, my family, my friends, an amazing medical team and medical facilities. The opportunity to be able to afford medical aid.  I am grateful that things no longer taste like metal, for funny memes and encouraging messages – for small moments of joy – be it that cup of morning coffee, an unexpected phone call, a feel good song on the radio or a chance to ride my bicycle again. I am grateful I get to make more memories.  I am grateful for this path and the stronger person I am coming out of this. I choose to not live in the past. I choose for this to only have been a chapter of my life – but not the whole story.  Connect with Susan on Instagram: https://www.instagram.com/susanjaynethomas_ Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetup s Free Events

B y Sara Kandler rainbow tendrils flail in the wind catch on the maple tree knobs a gift we brought you back from  a day at the beach fish meant to fly pinned lifeless to your bookshelf now hangs by our driveway ribbons twist and tear struggle in the gusts like you bent over your red walker back torqued like the fish hook of the Outer Cape aching knees give out at a moment’s notice one fall and I’m gone you taunted with a mischievous grin your favorite truism don’t  get  old or the rare compliment you done good and the one about the cabbie who declared let me be the foist ta congratulatchas you and mom settling in for the ride downtown dressed to the nines such a handsome couple no one could deny still you bemoaned your cavern deep  loneliness no real friends no one cared  a boy sent into the unknown for safety’s sake your arm flailing outside the train window auf wiedersehen you’re forced  to say grey pea coat brown valise twisted heart Follow Sara Kandler: https://medium.com/@sarakandler   Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetup s Free Events

B y Jill Rackham Breast cancer, you’ve changed my life and I’m getting cross with you now. How is it that my dear friend also has a diagnosis somehow. Eleven months after hearing those terrible words. My friend had to hear them too, this is just so absurd. But thank goodness breast cancer we both found out you were there. And we have massively supported each other to help lessen the scare. We have together analysed the words of our oncologist and surgeon. Discussing everything in detail to try and reduce our mind’s burden. Even though our treatments and surgery gave us ailments and pain galore. We were always going to do anything to make sure that cancer was no more. We could talk to each other so honest and openly. Whilst helping each other to try and still see things positively. The hard-hitting words we have both heard will never leave us be. And maybe in years to come our journeys will get muddled and we won’t know which parts happened to my friend or me. We are now both adapting to our new normal life. And have hopefully overcome so much of our strife. Dealing with cancer is certainly tough for me and my friend. But I know the friendship bond we now have definitely has no end. We have felt each other’s pain in the darkest of moments, and now want life to be full of cheer. Breast cancer, we WILL overcome you, because you definitely have picked on the wrong two friends here! Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetup s Free Events

By VH Lester Where did I go when they drugged my veins  Who was the angelic nurse who effortlessly managed my pains? Who was the gentle man who held up my hair? Who were the compassionate friends always there At the end of a call or dropped by to check in Kind words of wisdom when in despair  Who are the suffering others that also slog through this hell The man in the corner who suddenly fell  The lady who sat and listened to bad news  The gentleman who sat calmly watching on pews  Did that nurse get any time off  Did the doctor who’s relentless with patients ever get cross Did the tea lady Jackie ever tire of her gift to uplift us all with biscuit or cake – with a look that’s so knowing and utterly bare that slays you as she says “sweet child do take care” I’m in bewildered surprise at these passionate folk who tirelessly give all for us patients to miraculously cope Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetup s Free Events

By Gloria Shoon As I follow my heart’s wisdom And explore nature and all she has to offer I find myself dreaming Daring to face the past Whilst treating my mind, body and soul... My brain and heart connect passionately Geared for fun and living in the moment My soul whispers Believe in yourself Just Do It There is more to explore... The golden NURTURE stone spoke Throughout our Conscious Awareness Retreat The meditation that took me way, way, way back... Lying on my Papa’s chest in the hammock in a gentle embrace Nursing on my Mama’s breasts while cradled in her loving arms The Circle of Life Mandala with 8 big leaves attached to the Inner Circle 8 smaller leaves that weren’t All just slightly dancing in a clockwise direction From the spiraling Fibonacci sequence Again Nurture in Nature The circle at the centre Movement of the 3 Body, Mind, Soul Infinity... From hiking Bell Rock To posing for a photo with a Statue of Sacagawea A symbol of women’s worth and independence Reminded me of the Coin we were gifted in management training in IBM in 2000 Which to this day still lives in my wallet Never to be forgotten... Then to hiking The Sedona Airport Trail To walking the 8 midway along the path A weekend of Nurture-Recharge-Transform With 11 sis-stars and 1 brother... Finding the Archangels Patio  Perfect spot for the Inner Divinity Meditation To invoke the presence and symbolism of what they represent Archangel Michael - Safety - Connect with Our Higher Self, Source, The Oneness Archangel Gabriel - Messenger - Connect with our Inner Wisdom Archangel Uriel - Lights the way - Take action, 1 step at a time Archangel Raphael - Healing - Our Inner Healer So we can nurture those characteristics within ourselves... Rolling along, with a style all my own I make my mark A golden 5-pointed star shines brightly Believe, Achieve, Succeed OMG - Oh My God!!! Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetup s Free Events

By Teresa Kander Fighter? Warrior? Survivor? No, that’s not who I am this time. I once fought cancer and won, But now there will be no final victory-- I may win battles along the way, But the war will go to the enemy. It’s not that I will ever give up on life; I plan to live every day to the fullest. Cancer won’t steal my joy in the days to come, Even when it comes to steal my life. TDK 10/5/24 Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetup s Free Events

By Nancy Hodgkins A profound inescapable sadness Unrelenting. Unerringly the ache seeps into every pore of my heart and soul. Hijacking my natural joy. Like a flower struggling bravely not to wilt in a torrential rain. Longing for safety in a shelter away from the heaviness of the emotional storm The wind hears the flower’s sigh of defeat. … Unimaginable Regret … An impossible wish to turn back the hands of time. A lightning bolt strikes. Cuts through the sky like broken glass eroding warm memories and leaving them tattered on the edge of despair. Thunder rages, trees bend until the storm finally passes on. A ray of sunshine peeks through the dark clouds and the flower’s petals shift towards the light reaching for a glimmer of hope. Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetup s Free Events

By William Laferriere Darkness descends, yet Something flickers,  A flame illuminating my path Whispers in the universal void, My spirit, a connective thread Weaves through this labyrinthine existence Unseen, yet present, The rhythm of the universe, A sweet, soft song guides my steps I look to the mountains, I look to the wind, I strive to overcome the impossible Amidst all the chaos and confusion, I stand secure, unwavering, at the helm, And I navigate towards calmer shores In moments of doubt, A sudden surge, a wave of conviction, Washes away uncertainty Through the many valleys of remorse and sorrow, It transforms into a gentle, clear stream, Carving new channels of hope When joy overflows, It dances, a wild and free spirit, Vibrantly painting the sky In the quietest of moments, It whispers ancient wisdom, and Echoes of lessons to be learned Formless yet formed, Invisible, yet seen, My spirit guides, nudges, embraces It is the compass in the storm, With roots in shifting sands, Providing wings needed to soar Through life’s many challenges, It remains, a constant companion, Ever-evolving, ever-guiding, ever-me. Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetup s Free Events

By Jill Rackham “Mental Chatter” we have become very good friends. Always chatting to me there is no end. Hearing the word “cancer” has definitely made you more prominent. However, I really don’t want you to be this dominant. You are really quite animated during the night. Sometimes your chatter does give me a fright. Repeating conversations with the oncologist, you were listening so well. I wonder “Mental Chatter” how long you will be around, only time will tell. You remind me of each surgery and the surgeon’s every word. I don't need your reminder, I won’t forget anything I heard. I am so ready for a peaceful night’s sleep, that is all I ask. Maybe you could give me some much needed peace at last. Connect with Jill on Instagram Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetup s Free Events

By William Laferriere in a bleak silent antiseptic room machinery lightly hums thoughts drift like asymmetrical leaves on a stream uncertainty and courage unfold a mosaic of moments fragmentary yet whole the body a landscape of change each and every scar a story a testament to resilience to the will to endure to transform and transcend the face in the mirror seems unfamiliar the eyes hold a fierce light a determination that defies words a silent promise to oneself the world outside moves in its rhythm yet here time warps bends and stretches moments of clarity amidst the haze finding strength in unexpected places hands reach out connections form threads of empathy weave a tapestry shared journeys and whispered fears laughter echoes in the void in this space of becoming and unraveling  there is beauty in the struggle a graceful intent a metamorphosis unfolding quietly powerfully the emergence of something new from within and as the dawn breaks anew each day there is hope in the light filtering through a reminder that transformation is not an end but a beginning a continuous journey towards wholeness Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetup s Free Events

By VH Lester (last radiotherapy) 20.12.24  Hit me baby one more time Give my fraction of radiation  One more step along this bumpy road I go  Yes this is it here I go last push  Insurance policy for my future  Promises of never never  Cold hands draw red and black markings like road paint  Seeing my distorted reflection and suddenly feel faint l feel like a microwaved chicken pie warmed up with rays deep inside  I’m never scared just quite amazed this big white ship keeps my place whilst radiologists rush around symphony no. 5 in the background  So many needles I’ve totally lost count, from operations to chemo I’m all energied out  They said it takes a year to feel sane I certainly agree now 6 months of treatment ago it came  What started with a lump turned into a mountain climb  But I’ve reached the summit  I’m proud to say because today my dears is final boobie radiation day  Yes I’m going to run before I can walk and feel the ice cold wind in my mouth as I talk  I’m going to places I’ve never been, behave like an outrageous drama queen  I’m going to hold my mum and dad so tight they will have to struggle or put up a fight I’m going to look in my children’s faces and squeeze them when we are in the same places  I’m going to hold my darling’s hand and stroke his face as he understands, he’s been there night and day non stop I can’t get enough  Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetup s Free Events

By Sara Kandler I manage to unwrap my three-year-old’s surprisingly strong arms from my neck and do two drive-thru errands while the baby’s still awake in her car seat behind me and we’re humming so sweet while I spin the steering wheel slowly to the left and then to the right noticing the family-run grocery store is now a second-rate gym I should check it out and the boutique where I used to buy my boot-cut jeans now touts music classes for kids a good idea and my little one’s fussing and can I make it home in time for her to get a real nap and for me to get on the computer and suddenly I’m doing the hand-over-hand maneuver I practiced in driver’s ed with my three besties and the odd but well-meaning instructor until I’ve pulled up in front of the stucco home of an old friend who convinced me we should be more and I believed him until he explained a few months later this is just too much — I’m struggling to breathe baby now crying son must be asking for me bland house still standing music from mixed tapes spilling out into the fresh fall air This scar This car I need to get home Follow Sara Kandler: https://medium.com/@sarakandler  Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetup s Free Events

By Triona Lonergan Somebody  said that everything happens for a reason. Somebody  said you’re only challenged with what you can handle. Somebody  said the best way out is through. Somebody  said nothing is impossible, Somebody  said things do not change, we do Somebody  said that difficult roads lead to beautiful destinations.   They  told me to trust the process They  told me to embrace the uncertainty They  told me it always gets worse before it gets better They  told me life won’t wait. They  told me that if you’re going through hell, keep going. They  told me that sometimes you win and sometimes you learn.   When somebody  assumes, they  can’t see what is When somebody  smiles, they  conceal their story. When somebody  stumbles, they  make it part of the dance. When somebody  says the truth will set you free, they  must be willing to hear it. When somebody  believes in tomorrow, they  will live for today.     Unless somebody  faces adversity, they’ll  never understand that …   The only way somebody  survives is by believing they  can!!   Somebody , the wisest person they  ever quoted. Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetup s Free Events

By Pooja Jain Scribble, doodle, write your heart out Scratch the paper with your sorrow, Decorate it with your love, Color it with your anger. Why must we turn to guns to end injustices? Who will hear when people are dying? Pick up the mighty pen, Scribble, doodle, Write your heart out. Let the world listen Give someone a chance to read, And write back to you. Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetup s Free Events

By Jill Rackham BRCA faulty gene, I feel fed up with you now. I can't believe I have you and you are within my family somehow. You have been sitting silently inside me all of my life. I only discovered you when breast cancer came along causing much strife. With no immediate family history of breast cancer how could this be. It was such a shock to find out that you had made cancer grow inside me. Further surgery became part of my cancer management plan. It felt never ending but I am determined to do all I that I can. Surgery is now complete but the shock of you will take some time to recover from. Thoughts often wondering if this faulty gene is something I have now passed on… I've now done everything I can to reduce my high risk of breast cancer returning. And indeed of ovarian cancer stirring. I'm hopeful that as research continues science will lead to your fault being corrected. This could mean future generations will not be in any way affected. Only 5% of breast cancer is caused by an inherited faulty gene. I would love for this statistic to be non-existent and not even be seen. BRCA faulty gene you feel like a heavy burden to carry around. I so wish I didn’t have you, but I do and thankfully you were found. Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetup s Free Events

By William Laferriere unraveling the knots of my heart (dedicated to the many known unknowns) Pain, a throbbing pulsation within the chest, why do you linger? why do you persist? memories are like thorns,  they pierce the present, but what if...  what if we could transcend? forgiveness,  it’s but a whisper in the night, can I be the balm?  can I transform? the weight of grudges, so heavy to bear, & yet letting go feels like falling through white mountain air who am I without this pain? my identity seems wrapped in wounds,  and usually in vain, but forgiveness beckons,  a kind and gentle hand, offering up a well lit path  for to forgive is to free oneself,  but how? when anger feels like home,  like clay molded around my heart,  familiar, known, yet suffocating,  leaving me alone breathe… breathe in forgiveness,  breathe out spite, a mantra in the dark,  a flickering, shimmering light, each exhale releases a fragment of pain and hurt, each inhale, a chance to assert for I am more than my pain, more than the sum of loss and gain. forgiveness, not for them, but for me, a key to unlock, to set myself free but wait—is it that simple? that clean? to wash away tears and a multitude of years,  to wipe that bloody slate clean? perhaps it’s a journey,  not a destination, a daily choice,  an enjoyable & quiet liberation forgiveness doesn’t mean forgetting, it’s understanding, it’s resetting a narrative we tell ourselves  choosing peace over the need to be right and in this course,  this conscious shift, I find that pain begins to fade not all at once, but in waves, in stages, turning hurt into wisdom, life’s but a process rewritten with compassion’s pen, for others, yes, but for myself, again and again and again for in forgiving others, we forgive ourselves nurturing the light that always follows so let it go, let it blossom, let it flow, like a river to the sea,  let it go  let it go it transforms through the alchemy of forgiveness  into strength,  into empathy,  into you and into me evolving, growing, forever becoming, no longer trapped in its numbing forgiveness: a philosophy of the heart, where healing and wisdom commence as one and in this stream of conscious thought, I find that peace was not purchased but cultivated,  nurtured from within, where forgiveness and love have always been. Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetup s Free Events

Over 70% of people with a breast cancer diagnosis do not know why they developed the disease. Could it be environmental? The built environment is a term which refers to human-made surroundings, ranging from buildings, schools and office spaces to parks and neighborhood infrastructure. It is the setting in which we live, work, and socialize. Have you ever wondered how the environment around you affects your health and well-being? Neighborhoods are key determinants of health. The infrastructure of your neighborhood plays a significant role in your health and well-being. As an example, does your neighborhood have sidewalks where you can easily take walks, and for your children to safely ride their bicycles? Do you have access to outdoor green spaces and parks ? Do you have access to fresh groceries and healthy food? Studies have shown that these built environment factors are associated with physical activity levels and dietary patterns. If you live in a suburb, you may have access to good roads and sidewalks , but what is the tradeoff; reliance on cars contributing to air pollution and a more sedentary life-style driving to and from work, to and from the grocery store and so on? That is not to say we should all rush to move into the cities either. While city planning allows for increased bike lanes and a commuter culture of walking to the bus stop or walking a few blocks from the train to the office, people may also be more likely to pick up fast food from a convenience store, or eat out more often versus cooking at home . Our environment influences our behaviors. Neighborhood factors influence the health habits among cancer survivors, affecting survivorship outcomes, disease recurrence, and mortality. Medical evidence is beginning to show the correlation of neighborhoods' disparities in cancer risk. If people are living in an environment that promotes a more sedentary lifestyle, they are at an increased risk of gaining weight and becoming obese, which can lead to poor health outcomes and longer term health risks such as cardiovascular disease, diabetes and cancer. Today’s #FeatureFriday focuses on the built environment and the conscious decisions we all take to move our bodies daily and advocate for sidewalks, bike lanes, access to healthcare, healthy foods, education, and to cut down on toxic carcinogens in our environments. How has your environment affected your health? Let us know at hello@survivingbreastcancer.org . Articles: Is Cancer Prevention Influenced by the Built Environment? Transportation is an element of the built environment interrelated to accessibility and housing. Good access to transportation ensures access to high-quality screening services and has been found to be associated with less severe stages at diagnosis for many cancers. Transportation infrastructure, such as ports, railways, and expressways is also associated with higher rates of air pollution and, in turn, higher exposure-based risks for lung, colorectal, and nervous system–based cancers. Environment and Obesity Many environmental factors that affect relative weight can be classified under sixteen headings. The first of them, the built environment factors that act upon body weight balance include physical, chemical, biological agents, urban housing and social conditions, transportation and pollution related to the proximity of influential agricultural or industrial environmental centers of activity. There is a statistically significant relationship between some aspects of the built-up environment and risk of obesity. Understanding the influence of both opportunities for physical activity and access to healthy foods is critical to obtaining a comprehensive picture of this connection. Social Determinants of Health Social determinants of health are conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks. Examples of these resources include safe and affordable housing, access to education, public safety, availability of healthy foods, local emergency/health services, and environments free of life-threatening toxins. Understanding the relationship between how population groups experience “place” and the impact of “place” on health is fundamental to the social determinants of health—including both social and physical determinants. Leveraging the Built Environment for Health Equity According to the Centers for Disease Control and Prevention, the built environment “includes all of the physical parts of where we live and work” (2011, 1). These include our homes, workplaces, streets, neighborhoods, infrastructure, buildings, parks, trails, and even vacant properties that once contained structures. Health equity means that “everyone has a fair and just opportunity to be as healthy as possible.”1 To achieve health equity, communities must address the differing levels of access that various groups have to health-promoting systems and resources like housing, transportation, jobs, parks and recreation facilities, food, medical care, and neighborhoods and their differing levels of quality, cost, and safety.

Lymphedema refers to swelling caused by a build-up of lymphatic fluid in the body. It is commonly brought about by the surgical removal of or damage to one's lymph nodes due to cancer or cancer treatment. For example, a tumor may block the flow of lymph fluid and result in a blockage. In other cases, lymphedema may develop due to damaged lymph nodes as a result of surgery or radiation. Your lymphatic system serves a critical biological role. It’s job is to circulate lymph fluid (a protein rich solution) throughout your body, capturing bacteria, viruses and waste. These wastes are then filtered through your lymph nodes, by infection fighting cells called lymphocytes, and then flushed from your body. According to the NIH, 5-17% of women who have a sentinel lymph node biopsy (SLNB) develop lymphedema and the percentage increases up to 53% for women who have an axillary (armpit) lymph node dissection (ALND). Lymphedema can occur a few months after treatment and, in some cases, may manifest 20 years later. While there is currently no cure for lymphedema there are precautions people can take to reduce the chances of developing it - such as keeping the affected arm clean and avoiding cuts. Suggestion: When going for your follow up doctor's appointments, ask to have your blood pressure taken, and/or any bloodwork drawn, from the non-affected side. You may may also want to avoid wearing tight clothing, watches and restrictive jewelry to prevent any lymph blockage. In the event that you develop lymphedema, there are several therapies available to manage the swelling, reduce the pain and promote the flow of lymph throughout the body. You may consider wearing a compression garment when flying or working out as a preventative measure. Compression garments may also be worn more routinely to manage symptoms. The Lymphedema Network has a directory of massage therapists who work with patients and perform lymphatic drainage. This practice can be taught to patients and is a technique that can be used daily at home. Depending on the severity, a lymphedema therapist may also recommend bandaging/wrapping the arm to mimic a pumping sensation and help promote the flow of lymph fluid. While those who have had lymph nodes removed (or had radiation to the lymphatic area) may feel that they are always in a state of managing lymphedema - either preventative or treatment, the good news is that there are several treatments and therapies available so that the swelling and pain do not become severe. If you have developed lymphedema, massaging and wrapping your arm can become part of your bedtime routine just like brushing your teeth and flossing. Today's #FeatureFriday highlights information on maintaining a healthy lymphatic system after a breast cancer diagnosis as well as information and resources on prevention and treatments What are you doing to prevent or manage lymphedema? Let us know at hello@survivingbreastcancer.org . Articles: The Science behind Compression Therapy in Lymphedema Management Lymphedema does not dissipate by itself and continues to progress without adequate treatment. The goal of lymphedema management is to reduce the lymphedematous swelling to a normal or near normal size utilizing remaining healthy lymph vessels and other lymphatic pathways. Once the lymphedema is decongested, the secondary goal is to maintain the reduction and to prevent the re-accumulation of lymph fluid. ...................................................................... Physical Therapy Guide to Lymphedema About one in five women who are living with or beyond breast cancer and who have had the lymph nodes in their underarm removed during breast cancer treatment will develop lymphedema. Identifying and treating lymphedema early helps to ensure more rapid and improved outcomes. PureTech Initiates Phase 2A Trial of LYT-100 (Deupirfenidone) in Lymphedema A clinical-stage biotherapeutics company dedicated to discovering, developing and commercializing highly differentiated medicines for devastating diseases, today announced the initiation of a Phase 2a proof-of-concept study of LYT-100 (deupirfenidone) in patients with breast cancer-related, upper limb secondary lymphedema, a chronic and progressive disorder for which there are no FDA-approved drug therapies. LYT-100 is PureTech’s wholly-owned product candidate that is being advanced for the potential treatment of conditions involving inflammation and fibrosis and disorders of lymphatic flow. Lymphedema: What Are Your Surgical Options? If your lymphedema progresses despite using medical treatments, you may be a candidate for surgery. There are several options that your doctor will discuss with you: Vascularized lymph node transfer surgery (lymphovenous transplant), Lymphaticovenous anastomosis (also referred to as lymphovenous bypass), or Charles procedure (skin grafts)

"How did you sleep last night?" Did you toss and turn? Did you have vivid dreams? Did you sleep soundly? There are many factors that contribute to a good night's sleep such as food choices, body weight, alcohol consumption, and even one's age. As reported by Snore Lab, 10% of young adults under 30 snore compared to 40% who are over the age of 50. People diagnosed with cancer may have even more challenges sleeping due to the side effects of treatment such as insomnia or hot flashes which disrupt sleep quality. Sleep plays a significant role in overall health. It affects all aspects of the body ranging from increased energy and serotonin levels to better mood, cognition, and immune function. According to the American Sleep Association, 50-70 million US adults have a sleep disorder; 48% of people report snoring and 21% of women have obstructive sleep apnea. Many women snore as they age, especially at the beginning of menopause due to the change in hormone levels . Estrogen is essential for muscle and cell health. When the female sex hormone is depleted, muscles tend to soften and lose their elasticity and form. Moreover, women entering perimenopause, menopause, or medically induced menopause associated with cancer treatments, become prone to muscle deterioration, (think of increased fat around the midsection, hips and thighs). However, the soft tissue in the throat is not out of harms way! Estrogen and progesterone maintain the airway’s muscle tone in the throat, and keep it from collapsing. However, as hormone levels drop, women who are in menopause are more at an increased risk of developing sleep apnea. According to the Mayo Clinic, t he tissue in the throat relaxes and can partially block your airway and vibrate. The narrower the airway, the more forceful the airflow becomes. This increases tissue vibration, thereby causing snoring to grow louder. In this week's #FeatureFriday, we explore the correlation between snoring, menopause, and breast cancer. How are you sleeping? Let us know at hello@survivingbreastcancer.org . ~SBC Editorial Team Articles: Association of Estradiol with Sleep Apnea in Depressed Perimenopausal and Postmenopausal Women: A Preliminary Study Women’s risk of obstructive sleep apnea (OSA) increases substantially during and after the menopause transition, when depression risk is also elevated, raising the possibility that estrogen withdrawal contributes to OSA vulnerability, in turn contributing to mood disturbances. These preliminary results suggest that, in addition to higher BMI and age, lower estradiol may be associated with increased Obstructive Sleep Apnea (OSA) risk in depressed women during the peri- and postmenopause, raising the possibility that estradiol withdrawal associated with menopause influences upper-airway patency in women. Study links sleep duration and frequent snoring to poorer breast cancer survival. Results show that women who typically slept less than the recommended 7 hours of sleep per night and were frequent snorers in the years before their cancer diagnosis experienced a poorer cancer prognosis. The findings were especially robust for women who were diagnosed with breast cancer. Breast cancer patients who reported sleeping 6 hours or less per night and snoring 5 or more nights per week before their diagnosis were 2 times more likely to die from breast cancer (hazard ratio = 2.14) than patients who reported sleeping 7 to 8 hours per night and rarely snored. Sleep Apnea and Cancer The tissues in your upper airway tend to lose structure as you sleep. You're relaxed, after all, and so are the muscles in the chest, neck, and face. Breathing in and out through an airway that's surrounded by soft or "flabby" tissue results in audible vibrations in the throat. These sounds may be soft or loud, or you might hear groans or whistles instead of the rattling most often associated with snoring. Sleep is a whole-body process that has a unique relationship to all body systems. When sleep is disrupted, it is fair to say that system disruption also occurs. Over time, these disruptions render an environment where chronic disease can flourish. M enopause and Sleep Generally, post-menopausal women are less satisfied with their sleep and as many as 61% rep ort insomnia symptoms. Snoring has also been found to be more common and severe in post-menopausal women. Snoring, along with pauses or gasps in breathing are signs of a more serious sleep disorder, obstructive sleep apnea (OSA). Changing and decreasing levels of estrogen cause many menopausal symptoms including hot flashes, which are unexpected feelings of heat all over the body accompanied by sweating. They usually begin around the face and spread to the chest affecting 75-85% of women around menopause.

The San Antonio Breast Cancer Symposium (SABCS) takes place annually in early December and has become the coveted event of the year! For 43 years, experts have been gathering to discuss and present state-of-the-art research in breast cancer. What once was a local one-day regional conference back in 1977 has expanded into a five-day international symposium attracting 8000+ physicians, researchers, surgical, gynecologic, and radiation oncology, as well as patient advocates from across 90+ countries. From research presentations, poster sessions, networking, and advocacy, SABCS 2020, in it's virtual environment this year, did not let us down. In case you missed the flurry of #SABCS2020 going viral across twitter, this week's #FeatureFriday curates our key take-a-ways and hot topics from the conference. Did you attend any of the sessions? What were your highlights and favorite sessions? Let us know at hello@survivingbreastcancer.org . ~SBC Editorial Team Articles: Anastrozole vs Tamoxifen: Similar Outcomes, Different Toxicities “Although our analysis did not show any significant difference in terms of recurrences between anastrozole and tamoxifen, it really shows that an improved understanding of adverse-event profiles will help patients with hormone receptor–positive ductal carcinoma in situ to make an informed decision regarding their treatment,” said study presenter Ivana Sestak, PhD, Centre for Cancer Prevention, London, United Kingdom. Should All Breast Cancer Patients Receive Genetic Testing? Recent years have seen calls for genetic testing for all patients with breast cancer, most notably from the American Society of Breast Surgeons, w hich issued guidelines in February of last year urging genetic testing with a multi-gene panel for every person diagnosed with breast cancer. Published research also has supported population-based screening among those diagnosed with the disease, while other research has urged caution for such an approach. According to Robson, since criteria for genetic testing was first established, some of the assumptions previously used to asses risk have since been debunked. Something Robson says has become evident in recent years is that family history criteria are somewhat insensitive for detecting pathogenic variants (PVs). SABCS 2020: What's Hot, Including a Major Chemotherapy Tria l The "hottest" presentation at the upcoming 2020 San Antonio Breast Cancer Symposium (SABCS) coms from RxPONDER (abstract GS3-00), a major randomized clinical trial assessing use of a recurrence score among women with lymph node-positive, early-stage breast cancer to determine who might safely forgo chemotherapy. If the new trial sounds familiar, that's because it's a lot like the TAILORx trial, the results of which were first presented in 2018 and have changed practice in women with early-stage disease and no lymph node involvement. "This is the lymph-node positive TAILORx. It's extremely important," Kaklamani told Medscape Medical News, adding that both trials involved women with HR-positive, HER2-negative disease. Can Mindfulness Meditation and Survivorship Education Help to Reduce Depression in Young Breast Cancer Survivors? About 20% of breast cancer cases occur in women younger than 50. Persistent depressive symptoms, lasting 2 weeks or more, are especially problematic in the target population. The results of this new study highlight how 6-week interventions can reduce depression in younger women treated for breast cancer, and in the case of mindfulness meditation, improve related symptoms such as fatigue and sleep disturbance.

Happy New Year. Have you made any resolutions to serve as health goals for the upcoming year? At survivingbreastcancer.org we feel it is crucial to our well-being to have a "surviving" mentality. Ongoing research is investigating the risk of developing secondary cancers is affected by lifestyle or environmental factors. "However, most studies have been based on data from cancer registries or medical records, which generally don’t have data on these potential risk factors." according to the NIH Division of Cancer Epidemiology and Genetics. Studies show that compared with the general population, adult cancer survivors have a higher risk of developing a second primary cancer and an even higher risk of dying after such a diagnosis. The risk of developing a second primary cancer among adult cancer survivors has increased significantly in the last 15 years, likely due to the growing number of long-term cancer survivors, and especially those who have been exposed to carcinogenic treatments and/or certain lifestyle-related cancer risk factors (for example smoking, obesity, alcohol use, toxic cleaning chemicals & make up, etc., and certain infections). While there is no cure for cancer (yet), and we are still tying to understand why some people are predisposed to developing cancer and others are not, we highly recommend the following healthy eating and exercise tips (if possible): Reduce or eliminate alcohol consumption. Study your medications. (Work with your oncology teams to stay on top of developments in the field). Work with a nutritionist and/or exercise coach to develop a realistic plan. It is not uncommon to hear that women on Tamoxifen or an Aromatase Inhibitor gain weight or struggle to lose weight. This is most commonly associated with the lack of estrogen /hormones in the body and the effects of menopause (either naturally or medically induced). By working with a nutritionist and exercise coach, they can assist you in designing a plan that works for your lifestyle! Join our community, or similar ones, that offer substantive webinars, diet/education resources, exercise coaching & partnering and yoga***. *** At survivingbreastcancer.org we have created a buddy system utilizing WhatsApp to assist in the ongoing community exercise program. Please remember there is no shaming. If you can lift 100 lbs and I can only lift 10 lbs then be cognizant of the delta. We are here to support, encourage and assist. We have been through an extraordinary year, and the COVID-19 pandemic isn’t over yet so be safe, remain socially distant, and by all means wear a mask and get the vaccine. Lastly please consider our upcoming webinars and podcasts as we discuss ways to insure a healthy and positive new year. List of events: Thursday Night Thrivers Meetup Breast Cancer Book Club Empowered with Exercise Benefits of yoga Boosting Immunity through Balanced Nutrition RSVP here . What resolutions are you making for 2021? Let us know at hello@survivingbreastcancer.org . Articles: Lifestyle Factors Can Lead to Multiple Cancers Over a Lifetime—Here We Go Again Even in the best of circumstances, when cancer is cured, survivors may be left with long-lasting adverse effects of treatment and an increased risk of developing other cancers in the future. disturbingly increased risk of second primary cancers first became apparent in survivors of childhood and young adult cancers, and was thought to be due to genetic cancer predisposition syndromes that can cause multiple malignant diseases at a young age as well as to the aggressive and carcinogenic treatments they often receive. 12 Ways to Practice Self Care After a Metastatic Breast Cancer Diagnosis I’ve been living with metastatic breast cancer for 18 years and have found that consistent exercise—such as walking or yoga—has been great for my bone health. —Terlisa Sheppard “Since my years ago, I’ve continued to live a full and meaningful life. I start my days in private with prayer and meditation. I enjoy baking, I walk 2.1 miles at least five days a week, and I am active in my community. I also speak at breast cancer awareness events, which feels liberating.” —Karen Stock 12 Benefits of Walking That Will Make You Want to Lace Up If you do have an illness or chronic condition, walking is often more accessible (and sometimes more palatable) than other forms of exercise. And it still brings big benefits—for instance, improved function and reduced fatigue during breast cancer treatment , better blood sugar control (when done after eating) if you have diabetes , and improved quality of life if you’re a cancer patient or survivor . BREAST CANCER: DIABETES RISK REDUCTION DIET LINKED TO IMPROVED SURVIVAL A breast cancer diagnosis may increase the risk of developing T2D. Therefore, identifying strategies for T2D prevention among breast cancer survivors may play a key role in improving their survival outcomes. One approach may be through a diabetes risk reduction diet (DRRD), a dietary pattern comprised of 9 components that has been associated with 40% lower T2D risk in a previous Nurses’ Health Study publication.

This year more than “forty-two thousand (42,000) woman in the US will die of breast cancer” ( BreastCancer.org ). At survivingbreastcancer.org we are privileged to continue recording several discussions (webinars) with Abigail Johnston and her peer group Grieving Together. Topics have ranged from estate planning, palliative care, & hospice to the many forms of grieving. Our upcoming webinars and #FeatureFridays look to further these discussions, and to perform a deep dive into the loss of loved ones due to breast cancer. On January 24th we meet the mothers who have lost their daughters to breast cancer. On February 7th we meet the husbands who have lost their spouses. And we close the series on February 21 by meeting the daughters who have lost their mothers to breast cancer. In today’s #FeatureFriday we look at Disenfranchised Grief. Grief is a complex emotion that may assume many shapes and manifestations. There are several notable types of grief, with disenfranchised grief one of the least well-known. For that reason alone, it may be one the most demoralizing. Disenfranchised grief is a term used to describe grief that is not acknowledged by society. Coined by Ken Doka, he describes it as “Grief that persons experience when they incur a loss that is not or cannot be openly acknowledged, socially sanctioned or publicly mourned.” [1] Examples include the · Death of a friend · Grieving the loss of someone we’ve ever known online · A trauma in the family · The losses of a pet · Infertility · Miscarriage · Losing someone to suicide · The loss of a partner in an extra-marital affair · Loss of independence It “is an ethical failure to respect the bereaved both in their suffering and in their efforts to overcome it and live meaningfully again in the aftermath of loss” [2] Disenfranchised grief also occurs when society treats your grief as insignificant. In these cases you are not only grieving in silence, but also the right to mourn that loss. Thus disenfranchised grief occurs when society invalidates that feeling of grief or treats it as insignificant. This may happen in cases where the loss suffered is stigmatized, if the relationship is seen as insignificant, or if the relationship is stigmatized by society. “One of the most demoralizing things about disenfranchised grief is that often grievers don’t get the support they need. This means they can become vulnerable to loneliness, guilt, and depression.” [3] This lack of support serves to complicate the grieving process and makes it harder for the griever to heal. Origination of disenfranchised grief Disenfranchise as a concept was originally used to describe the action of depriving someone of their civil rights. Similarly, this deprival is essentially what people who experience disenfranchised grief feel, as their right to mourn is not recognized by society. Factors than can cause disenfranchised grief Normally we get support and validation from others after losing something or someone we love. This recognition plays a pivotal role in the mourning process, since recognition and validation are necessary for healing. However, people who feel disenfranchised grief don’t receive this recognition, so in addition to losing their loved one they also lose the opportunity to mourn it, thus they’re denied the right to recover from that loss. How disenfranchised grief occurs Grief that is not acknowledged If the relationship between the griever and the person they lost is not recognized, people may minimize the griever’s feelings because they don’t perceive the bond strong enough to warrant grief. Similarly, the stigma of people with mental disabilities and the perception of their inability to “show” emotion. One’s loss is not recognized In some cases, the loss is not considered emotionally significant or there are value judgements made on the person who passed away because of stigma such as suicide, or being in a gang. Grievers themselves are not acknowledged Following a loss, there’s usually an 'obvious griever' who receives the necessary support, but that could leave other grievers who do not receive condolences without an outlet to express their feelings. For example, the wife who lost her spouse, but what about the coworkers of the spouse? How to cope with Disenfranchised Grief It’s important to provide acknowledgement and self-validate what you are feeling. Your thoughts and feelings serve a vital purpose in your healing. Recognize how you feel today because of the loss and what you need to do to move forward. Allow yourself to be with those feelings without judgment. Grief will look different for different people and there is no right or wrong. Some people may be more private, others may make art and memorialize their loss in creative and meaningful ways. [4] Healing does not mean that the grieving ever goes away, that loss will forever be part of us, but perhaps, as we heal, it will take up less space as it ebbs and flows throughout our day to day. News Articles A Nonheroic Cancer Narrative: Body Deterioration, Grief, Disenfranchised Grief, and Growth Cancer narratives are a phenomenological source of insight allowing us to develop knowledge on personal and societal transitions in the self-identity of individuals with cancer as their lives are abruptly threatened by it. This study analyzes a nonheroic narrative focusing on Dan’s (pseudonym) grief and disenfranchised grief as his cancer progressed. It illustrates his growth in self-identity despite his body’s deterioration throughout his long hospitalization until death at the age of 33 years. Women, breast cancer survivorship, sexual losses, and disenfranchised grief – a treatment model for clinicians Women who have survived breast cancer often suffer from short-term and long-term sexual side effects due to the different treatments that they undergo. The sexual side effects and altered sexual self-schema can affect their quality of life significantly and may result in a deep sense of loss. However, their intimate partners, family, friends, health care providers, and psychotherapists may not acknowledge this ambiguous loss. Hence, grief related to their loss may be disenfranchised
a kind of grief that is precipitated by a loss that cannot be socially sanctioned, openly acknowledged, or publicly mourned. Experiences and Needs of African American Children and Adolescents in Supportive Care Roles for a Relative With Breast Cancer Family members and friends of cancer survivors share in the survivorship experience (National Cancer Institute, n.d.), have similar needs, and experience psychological distress not unlike that of diagnosed individuals. According to Weaver et al. (2010), an estimated 562,000 U.S. minor children live with a parent in the early stages of cancer treatment. Children and adolescents living with a parent with cancer desire knowledge about cancer, experience role changes, and rely on family and the community for communication and normalcy in their lives. Causes of Disenfranchised Grief Disenfranchised grief is a term used to name grief and mourning that society as a whole and/or a persons immediate family and friendship circle don't recognize as legitimate. The relationship to the person they lost isn't acknowledged or the impact of the loss is minimized. References: 1. Doka, K. J. (November 2018). Is there a right to grieve? https://www.psychologytoday.com/us/blog/good-mourning/201811/is-there-right-grieve 2. Tillman, D. (October 2013). Grief and loss weekly reflection paper. https://lifesjourney.us/ambiguous-loss-and-disenfranchised-grief/ 3. Marques, D. (October 2019). What is disenfranchised grief. https://www.happiness.com/magazine/health-body/disenfranchised-grief/ 4. Padilla de Front, D. & Mayner, D. (February 2020). Disenfranchised grief: what it is & how to cope. https://www.mindpathcare.com/blog/disenfranchised-grief-what-it-is-how-to-cope/ Find Survivingbreastcancer.org upcoming events covering these topics on our website.