By Linda Hansen I never worried about breast cancer. No one in my family ever had it, so I was sure that I was low risk. I got annual mammograms, and they were always clear. None of my physicians ever said anything to suggest that I should be concerned. After all, I was low risk. When I hit menopause and had horrible hot flashes that kept me from sleeping, my doctor suggested hormone replacement therapy (HRT). I knew that HRT increased the risk of breast cancer, but the doctor said I should try it. After all, I was low risk. Soon after starting HRT, the hot flashes stopped, and I was soon sleeping again, and able to function. I wasn’t worried about HRT’s impact on breast cancer because I was low risk. Two years passed on HRT, and I kept getting annual mammograms that were clear. I didn’t worry, because I was low risk. I tried to do some exercise and eat reasonably well as I got older. Then again, I live in a state known for deep-fried cheese and bratwurst. Even so, in May of 2010, when I was 54 years old, I decided to try jogging. I was surprised to note that every time my right foot hit the pavement, I felt a brief pain in my right breast. I wondered what it was, but because I was low risk and I’d had a clear mammogram just five weeks earlier, I didn’t worry about breast cancer. When I got home from jogging, I checked my breasts while in the shower. I didn’t feel anything unusual, but that was expected since I was low risk. I got out of the shower, and as I applied deodorant, I noticed that a dent appeared in my right breast as I raised my right arm. When I put my right arm down, the dent went away. I was sure that it wasn’t breast cancer, but I was curious about what it might be. Rather than doing a typical exam as instructed by my doctor, I squeezed both breasts from the sides. I noted that the right breast seemed denser than the left. Although I knew I was low risk for breast cancer, it was time to call a doctor. The following morning I met with my gynecologist and explained my symptoms. He did a breast exam, and I showed him how I found the density. He said he could feel what I described, and told me he would be right back. I wasn’t concerned, after all, I was low risk for breast cancer, but I was curious. The doctor returned a few minutes later, holding a piece of paper. He handed the paper to me and told me that I had an appointment with a breast surgeon Monday morning. The paper contained all of the details. Although I was low risk for breast cancer, I was starting to get concerned. I didn’t tell anyone about what was happening with me, as I knew my family and friends might worry even though I was certain that I would be fine. Monday morning I went to the hospital to meet the breast surgeon. She examined my breasts and told me that I needed an MRI. The hospital would not schedule the MRI until they were sure my insurer would pay for it. For three weeks my doctor argued with the insurance company about the need for an MRI. Finally, it was scheduled. If you’ve never had a breast MRI, you’re missing a real treat. A wooden structure was placed on the “bed” of the MRI. It looked like a cornhole board but had two holes across the top rather than one. I was told to open my hospital gown and lie on the board so that my breasts hung through the holes. A tech reached underneath and tugged on my breasts to get them in the position that she wanted. I’m from Wisconsin, so I’ve spent time on a dairy farm at milking time. As the tech pulled my breasts I did the first thing that came to mind: I let out a long “Moo!” My breast surgeon hung the MRI film on the light box at my next appointment. I didn’t need any medical training to know that something was wrong: one breast appeared nearly black and the other appeared white. Looking at the films, I asked “Other than breast cancer, what could this be?” She responded bluntly. “I think you have breast cancer, but I can’t be sure until I biopsy it.” I was stunned. Didn’t she understand that I was low risk? This couldn’t be right. But eventually I learned that breast cancer doesn’t care if you’re low risk, and low risk doesn’t equal no risk. Life as I knew it quickly changed. I was diagnosed with stage IV breast cancer in June of 2010. I opted for aggressive treatment and more than 10 years later there is no evidence of disease on my scans. I’m doing well and enjoying every day. Carpe Diem !

By Courtney Proctor July 2012 – July 2013: A Year of Misdiagnosis I was 28 years old and otherwise healthy with no history of breast cancer on either side of my family when I found the lump in my left breast and I told myself it was probably just a cyst. However, I was on the heels of an immensely challenging 11-year period of seemingly random health issues -- including multiple emergency surgeries, a spot of skin cancer, and 3 lost pregnancies -- so I had trust issues with my body to say the least. I made an appointment with my OBGYN to have the lump checked and held my breath, really hoping for a respite from health issues. My doctor did a physical exam at the appointment and with assured confidence told me it was just a cyst (spoiler alert: it was cancer). To say I was relieved is an understatement. I practically skipped out of her office, feeling comforted that I wasn’t facing yet another life changing health crisis. A few months later I started to feel more tired than usual, which I largely wrote off by telling myself it was just because there was a lot going on at work. Then one day, about 6 months after I first found the lump, I was in a fitness class and I noticed that my left armpit was a little sore. It kind of felt like razor burn or sun burn, and it ached a little. The sensation continued but initially it was inconsistent – it would be there for a couple days then my armpit would feel normal for a week or more. I had an annual exam with my OBGYN coming up in a few weeks so I tried not to feel too uneasy about it, telling myself I’d have her check it out at the appointment. Looking back, I think how naïve I was not to have known it was a huge warning sign given the lump in my left breast. But I didn’t know much about breast cancer or lymph nodes and I didn’t think a lump in my breast would be associated with armpit pain….and I certainly did not think I had cancer! At my annual exam, my doctor rechecked the lump in my breast and noticed it had grown. I was crazy impressed that she could tell just from feeling it that it had grown, because it wasn’t noticeably larger in size to my untrained, layperson fingers. She seemed unconcerned about the growth, hypothesizing that it was a type of cyst that may grow and shrink with pregnancy. A cyst that does party tricks…doesn’t sound too menacing. When I told her about my newfound armpit soreness, she felt my armpit and said she didn’t feel anything amiss, but I could tell she was slightly concerned and she suggested I visit a breast specialist just in case. By the time I was able to get in to see the breast specialist a couple months later, the soreness in my armpit was more prevalent and consistent. It felt swollen and irritated quite often and a palpable lump had formed in my armpit. It seemed like the specialist had looked at my chart and already concluded the lump was a cyst before he even saw me. He barged into the exam room I was waiting in, and without asking me anything he felt the lump in my breast and exclaimed that it was indeed a cyst. This type of cyst, he said, will continue to grow and grow until you remove it. So, he recommended that I have it removed but he didn’t want to dampen my summer plans with a pesky cyst removal (summer is a big deal to Michiganders 😊) and he suggested I schedule the surgery for the fall. Super cool, another surgery. Can’t wait. He was about to get up and leave, washing his hands of me until fall, but before he did I told him about the pain and lump in my armpit. He felt my armpit and then he said one of the most utterly unbelievable things anyone has ever said to me. It was confusing and seemed suspect at the time, and now that I know what I know about breast cancer, it’s nearly impossible to believe the conversation went down like this…but down it went. This breast specialist told me the lump in my armpit was a lymph node and the only reason I could feel it is because I had less fat on my body relative to others. The explanation didn’t make sense to me because the amount of fat on my body hadn’t changed much in years and my armpit had never felt this way before, so I didn’t understand why my lymph node chose to make itself known now. I must have had a confused expression on my face because he went on to say that if I had more fat on my body the fat would cover the lymph nodes and I wouldn’t be able to feel them. Pretty sure the look of bewilderment remained because he continued, saying that if I felt around in my right armpit, I’d probably feel a lump there too. With that, he stood up, turned around and walked out of the room. As I sat in the exam room, with a sinking feeling in my gut and lingering confusion, I reluctantly probed my right armpit hoping I would indeed feel a lymph node. The search returned nothing. No lymph nodes to be felt. It was getting harder to convince myself that everything was ok, but a breast specialist who sees women with breast cancer daily had told me my I was fine, that this breast lump was not threatening and could wait. So I should be feeling good, right? A couple months later I was taking a shower and felt multiple lumps in my breast. I was shocked that seemingly overnight so many lumps had formed that I couldn’t tell where one ended and another began. I got an appointment with an RN at my OBGYN office for that same day. I was scared, but the emotion that was even more present in my consciousness was frustration and annoyance that I was once again heading to a doctor office. The RN felt the lumps and she said it’s probably a type of cyst that grows in clusters, like grapes. But she ordered an ultrasound to be sure. That ultrasound is what finally lead to a correct diagnosis. The ultrasound results were concerning (obviously!!!), so I went for a mammogram which again came back as concerning and lead to a biopsy. 5 days after the biopsy, and 364 days after first seeing my OBGYN about the lump, I got the call confirming I had breast cancer. I was 29 years old. When I heard the words “I’m sorry, it’s cancer…”, my world stopped and everything I had been trying so hard to control came crashing down. Cancer Stats Stage 3 invasive ductal carcinoma, ER+/PR+/HER2+, BRCA negative, cancer found in 9 lymph nodes Treatment Plan and SO Many Decisions I was able to see an oncologist the day after I got the diagnosis, and everything moved quickly from there. My oncologist recommended a mastectomy, 6 rounds of chemotherapy, Herceptin and Zoladex, and 25 radiation treatments after chemo. She said that as long as my body responded to the chemo, I had a very high chance of survival. There was a part of me that felt grateful to hear the prognosis, but an even larger part that was so immensely terrified about what was to come it felt too risky to feel hopeful. The fear and uncertainty were overwhelming, and the decisions I had to make were dizzying. Would I have a lateral or bilateral mastectomy? Since the cancer was hormone receptor positive would I have my ovaries removed or get a pill shot into my stomach every month to put me into menopause? Would I do the recommended 6 rounds of chemo with all the possible long term side effects? Then there was the decision about radiation and working during chemo or taking a medical leave. And reconstruction decisions after getting through treatment. I felt like I was drowning under the weight of all these impossible choices with impossible to predict outcomes. I wanted answers. I wanted certainty. I wanted to know how I would get through it all. I wanted to know how it would end. Of course, I couldn't know so I tried to take it one decision at a time and make the most informed decision I could. I ultimately had a left mastectomy initially, completed the recommended chemo and radiation, did the monthly shot of Zoladex for a year then had a right mastectomy and my ovaries and fallopian tubes removed at the time of my breast reconstruction surgery. Choosing to Change From the moment I got the call telling me I had cancer, there was one thing I knew without a doubt. Given the way my life had been going - survival meant change. If I wanted something other than the dis-ease, illness and loss I had been experiencing I needed to change. Instead of continuing to run myself into the ground trying to change my external circumstances I had to change from the inside. Thankfully, I was able to take medical leave from my job during chemo so I could finally heed the battle cry of change my body had been shouting. Trying to figure out how to change my life felt overwhelming and I didn't know where to start, so naturally I did the only thing I knew how to do really well - research and data gathering. I read books, listened to seminars and trainings on mindfulness, meditation, Ayurveda and other holistic healing modalities, and what I learned blew my mind wide open. I had always been intrigued by the wisdom and practices of eastern traditions, but I hadn’t put anything I’d previously learned into practice consistently. That wasn’t an option for me anymore…I had to find a way to lessen the stress and pressure I had put on myself. So I started meditating regularly and using the procedures and side effects of treatment as a laboratory for my newfound mindfulness practices -- and to my giant surprise, it worked! Pain was more tolerable when I paid attention to it and stopped resisting it- seriously who would have thought?!? Tough emotions I had habitually buried for fear of being swallowed in their intensity were cathartic and actually shifted into acceptance or peace when I could be present enough to ride the whole wave of the emotion as it ebbed and flowed. I learned how to be aware of my thoughts and focus my attention and having that awareness allowed me to see the stories I was telling myself that caused unnecessary fear and anxiety and gave me a choice to let the story go without getting wrapped up in it. Of course, I still had many moments of anxiety, despair and poor me -- after all I was bald from chemo, a uni-boob (as I lovingly referred to myself for the year between my mastectomy and reconstruction) and recently thrust into medically induced menopause while battling cancer! I mean, I was bound to have some super crappy moments. But I was present with my emotions and held myself and my experience with compassion and acceptance as best I could even during those dark times. As I continued to practice being present, I realized that I no longer desperately searched for the "other side" of cancer, my mind wasn’t constantly wandering to the what-if's and the how-will-life-be's. Instead, I had many moments of acceptance, surrender, peace, and gratitude every single day. It felt amazing, but also very unfamiliar. Contemplating this unfamiliar sense of stillness one day, I silently wondered what am I feeling and I heard a voice in my head respond with "Home….you've come home." When I let go of the death grip I had on all the qualifiers of how life needed to be in order for me to be happy and ok, I found my center, my true self, and it felt like coming home. I felt a belonging and recognition -- like ahhh, there you are, I've been searching for you but I didn't know it was you I was searching for! That sense of being home, being in my center, is the gift I received by allowing cancer to wake me up to my life, and I continue to carry it with me 7 years later. Yes, I still get knocked off course. Yes, I have REALLY hard days and I'm as far from perfect as the next spirit in a human suit. But I catch myself quickly (most of the time) if I get knocked off center and more importantly I know how to get back home. I can definitively say that I don't want cancer again, and I can just as definitively profess that I am grateful for the experience because I learned so much about life and about myself. I have far more tolerance for uncertainty and change, resilience for days, trust in myself and the flow of life, and an inner knowing that I am supported and exactly where I need to be. You are loved, you are supported, and you matter. Much love to you. ____________________________________________________________________________ Courtney Proctor is a Certified Spiritual Life Coach who helps women clarify what they truly want, reconnect with who they really are and step into their fullest potential. She is also a HeartMath® Certified Mentor and offers individual and group classes for building resilience. You can learn more about her services at atmancollective.com or send an email to courtney@atmancollective.com.

The above aphorism is commonly attributed to the French philosopher Voltaire. Voltaire was the pen name under which the author, François-Marie Arouet published a number of books and pamphlets in 18th century France. He was a key figure in the Enlightenment, and notably was quite controversial in his day, due largely to the critical nature of his writing. His work drew on the many essays of Aristotle, Confucius, and other classical philosophers, who advanced, among other things, the principle of the “golden mean” which counseled against extremism. Let me explain this theory by using simple math. The 80–20 concept explains it this way: it commonly takes 20% of the full time allocated to complete 80% of a task, while to complete the last 20% of that task takes 80% of the effort. Another way to look at this theory is 20% of your surroundings (people, obstacles, health issues) yield 80% of your problems, and the corollary effect should thus allow us to focus on the greater good of 80% VS the 20% obstacles to our wellbeing. With that in mind achieving absolute perfection may be impossible, and any increase in effort will result in diminishing returns, thus any further activity becomes increasingly inefficient. So you may be asking “where are you going with this.” To my many breast cancer friends and loved ones I offer the following: We do not need the perfect when we can thrive with the good. Seeking the perfect in writing, art, cooking, appearance, relationships, health, etc., may be harmful to our ephemeral wellbeing. Keep in mind that you beat cancer by how you live your life. Therefore it’s best to live that life on your own terms.

By Donna Barrett I am a breast cancer survivor. I have been cancer free for two years. But it’s been a lonely, scary and fearful two years. While my mastectomy was able to remove the tumor and all signs of cancer, my journey did not end with that first surgery. I was never a breast girl. Since my teen years, I’ve always been a very tall, very skinny, lanky girl. My breast size was an A cup, attempting to be B’s as I grew, but failing miserably. I learned to accept my small breasts early on. I embraced fashion and style that fit my long, lean, flat features. I could proudly rock a deep-V cut top or dress that would make J-Lo proud. When I gave birth to my daughter, I found new respect for my breasts as I embraced the miracle of being able to nourish my newborn with mother’s milk. Breast feeding was never easy for me, but it became a necessity. When we discovered my child was allergic to all forms of formula, cow, goat, soy, I was the mommy milking machine. I fed and pumped the white gold until she was 18 months old. When the milk was gone, and she could sustain herself on other calcium rich natural foods like broccoli I was grateful to return to my little A cup breasts. Fast forward to Indian Summer of 2017. Now in my 50’s, while my style was age appropriate, I could still wear a bikini with pride. This awareness and respect for my body and my tiny breasts, is how I was able to save my own life. Only 11 months after an all-clear mammogram, it was when I was removing my bathing suit in the bathroom, when I noticed in the mirror, a one-inch round discoloration under the skin of my right breast. Upon closer examination, it felt like a cyst. It seemed to appear out of nowhere. I didn’t panic. It was just a cyst, I thought. However, I immediately contacted my OB/gyn office and requested to move up my previously scheduled annual exam. I even pressed to see if someone could see me the next day. I’m forever thankful, they did squeeze me in to see their Physicians Assistant. While I was in that office for an exam, this alert PA was able to schedule a mammogram at the Swedish Breast Center in Seattle that same morning. The mammogram results were significant so that they scheduled a biopsy for that afternoon. Within 48 hours of my noticing this dark discoloration on my breast in the mirror, I got the diagnosis: Stage 1A Invasive Ductal Carcinoma in Situ. Invasive Ductal Carcinoma is the most common form of breast cancer. Common? Believe me, hearing the word, carcinoma, does not feel common. It is unfamiliar. It is frightening, like the shadow of death just did a fly over. Beyond the fear, this was my own body attacking me and this becomes so personal, I’ve never felt so incredibly alone. I’m a planner, and so I began my plan of attack. Like a “World War Z” zombie virus, I needed to get this cancer cut out of my body as soon as possible. Meeting with the breast cancer surgeon, I was given options. Option one was lumpectomy plus lymph node biopsy, then 6-8 weeks daily radiation and chemotherapy pending lymph node results. Option two was single right mastectomy with no radiation and the lymph nodes could be taken during the same surgery. I was also offered that an implant could be inserted during same surgery directly after the mastectomy. As a multi-tasker by nature, this was an option I liked and so I took it. The next part that was even more stressful than the diagnosis was waiting for the surgery. That was the longest 7 weeks of my life. I never asked, but I guess when your “only” Stage 1, there isn’t any rush to the operating table to save your life? I politely didn’t ask, and just assumed this was the norm. I’ve now learned, that with a cancer diagnosis, never assume and don’t be afraid to ask questions. I had no experience with this and in my own personal head space, I couldn’t even think of who to ask for advice. I did the Google everything about IDC. Read every page of the National Breast Cancer web sites, Mayo web sites, WebMD and more. What I didn’t know to ask the surgeons is where they would do the incision to remove my breast? When you do a mastectomy, what tissue remains intact? I know the answers now. My tumor was on the very top of my breast right next to my nipple. They cut the incision diagonally across the main part my breast making for a highly visible, 6-inch slash across my breast. The implant used was the perfect size to match my remaining left breast. However, as the skin was stretched over that “perfect” implant, it was a tight fit. After the surgery, I was given nitro-glycerin cream to rub over the skin to keep the blood circulating and basically, alive. Once home, I had help from my sister to care for my dogs and do basic home chores. I felt pretty good and was very mobile and not really in any pain. Then we got the lymph node report. The cancer was not present and thus, did not metastasize. No more cancer. They got it all. I felt so lucky. Recovery seemed like a breeze. Then 10 days after the surgery, and 1 day after my sister left, I dropped a tissue. As I reach down to pick the tissue up from the floor, my upper right pectoral muscle exploded in pain and began to swell into a baseball size hematoma. The pain was excruciating. I went to the ER and was admitted overnight for observation. As I still had one drain tube, they were able to confirm the internal bleeding stopped and decided to not operate. However, the pectoral muscle remains rigid and swollen still today. But the story doesn’t end here. This was the first post-surgery complication. 45 days after my mastectomy and implant reconstruction, the scab of my giant incision began to fall off. In hindsight, after having multiple surgeries since this, having a scab were the sutures where should have been a red flag. As the scab fell off in the shower, I looked down at my breast. Like unzipping a zipper, I could see the implant through a two-inch open seam. That scab was the only thing keeping my incision closed. Having since moved for my job, I was no longer in the same city as my original surgeons. I ended up at the emergency room at Mayo Clinic in Phoenix. Discussions occurred between Mayo ER surgeons and my original plastic surgeon. They decided to remove the implant and not replace it at that time. This was now the second complication. Now, as I mentioned early on, I am not a breast girl. I decided I would give flat a chance and applied for the insurance to get a breast prothesis. I also, spent many a night, just wishing I had done a double mastectomy and decided to go flat originally. But, there just wasn’t anyone I felt I could ask or talk too. The original cancer surgeons don’t even give you advice. The plastic surgeon’s goal is to make you look the same, normal, as if you never had cancer. It is easy to fall into the latter’s guidance because all you want post cancer is to get back to normal. After this second complication, I needed a break. The Mayo plastic surgeons explained many options to me which included a spacer to stretch the skin then replace with implant, DIEP-flap reconstruction using parts of your abdomen, or the latissimus dorsi flap which uses parts from your back. I took a year to decide. I mentioned I am a lean, athletic body type. Thus, there wasn’t a lot of fat available in my abdomen nor on my back. I chose the spacer for stretching skin and then inserting a small implant a few months later. After the spacer is inserted and the doctors ensure you are healing, the spacer is slowly filled with a saline solution to begin the process of stretching the skin. The first two saline fills went well. The third fill is when things began to go wrong. While earlier hematoma had hardened my pectoral muscle, that muscle was still muscle and it was pulling the spacer higher into my clavicle bone and pressing it into my rib cage. I basically had a giant saline filled boob sitting about 3 inches higher than my remaining left real breast. Imagine going to work, going out to events, trying to disguise this monster boob, which entailed making the left boob look as big. I felt eyes on me all the time, wondering if I had a horrible botched giant boob job. Complication number three is now in the books. This monstrosity had to come out. More surgery. With careful consideration, I finally decided to do the DIEP flap reconstruction. The surgeons convinced me there was enough tissue in my abdomen. But this is an 8-hour surgery. My fear of being under anesthesia and on an operating table for that length of time is frightening. Driven to be normal again, I went for it. When I woke up in the Critical Care unit at Mayo, the most vivid recollection was the pain in my elbows. Why the elbows you may wonder? During this surgery your arms are laid stretched out flat as if you are laying on a cross, for eight hours, and not moved thus getting stiff and sore. The abdomen was injected with a painkiller and as the skin was used for a portion of my new breast, so there was no feeling in my stomach. Additionally, the new breast with the tissue, skin, vein and artery from your abdomen is too new to feel anything. I was numb everywhere except those elbows. With DIEP flap the surgeons and nurses check on your new breast blood flow to make sure the borrowed vein and artery work in their new-found home. You also have a catheter as you cannot move to use a bathroom. If you’ve never had a catheter before, then I will spare you from describing it. Let’s just agree it’s gross. After a day once the catheter is removed, the nurses become drill sergeants getting you up and out of bed and walking. Nothing prepares you post DIEP flap surgery then the first time you attempt to stand up. You can’t stand UP, literally. There’s no give in your abdomen and so you begin your hall laps looking like the hunchback of Notre Dame. I was once again, full of fear. What had I done? I was certain I would never stand tall again. At 5’11” my mother always taught me to be proud of my height, stand tall and never hunch. It took me many weeks before I could stand tall again. 6 months post DIEP flap, the scars on my abdomen aren’t healing very well and they may have to do more surgery there. The new breast scars and how the tissue lays aren’t perfect either. I don’t have matching breasts, but I have two breasts now. I have my original made by God, and I have what I like to refer as my “Franken-boob” created by man. My previously flat stomach is even flatter. And I can still manage to rock the bikini. As for my love for low V-necks, that may take more time as the breast scars are still highly visible. As a breast cancer survivor looking back my surgical history post mastectomy and reconstruction complications, I had to keep telling myself, “look, you beat cancer; they got it all; and you are the lucky one.” Through genetic testing at Mayo, I found that my breast cancer was not genetic. The oncologists believe I may only need the estrogen blocking therapy, Exemestane, for 3 years, not 10. I’m know I am one of the lucky ones. It’s hard to explain to others who have never or will never have breast cancer. While I was never one who cared about the tiny size of my breasts, and never saw a need to increase their size when I was younger, I feel now that this cancer has brought too much attention to my breasts. They're just boobs. It’s been a little over two years since my breast cancer diagnosis. It’s exactly 849 days when this unplanned journey began forcing me to become a little obsessed with my health, my breasts and my body. My body is not perfect. My boobs are not symmetrical. My stomach has huge scar stretching from hip to hip. These are just physical scars. These will diminish over time. As I am writing about my breast cancer journey today, on this rare palindrome date, 02/02/2020, which is when a date reads the same backswords and forwards, I’ve decided I don’t need to wait for the next palindrome to occur in 101 years to put this cancer journey behind me. It’s been a scary and fearful two years. It’s time to begin the healing my inner scars and leave the cancer behind me. It’s time to seek out new, happier journey. To start new journeys where I know I am lucky enough to explore because I am still cancer free and I intend to keep it that way.

By Rebecca Santos I never thought I'd be diagnosed with breast cancer. And why should I? I'm 27. I have no family history. I'm not a carrier for the BRCA genes. I'm healthy and active. But still, here I am. I hope to be a voice that raises awareness that breast cancer can happen to healthy young women too! This year has already had so many surprises, but breast cancer has been the most challenging surprise yet. I'm a Latina first generation college grad who got accepted into medical school in February, got engaged in March, and to my surprise, was diagnosed with Stage 0 Breast Cancer (DCIS) May 27, 2020. While it was hard to process my cancer diagnosis, I was not surprised because I had spent a year having my symptoms being dismissed because of my age, health, and family history. My symptoms on my left breast : During the first six months, I had a large mass on my lower left breast that was so painful, I had to stop wearing bras. I had a scab with discharge coming out of it, sometimes yellowish-clear and other times red. I was told it was most likely an abscess and was given medication, but my symptoms never went away. I also felt a piercing pain coming through to my nipple and my left breast was sensitive to touch. Telling my family and friends that I had cancer was difficult because I didn’t want to burden them with fear or worry. Everyone cried, but they were all supportive and positive that I’d get through this. Losing my breast wasn't as difficult to process as having to lose one nipple (TMI), and having to explain that to family/friends along with why I chose to remove both breasts...but I focus on the positives and what matters is that I am alive and well! I cannot stress the importance of getting a second opinion! Mainly because you want to be confident in and comfortable with the surgeon who is  doing one of your most life-altering surgeries. My first breast surgeon gave me the news that I had cancer and the choice to keep my “healthy” breast. They didn’t explain my condition or their plan of action the way that I expected. In fact, the 8 minutes I sat with them was not enough time to explain very much at all about anything. As a result, I went for a second opinion and it was a completely different experience. This breast surgeon spent over an hour explaining to my family and I the type of breast cancer I had and what it meant, gave us a detailed course of action, pamphlets with information, and was empathetic that I had to face this at such a young age. I already had my mind made up to have a double mastectomy and my new breast surgeon agreed that it was best for me because although I only had cancer in one breast, there was no guarantee that in the future I wouldn’t get cancer in my other. Had I kept my "healthy" breast, I would have had to take a medication called Tamoxifen, which has a very extensive list of negative side effects. (Disclaimer: according to my oncologist, I was not a candidate for this medication because my cancer was not genetic and both breasts were removed, so there would be no benefits for me.) Lastly, I'd live a life of mammograms and screenings every six months for the rest of my life ! Not to mention, I'd live in fear and worry of getting breast cancer again. Almost three weeks after my diagnosis, I had a double mastectomy and expanders put in, on June 15, 2020. While my breast cancer was Stage 0 (DCIS), my cancer cells were grade three (cancer cells that look abnormal and may grow or spread more aggressively ) . While I was told I would not need chemotherapy once they confirmed that the cancer had not yet developed into invasive cancer, I was told that I may need radiation. Now with medical school starting so soon, I had to discuss all of the what-if’s with my team of doctors and began to overthink and fear the possibility that I’d have to miss a semester of medical school or possibly have to delay my start for another year. Now that the cancer is out, t he chances of cancer reoccurring are extremely low and the negative long term side effects of radiation are not worth it in my case. I decided that I wouldn’t let any of this stop me from achieving my dream of becoming a doctor and due to COVID-19, my medical school classes will start online, so not only will I get to stay home and fully recover, I won’t miss a day of medical school! It's not how I imagined starting medical school, but I've seen God's hand through all of this and know that He'll be glorified! I hope to be a voice that raises awareness that breast cancer can happen to healthy young women too! Awareness and early detection are so important, so never ignore your symptoms! Know your body, and if something’s off, GET IT CHECKED OUT!

By Nicole Mancini Originally published in Crabbies, Jellies, and Iron by Susan DiPlacido. First Ironman Nicole Mancini has always loved running. She has found memories of her dad taking her to the track where she would ride her bike as he would run. Then, as she took it up, it always helped her clear her head. In 2015 she did her first 5K, and while there she noticed Athletes Serving Athletes, which is a non-profit that empowers those with disabilities to compete in mainstream running, and, at the time, triathlon events (ASA has since limited their scope to running events.) Nicole was impressed and intrigued. Thus, began her athletic and helping hot streak. She signed up to become a running wingman and began with 5K events. Meanwhile, she watched as some of her teammates trained for wingman positions in triathlons. Nicole didn’t even know how to swim. But something that silly wouldn’t stop her. She started swimming at the Y and attended ASA’s triathlon camp while competing on the run portion in a sprint tri in 2016. She watched as the founder of the group trained for Ironman Boulder with an athlete, and Nicole thought it was a great gift. She did her first Olympic and half distance in 2017 and was ready to sign up for her first 140.6. On December 21, 2017, Nicole was officially diagnosed with invasive early stage breast cancer. She had already endured numerous scans, tests, and mammograms to get to the diagnosis. Hormone therapy began the next day and she underwent surgery on February 28, 2018. She had a double mastectomy and her hormone therapy is still ongoing. In May of 2018 she raced Chattanooga, 70.3. In 2019, she also raced Eagleman and Atlantic City 70.3 just two weeks prior to IMMD. Though she has a small circle of supportive training friends, the long demanding training hours made her husband and 11-year-old son think she was a little nuts, and the schedule was a bit frustrating for the family at times. But she needed to do this race. Cancer is chaotic, and she wanted the structure and routine of training, . She had been drained of her spark and passion, and she was looking to reignite that! She wanted to find herself again. Training was particularly hard on Nicole’s body. She also battled a possible Lyme disease scare and enlarged heart. She was often sick, her hair fell out, her joints ached, she suffered night sweats, and insomnia, heart palpitations, and drastic mood swings that further exasperated tensions in her home. But she persevered and kept on going. She had to take some days off, but she didn’t quit. The jellyfish were a concern for her, because she’s been stung before and reacted very badly. In fact, she cried on the morning of the race. But if everything else didn’t stop her, jellyfish weren’t going to either. She suffered multiple stings, had to reapply cortisone several times along the way and her feet got swollen and purple. All through the run, painful blisters continued to worsen. She promised herself should would never do another Ironman again. Team 360 which is an organization similar to ASA was manning the aid station at the bypass. Nicole knew several people there and their hugs and cheers, along with pictures of their athletes, were just the inspiration Nicole needed. Quitting wasn’t an option. She had to do this to show others that it is possible. She wanted to inspire someone else, to give her friends who are struggling in chemo something to look forward to. To prove to others that they’re capable of so much more than they think. It was her 1 year and 7-months cancer free anniversary. She made it through that. She had been looking to reignite her spark. Something must have sparked in her that day because she set that race on fir and successfully crossed the finish line. She didn’t just find herself at the end, she found an Ironman. And plenty of others have found something else through her: Inspiration .

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

Now that I am on the other side of my treatment I have been much more open to reading about other people’s experiences with cancer and their treatment. A lot of people talk about their “new normal”. I have been trying to figure out if I have a new normal yet.  But it made me think, did I ever have a “normal”?  Life is full of ups and downs. When I was little I was convinced that the Brady Bunch was a “normal” family that I aspired to have. At the time it was just me and my mom, so I was on the lookout for a single dad with 5 kids. Specifically 3 boys, one girl old er than me and one younger so I could be a big and little sister.  Eventually I realized that probably wasn’t a realistic family goal for me to have, so I adjusted my view of a “normal” family. Growing-up in California, I have learned that a family is a family and no two are the same.  As I grew up, like everyone, my life was a series of unexpected events. I didn’t get into classes I wanted, friends turned into enemies and then friends again, I changed colleges twice, relationships started and ended (luckily, I did find the right person at the right time), I got my dream job that wasn’t so dreamy and changed jobs again and again. Each time there was a change, whether it be personal or professional I didn’t stop and define a “new normal” I just kept going. What else was I going to do? Just sit down and stop? That’s just not how I work.  Back to my cancer treatment. There was nothing normal about it. In fact, I am a firm believer that no two treatments are exactly the same because everyone is different, the support system for everyone is different, doctors do things slightly differently and patients react differently. That’s not to say that hearing about similar experiences isn’t helpful, it is, I’m just saying that there is not a “normal” way to experience it.  So, what’s my point? Just as there is no “normal” in the rest of life, I don’t think there is a right way to define your “new normal” at least not for me. For me that would mean looking at and analyzing things that I think I missed because of my cancer treatment or things that I might not be able to do right now as I still heal from the experience. The worst for me is thinking about the things I can’t control that might be in my future. So for me, my “new normal” is just going forward. Not defining things, not setting-up expectations or boundaries for what I can and can’t do. Just going forward adjusting and adapting on a daily basis as I have always done.  This might not work for everyone, but for some, I hope it might help. Breast cancer was just another thing that life threw at me that I had to figure out how to get through. And I did get through it. It’s time to move on and enjoy my family, my friends and the life I have.  PS: My husband and I decided to have only one child and we love her and are so proud of her. Thank goodness I got over my Brady Bunch phase :)

I was 39 when I was diagnosed with breast cancer -Stage II infiltrating carcinoma and 49 with breast cancer -Stage IV metastatic breast cancer. It was May 2010 when my world was shattered. I had divorced my husband the previous year and felt totally free for the first time in my life. I was healthy, loved to exercise, and was eating healthy on most days. I was working as a nurse in a pediatric office in Littleton, Colorado. My son was a couple of years away from graduating high school. Life was great. I have a family history of cancer and I started performing self breast exams in my twenties. In April 2010, I felt a lump in my breast and saw a dimple over the spot where I felt the lump. As a nurse, I knew the signs and symptoms of breast cancer, but for some reason my mind wouldn't accept it. As I think back, I felt like I couldn't have breast cancer because I didn't have health insurance. After the divorce, I couldn't afford it. But God made a way. I qualified for Komen funds, which saved my life. I was blessed to have the best surgeon and oncologist on my team. They gave me all the information I needed to make an informed decision. Sadly, I was miles away from family and friends, so I went into deep prayer and made the decision to have my breasts removed. As I sat on the exam table and told the surgeon my decision, I felt strong and sure. But as soon as he exited the room, I broke down and cried. It wasn't fair. I was the girl who raised awareness for breast cancer survivors, and now I was that girl. Ironically, five years later, my sister would insist that I write a book detailing my journey. I hesitated in doing so because it was my personal business, but she hit me with, "It's about giving God the glory." So, I self-published the book, "Seriously God, Am I That Girl?" Writing the book ended up being my therapy. I poured out all the details regarding chemotherapy (its side effects) and my reasons for stopping it and stopping hormone therapy as well. I completed two of the four rounds of chemo and stopped tamoxifen after a few months. On chemo, I felt like I was having a heart attack, and regarding tamoxifen, I just didn't like the side effects. I did end up removing my ovaries. In 2012, my PET scan was clean, and I moved to Atlanta to be closer to family. I found an oncologist and in 2015 was given the "all clear." I was determined to take advantage of my second chance at life. I worked and traveled to many places that were on my travel list. Since I loved traveling so much, I became a travel nurse. Again, life was great! I took an assignment in Dallas and Tucson. While in Tucson, I had this feeling of wanting to help women in a different way. I was ready to leave nursing after twenty years and try something new.  I love my family, but moving back home was not part of my life plan. We have our plans and God has his. So, in September 2019, I moved back home to Mobile and opened a painting studio, Her Timeout, in January 2020. The stress I was under opening this business saved my life. A lymph node in my neck began to swell. This one symptom would lead to an urgent care visit, PCP visit, scans, oncology visit, and a biopsy. The result, stage IV breast cancer. I was ready for God to take me. I couldn't. I didn't deserve this. I was a good person and this wasn't fair. My family was so concerned that they threatened to come break into my apartment if I didn't come out. After two weeks, I started chemo. My new oncologist had read my old medical records and he was ready for me. No quitting. He was stern. He told me that he could treat me, but I had to do my part. I wanted to see my future grandchildren, so I put on my big girl panties. I was ready this time for the side effects. I started taking daily vitamins, B vitamins, plain, coconut milk yogurt, raw garlic, and drinking plenty of water. I meditate and do yoga. This time around, I'm grateful to be home with family and friends. Instead of writing another book, as they suggested, I decided to blog about this journey. The title, of the blog is "Her Timeout." I honestly believe that when God gave me this name back in Tucson, it was not intended for a painting studio, it was his way of getting my attention to slow down. He was trying to save my life. What's next? I have to complete 6 rounds of chemo; less if my scan comes back clean, per my oncologist. Then monthly, hormonal injections until my oncologist "says so." I'm ready to walk in divine health because I deserve the best. I'm focused on healing my body and getting back to life! There's a big world out there to explore. God placed a work in me when I was born, and I must continue my journey to fulfill my purpose.  I have too many dreams to give up!

By Kandace From Survivor to Conqueror I ate well. I didn’t smoke. I didn’t do drugs. I was a marathon runner. I was too healthy to be sick…. March 2011 It was one of those California mornings: overcast and gloomy. When I looked outside, I saw that it was actually raining…Oh well I thought… It’s just going to be one of those days…There’s no way it could get worse…Boy was I wrong. ​ You see, I belong to an unique club…Where One out of three people in the USA belong to… but it’s a membership no one wants to be a part of… that you cannot quit from…and I don’t want YOU to be a member of… Today I am going to share with you all how I received my club membership, my connection with the doctor and club life... ​ I was training to qualify for the Boston Marathon. My training was tapering down and I was still tired. That same week I found a bump under my armpit. I made an appointment with my doctor. She ordered a complete blood panel. It came back ok. She ordered a mammogram and an ultrasound. I had to beat a specific time at the Napa Valley Marathon to qualify for the Boston Marathon. I put my heart and soul into it. It was one of the most important things in my life. I trained hard, ate well, slept well, and avoided unhealthy things. I didn’t smoke. I didn’t do drugs… That weekend I ran the Napa Valley Marathon and qualified. I was on cloud 9! I was indestructible. Discipline, Determination and Drive as my father would say! My life was running like clockwork. But… I made my appointments with my doctor. After a complete blood panel, followed by a mammogram, an ultrasound and a scan my world turned upside down. I remember walking into a hospital in Orange County for my appointments. Never worried. Never scared. I ate well. I didn’t smoke. I didn’t do drugs. I was a marathon runner. I was too healthy to be sick…. My scans were completed and I was waiting for the radiologist to tell me, “All clear. Have a nice day. ” … But instead, he came out and told me I needed to come back for a biopsy… Now I was scared! What was wrong? Cancer still had not crossed my mind. The following Monday, I went in for the biopsy and that Wednesday I would find out the results. Wednesday, March 23, 2011 was an unusual day…. It was pouring rain in sunny Southern California. It never rains here. My mom and I were called back into an exam room; we waited and waited and waited. I paced the hallway…. I found a nurse and asked her if she had the results from the biopsy. She came into the room and crushed me. “Kandace, I’m sorry. You have stage II breast cancer.” I said, “That’s not possible. I am only thirty years old. I just ran the best marathon of my life.” Mom and I immediately went into crisis solving mode. A family friend had been diagnosed six months earlier, so mom knew what oncologist and surgeon to ask for….I met my surgeon that evening and my oncologist two days later. My path of life was forever changed! I had no idea what was going to happen to me, but I knew in my soul that I was going to live: determination, discipline and drive. In the months to follow, I underwent a lumpectomy removing seventeen lymph nodes, seven of which were cancerous, had twelve rounds of chemotherapy, a blood transfusion, capillary leakage in my lungs, eight months of prednisone, thirty-eight rounds of radiation, ongoing physical therapy for my arm, four years of hormone therapy, and all of the complications that came along the way. I was knocked down over and over again, but I always stood up, brushed myself off and kept fighting. Failure was not an option. As the months of treatment were further and further behind me, I became stronger – physically, mentally, and emotionally. I had a great support system; in fact, I still do. I began working full time again, traveling and living life again. I was strong. I was going to live. I had a new reality! I was a young breast cancer survivor! I continued seeing my oncologist and having my yearly scans, which were always clear. Always something to celebrate! I reached my five-year cancer free anniversary and boy did we celebrate! I had a party with family, friends, and clients to rejoice such a big milestone. Six months following my five-year anniversary I felt normal in my new reality: working, running, and of course traveling. Friends would often tease me and say, “Kan, your suitcase is always packed. Where are you off to now?” I’d laugh and excitedly tell them about my next destination. September 2016 I suffered from edema in my left arm due to the lumpectomy in 2011. I had, and still have, a lymphedema treatment on my arm three times per week to keep the swelling down and to keep the scar tissue to a minimum. It is not my favorite treatment because it hurts when the chiropractor breaks up all the scar tissue. It was my normal 2pm time slot… At one of these regular appointments in September 2016, however, we found a bump in my chest…. I was not concerned given the PET scan six months earlier… Needless to say, it needed to be addressed. I called my oncologist and we set up an appointment to have the bump biopsied…. The results came back negative for cancer, but given my health history we did another scan. I remember sitting on my parent’s deck with my dad having a conversation about my current situation. I said, “Dad, I can handle whatever this is, I just don’t want to look like a cancer patient again”. He said, “I know Kan, I know.” I will never forget the day I met my mom and three of her closest girlfriends at the imaging center. We were telling funny stories - giggling and laughing. I was called back to have my scan. Half way through, the power went off. I had two options: come back another day or drive across town in rush hour traffic. The five of us hopped in the car. Finally, the scan was completed. I called my doctor and he said he would call as soon as he had the results. One can imagine my level of anxiety. My doctor called…. I answered the phone praying for good news. “Hi Kandace, It’s doctor A”. I’m sorry. I have bad news. Your cancer is back and you have tumors all throughout your body. The good news is that the cancer is the same cancer you had before, therefore it is treatable. I’ll have my nurse call you in the morning to get you in to go over all the details.”… I said, “Ok, thank you.” I hung up the phone, staring into nothing… I began having a conversation with Lulu, my golden retriever. “Lulu,” I said, “I can have my meltdown now and we will still have to retake the exam, or I can keep myself together, take the exam and then have my meltdown.” I took Lulu’s advice. I finished the exam and passed! Later, I threw myself on the floor next to Lulu and had my meltdown. “How could this be happening – to me - yet again?” …Why is this happening again? Moving forward with my new diagnosis, I was able to secure second opinion. I scheduled an appointment with Dr. James Waisman at the City of Hope. I had an instant connection with him and knew he would be my guide to remission. Dr. Waisman made me feel safe. He was direct and thorough when talking with me. I knew City of Hope was the right place for me. I would be on ten months of oral chemotherapy and shots to create remission. Since my cancer was estrogen positive I made the decision to have my ovaries removed. This was the best decision for my body! Exercise and nutrition absolutely play a vital role in keeping the mind and body healthy, But I felt my body needed extra support. I enjoy running on the beach. Strength training is a must for me; it keeps my bones strong and reduces stress. Yoga is great for the mind. I currently take daily supplements based on my blood work and receive weekly IV’s of vitamins and minerals. Being diagnosed with cancer two times as a young female is hard to imagine, and even harder to imagine that it would spread throughout my entire body after I had won the first round. I was thirty years old the first round and thirty-five years old the second round. I often wonder why me, but I always go back to the recognition that cancer is an indiscriminate serial killer without a conscience or morality. I am a positive person and believe the glass is half full. I continue my healthy lifestyle habits: training for half marathons, strength training, frequent infrared saunas and a clean diet, within moderation of course. My life is about balance and purpose: I travel the world because it makes me happy; I spend time with family and friends because I love them; and, I enjoy my career because I help people. I know in my heart that cancer would not have been put on my plate, not once but twice, if I wasn’t strong enough mentally, emotionally, and physically to handle it. Maybe I was meant to have this journey to help others who were going to be walking in my shoes. Maybe I was meant to have this journey to learn to love myself with compassion and grace. Maybe I was meant to have this journey because it was just the cards I was dealt. Maybe there is no reason. Maybe the decision I made to fight, whatever the obstacle or hardship, was the reason in itself. I can’t say that what I did was for others, but I truly hope in my heart that people that are in the fight can see my journey that I stumbled through as a beacon in the dark. Thank you all for being here! A big special thank you from the bottom of my heart to Dr. Waisman, his nurses and the City of Hope team. I am in remission once again and back living a meaningful and joyful life, running half marathons and traveling to new and far off destinations. If not for the discipline, determination and drive City of Hope has to treat and cure cancer, I may not be standing before you today, sharing the hope and healing I received at City of Hope.​ ​Every club member is unique and so is the connection they have with their doctor. Life in the club is theirs to manage (handle) ?... But I choose to be positive and hopeful…I believe in HOPE…because HOPE springs eternal…I use to have “Long Term” goals…now I have “SHORT” term goals! I use to think I am and was a “Survivor” of cancer…but now I believe and think I am and will be “CONQUERER” of cancer. ​I believe in the triumph of HOPE… over past experience!

By Liz Brown Where’s the Scoreboard? Is there anything better than a 10 year old parks and recreation baseball game? As I hobbled to my favorite lucky spot behind home plate equipped with a cooler full of water, Gatorades, and snacks for my favorite players, the excitement was in the air! Two teams on a field of dreams, as they say, playing their best baseball - a fight to the end. Unfortunately, maybe more so for the hard core parents than the kids, there will be a loser in this fight. But there will also be a winner!. One of the teams' players will jump for joy at the end of the game celebrating all the way home and the other will go home wondering what they did wrong. Oh wait, a close second to a battle on the baseball field are the sounds of Friday night lights on a small town high school football field. High school football players work tirelessly through the summer to prepare for their battles on the field. The cheerleaders show their support as the stands erupt after a long touchdown pass or a pop of a tackle heard from the top of the stands. The ups and downs of the game keep the fans watching every play intently. The band plays and the fight continues. Four quarters goes by in a flash (well, for us die hards) and again, there will be a winner and a loser of this full on fight to the finish. The loser will go to the locker room with a probable lashing from coaches as to what should have happened on the field to prevent the fumble or how missing that one tackle gave up the winning touchdown while cheers echo from the locker room as the winning team celebrates. I come from a long line of sports fanatics. My grandmother (who we affectionately called Meremere) would have one game on the tv in her family room,one on her small black and white tv in the kitchen, and one playing on the radio in the kitchen. My dad has never missed a golf tournament or a college football game. I have watched my three boys play countless games from elementary age to high school and my youngest, well, his ipad constantly beeps with updates from every MLB game while Sportscenter is a morning staple. We are used to winners and losers. We understand fighting to win a game. We understand, in losses, that game film is a must in evaluating what was done right in the game and how to evaluate what was done wrong. Cancer is not a game. There are no winners or losers. When I hear that I am fighting cancer, I can’t help but think to look for a scoreboard to see how much time is remaining in the game and thankfully, there is no scoreboard. I immediately shift my thinking to how can there be a winner and a loser in a disease? Often, we hear “she lost her battle with breast cancer”. Lost? What? I hear lost and immediately think, well, who won? What could have been done differently? What did we do wrong? Let’s look at this from a mathematical standpoint. The old adage of “keep fighting, you’ve got this” leads us to the conditional statement that “if we fight hard enough, then we will win this battle against cancer”. From geometry class, you recall (were you listening that day?), that the contrapositive of a conditional statement is always true if and only if the conditional statement is true...sorry had to get my math lesson in for the day-shout out to my math department in Manteo! In following that logic, the following statement would be true, “if we do NOT win the battle against cancer, then we did not fight hard enough”. Hmmmm, is that really what we believe….absolutely not. No matter what the age and no matter what the stage of any cancer patient, you can be assured they are doing everything they possibly can to do for what is best for their body, their family, and themselves. And furthermore, while I’m on a roll, why is cancer the only disease we “beat” or “fight” or “lose to”? I have asthma and no one says I am fighting it; no one says those words in conjunction to diabetes, epilepsy, heart disease, etc. nor should they. There is an implication of weakness or something that could have been done better when we use the word “lost”. We should never use such negative associations with someone who has died of cancer. In fact I read once where it was written in an obituary that she “won her battle with cancer as she joined the Lord in heaven.” So much better and much more accurate! In the beginning, I mentioned that I hobbled to my seat for the baseball game. A few weeks later, I found out that I had a compression fracture in my back at T9 - I guess that explains the hobble. The doctors could not figure out how I had fractured my vertebrae. I was otherwise a healthy and active 46 year old just running around juggling teaching and crazily chasing three boys with my husband. They could not figure it out until my regularly scheduled mammogram came back looking suspicious. And, as they say, the “you know what” hit the fan. In less than a week, I had a bone scan, a biopsy on my breast, kyphoplasty, a biopsy on my T9 vertebra, and multiple other scans. I went from teaching high school math one day to hearing the news of being diagnosed with metastatic breast cancer to my bones the next. Meta-who? My mom and I practiced saying the word and spelling the word. I didn’t even know how to pronounce metastatic much less understand what in the world it all meant. I was definitely in shock and to be quite honest, none of it registered until I asked my primary doctor, “Would I be teaching this year?” She quietly replied, “no” and then I understood that this was something big and unwanted. I started my 4 week regiment of the “red devil” chemo and 12 weeks of Taxol chemo within a week of diagnosis. I followed up with a lumpectomy and 20 rounds of radiation on my breast where the tumor had emerged. I started on Kisqali among all sorts of other medications but my liver was too sensitive to the Kisqali and I have had to since change to Verzenio. I am a year and a half into my story (not a journey to me because a journey is supposed to be fun). Metastatic disease is a roller coaster with oncology appointments every month, at the minimum, and scans every three months to make sure the cancer has not spread further. Every medication has its own side effects which is really fun in itself. I don’t want to ever look back and think about how I could have or should have done things differently. I will never lose because it is not a fight, it is simply a new lifestyle…..okay fine, some days I have to be stronger (look out Darana, my other soap box word) than others but I know that no matter what I win! I always win! I have a long road ahead and my new “job” is to take care of myself and my family, steer clear of stress, and go to as many ball games as I can so I can enjoy looking at a real scoreboard and smile no matter if we are on the winning side or the losing side. Now, if you’ll excuse me, I need to go pack my cooler! Liz Brown Manteo, NC I’m hoping to share my story and resources to help you or someone you love calm the waves in your crazy cancer storm. *****Blog/website: www.mbcoutlier .com *****Instagram: mbcoutlier

By Kathleen Friel, Ph.D., March Is Cerebral Palsy Awareness Month I have the interesting opportunity to live with two types of medical issues – cerebral palsy (CP) and metastatic breast cancer (MBC). CP is usually a condition that a baby is born with or acquires during the first two years of postnatal life. CP is most often called by a stroke or brain bleed – yes, babies and kids can have strokes, even in utero. Sometimes, CP is caused by malformation of the brain or a genetic issue. The bottom line is that the brain damage resulting in CP causes movement challenges. Sometimes, people with CP also have challenges in sensation, vision, hearing, speech, and/or thinking. I was diagnosed with CP around 1.5 years of age. The diagnosing neurologist told my parents I had no rehabilitative potential, and that the best life for me (and them) would be if they put me in an institution and focused on my soon-to-be-born brother. Thankfully, they found a new doctor for me, pronto. The wonderful doctor who guided my family through my first years of life was funny (he never wore socks, something that my four-year-old self found hilarious) and encouraged my parents to treat me like they’d treat any other kid. Sure, I had plenty of surgeries to make my legs walk better, speech therapy that enabled me to order pizza during college, and physical therapy that enabled me to stroll the mall with my friends in junior high. When I was prescribed occupational therapy in first grade, I figured it must be time for me to begin job training. Little did I know, OT is a discipline that focuses on improving finer motor skills like typing, cutting up food, and fastening buttons. I now run a clinical research lab at the Burke Neurological Institute in White Plains, NY. Soon after I got my PhD in neurophysiology, my dad tried to track down that neurologist who had given me such a grave prognosis. No luck. I would have loved to see his face when he learned that I indeed spend most of my time in an institution… running a research program! Greater Awareness is Sorely Needed My multi-faceted relationship with cerebral palsy (CP) gives me a rather unique perspective on CP awareness. The mission of my lab at BNI is to develop novel therapies for people with CP that are rooted in a deep understanding of the neurobiology of CP. Through our research, I’ve gotten to know hundreds of children and their families as they navigate life with CP. For those who have only ever met me over Zoom, now you know, it’s not my audio connection that garbles my speech, it’s CP! These perspectives all converge to one theme: greater awareness is sorely needed. Approximately 3 in 1,000 people have CP, which translates to approximately 800,000 people in the United States, and over 18 million people worldwide – approximately 50-50% split between children and adults. To put these numbers in perspective, 800,000 people is equivalent to the population of Seattle, and 18 million individuals is equivalent to the population of the state of New York. The Demand for Cerebral Palsy Research Recently, research has demonstrated molecular and cellular consequences of CP. People with CP typically expend 3-5x the energy of their nondisabled peers to perform activities of daily living. Muscles and bones in people with CP have less of an organized structure than in nondisabled peers – interestingly, some of these structural differences occur before a baby shows motor symptoms of CP. This raises the possibility that muscle and bone cellular disorganization contributes to the development of motor symptoms, rather than emerge as a consequence of aberrant movement. Much research is necessary. The work in my lab is focused on improving movement in school-aged children, to help kids gain more skillful movement ability, which then poises them to improve their confidence, quality of life, and independence. More work is needed to define early biomarkers of CP: despite most brain injuries occurring before or near the time of birth, kids are often not diagnosed until or after their first birthday. If we can diagnose early, we may find ways to intervene and prevent emergent impairments. We also need therapies to help adults with CP age well – many adults with CP develop age-related conditions like osteoporosis decades before nondisabled peers. Adults with CP 3x more likely to get MBC than people without CP, as I’ve learned in 2018, “ Unstoppable: How Dr. Kathleen Friel has made incredible accomplishments despite cerebral palsy and metastatic breast cancer ” ! Although CP is not a progressive neurological disorder, adults with CP experience greater pain, fatigue, and loss of mobility earlier in life than adults without CP. Going Beyond the Science Greater awareness about CP must go beyond the science. What’s it like to live with CP? I’m only one person, and my experiences do not generalize to all people with CP. Here’s a bit of my perspective. People often assume I have a cognitive impairment because of how I speak. It’s exhausting to deal with misperceptions. 2020 was a great year for avoiding unsuspecting strangers! By far, the most difficult aspect of my CP is my speech. Zoom chat is amazing, and trying to be understood while I’m wearing a mask is frustrating. Most importantly, people with CP – and other disabilities – want to be known as people. We have rich social lives, hobbies, favorite sports teams, and so much to offer. We’re more than the way we move or talk. Did you know…? People with CP and other disabilities spearheaded landmark legislation that protects the rights of people with disabilities, including the Rehabilitation Act and the Americans with Disabilities Act. The movie Crip Camp shares their story (available on Netflix!). In one part of the movie, people with disabilities held a sit-in in Sacramento to fight for accessibility in the 1970s. At one point, the disgruntled police shut off the phone system, so people could not call their supporters outside. Shortly after, some deaf participants went to the windows of the building and used sign language to communicate with the people outside. The police couldn’t stop them, and eventually conceded! The MBC Connection I was diagnosed with MBC in 2018, with a lesion in my spine. I think that the joint pain and mouth sores caused by my treatment exacerbate my CP impairments. Some days, speaking clearly and moving freely are quite difficult. I’ve needed more accommodations, and my fatigue (already a “CP issue”) can be frustrating. I have a wonderful oncology care team, but sometimes nurses, radiology staff, and others can make annoying assumptions about my cognitive capacity. Even answering, “Who is with you and how did you get here?” with, “Nobody, and I drove my damn self,” can be that “one more thing” that zaps my last nerve. I usually don’t say damn, but maybe I should! We all know how deflating it can be to go to our appointments, wait forever, get poked and prodded, literally eat/infuse poison in hopes it will only kill the cancer calls, and listen to that bossy little “Breathe in, hold your breath………. breathe out,” CT scanner voice. After that, if someone insists on taking me out to my caregiver, I want to throw a punch. But there is always hope. In December, a radiologist really pissed me off. A kind nurse asked me what was wrong, and I started crying. I pulled up my “Unstoppable” article, linked above, on my phone and gave it to her. Then she started crying! She asked permission to share it with the radiology department. I went for my next CT, and everyone was all smiles and pats on the back. I saw the same nurse, and she gave me a big hug. Many people with breast cancer have other health issues. I’m grateful for the opportunity to share my “CP + MBC” story during CP Awareness Month. We all have a complex identity, and the greatest gift we can give each other is compassion and kindness.

By Abigail Johnston I love the holidays. The family togetherness, the food, the exchanges of gifts, the celebration of what God has given us and the sacrifice of His Son, it’s all magical to me. Of course having my birthday in the mix, on the Winter Solstice, is also something to look forward to every year, but don’t get me started on the whole Santa thing. I literally start planning for the following Christmas in January each year when it comes to gifts and I’m always on the lookout for the perfect gift for the people on my list, which grows and grows every year much to my husband’s chagrin. That the end of the year culminates in getting to see people happy about what I’ve selected, that’s the highlight for me. Since 2017, when I was diagnosed with Stage IV Metastatic Breast Cancer (MBC), I’ve started to see holidays differently. I vividly recall the first celebrations following my diagnosis when I struggled with both wanting to go overboard in making memories and also wanting to simply withdraw from everything. The thought that this holiday, this birthday, this celebration, this time, this will be the last time, is always in the back of my mind. I still find myself staring at the people I love, during holidays or otherwise, trying to memorize their faces, fixing the memories in my brain so … what? So that I will remember after I die? My logical brain asserts itself and is pretty scornful of this fanciful notion that my efforts mean anything. Does me fixing this point in time in my memory mean anything now? I’ll be the one leaving a chair empty at the table at a time in the not so distant future. What does it matter whether there is a celebration this year or next when any one of them will be my last? Sometimes I think my logical brain is a bit bitchy or maybe just angry. No, I don’t have multiple personalities, but it helps me to cast these ambivalent feelings as actual characters with different points of view to better make sense of the whole. This living with two contradictory ideas/feelings at once is confusing. I’m alive, yet dying, happy, yet intensely sad, in excruciating pain, yet content, horribly nauseous, yet hungry for the mouth watering food, smiling, yet yearning for my bed. I have to carry all of these contradictory urges all at once. It can be exhausting. I ruminate over what my kids will remember and then frantically take pictures to preserve what I think is important. I secret away notes and letters and keepsakes, knowing logically that my boys likely won’t fully grasp their significance. I talk to all the people who I think need to know something about what I want after I’m gone, knowing full well I’m the one who cares about these things, not others. How do you reconcile wanting to celebrate and be present with the very real fear that you will be erased, replaced, become irrelevant in the lives of those you care about the most? This anticipatory grief amongst the very real festivities of the holidays is mind boggling/numbing/blowing. There are people in my life who have pulled back from me or created conflicts to separate themselves from me because of this, I think. Everyone deals with anticipatory grief in different ways. Courage requires one response, safety another. What you choose reveals something. What I choose reveals something. What results becomes a legacy of intimacy created by opportunities taken or separation because of opportunities missed. How many more opportunities can there be? And that’s all before we add COVID-19 into the mix. I talk to others living with MBC who are contemplating risking exposure and likely death from COVID-19 in light of the fact that due to our truncated life expectancy, this holiday season may well be our last. How do you weigh all the risks/benefits when attempting to make decisions amongst so many unknowns? Absent a crystal ball (and I need one of those), I think we have to make the best decisions with what we have to work with, right now. I think we have to focus on the knowns to make decisions, not make ourselves crazy with attempting to contemplate the unknowns. I think we have to be able to take responsibility for the things we can influence and just pitch the rest. Not an easy task. So not an easy task. I have discovered that to feel settled about my plans and my decisions, I do have to shrink my level of care for those around me to the ones who matter the most. Those who I have genuine connections to; those who are focused on making memories with me. That means I have to let go of many of the defaults of years past, not an easy thing. That means I have to be more picky and more intentional and more settled (i.e., not running around with a million projects) to be able to have the emotional capacity to focus on what matters most. These decisions are fraught with so many pitfalls and worries and feelings, present and past. It is a struggle and causes often sleepless nights in the lead up to the holidays; however, I know that when I put in some work to think this through rather than going with the flow, the holidays contain the people and elements that matter most to me in the end.

#FeatureFriday “You get shown the light in the strangest of places if you look at it right” (Robert Hunter) I have just finished reading Mother, American Night and was struck by the humor, warmth and love laid bare by the author. So I had to pass along these words of wisdom to our breast cancer community: in this heartfelt autobiography J.P. Barlow opines “After Cynthia died I was forced to decide whether the universe was senseless and cruel or actually had a purpose...I realized the physical world exists so that love can make sense, because without the frame of fear and doubt and suffering, love is effortless and meaningless.” Over the last few months it has been our great pleasure at survivingbreastcancer.org to be working with and hosting livestream webinars with Abigail Johnston and her many friends in the Metastatic Breast Cancer Community. Subject matters include palliative care , anticipatory grief, hospice, end of life , death doulas , and making talking about death less taboo. Abigail maintains that “to grieve means that you have loved”. Truer words may never have been spoken. Surely who doesn’t recall Tennyson’s proverb that “Tis better to have loved and lost than never to have loved at all” where he is clearly elucidating on the theme that experiencing love in life is worth the pain of losing it. Psychologists and philosophers have tangled with the notion that life was just a dream since and before the time of Descartes who wondered aloud whether the world we experience while awake might itself be a dream. Some point to the permanence of objects as the antithesis of this thought while scientists have a rebuttal argument that solid matter is actually made up of empty space. I’ll end with another enduring phrasing from Robert Hunter: “It all rolls into one and nothing comes for free, There’s nothing you can hold for very long, And when you hear that song come crying like the wind, It seems like all this life was just a dream”. Much love to all of you... Feeling Grief and Loss While You're a Caregiver It's OK to cry or admit that you're angry or frustrated. These are helpful ways to keep pent up emotions from turning into resentment toward the person you care for or from taking a toll on your health. You can't avoid what will happen, but you can have a say in how it happens. Learning about your loved one's condition is one way to do something, to have a sense of taking action that puts you in the game rather than merely watching from the sidelines. Get a better idea of the symptoms, treatment options, and possible side effects so you can prepare for and even get ahead of what may be coming. Disenfranchised Grief: When No One Seems to Understand Your Loss No matter what type of loss you’ve experienced, your grief is valid. Still, society often fails to acknowledge some types of grief, making it challenging to express your sadness or begin to navigate the healing process. Disenfranchised grief, also known as hidden grief or sorrow, refers to any grief that goes unacknowledged or unvalidated by social norms. This kind of grief is often minimized or not understood by others, which makes it particularly hard to process and work through. I Found An Unexpected Way To Process And Survive My Acute Grief: Texting A Stranger Kim and I were a few months deep into our electronic friendship at this point. A mutual friend, David, introduced us by text because he believed we should chat. He knew that my life was in a tailspin, and that about nine hundred miles north of my home, Kim was also flailing. He also knew we were both juggling things he couldn’t grasp ― single parenting while grieving. So, who better to understand than a total stranger, right?

You’ve just learned that you have breast cancer. You’re overwhelmed with emotions, questions, and fear. There’s so much to deal with, so much to consider, and so many decisions to make. One of those decisions is who you’re going to share the news with, at what point you might want to tell them, and if you even want to let them know at all. You might be concerned about upsetting people and dealing with having to console them. Telling friends and coworkers you have breast cancer can also make it more real to you as you say the words "I have breast cancer" out loud. Who you share it with, how you share it, and when you share it is all up to you. Sharing news about your breast cancer diagnosis is complicated and can potentially create almost as much stress as the cancer diagnosis itself, at a time when one of the last things you need is more stress. There’s no easy or right way to do it, and you don’t have to tell anyone if you’d rather not share. If you decide to tell friends and coworkers, it’s not just about breaking the news of your diagnosis; it’s also about managing the seemingly never-ending tsunami of questions regarding surgeries, treatment, test results, etc. However, knowing some of the questions you might encounter, and possible reactions you might get can be helpful. How to Share the News Who you share it with, how you share it, and when you share it is all up to you. It’s all about what you’re comfortable doing. It’s most likely going to be an emotional conversation, so it can take a lot of time and energy, which can be draining. If you’re telling people individually, either in person, by phone, or by email, you may find that you’re only able to handle a few “reveals” at a time. Some people choose to share the news on social media to avoid repeating the story with individual phone calls or meetings. Other people may be uncomfortable splashing their private life on the internet. People may worry that a broad announcement of their diagnosis will cause them to be treated differently or fear that the news will jeopardize their job or health insurance coverage. Potential Reactions Once you let the proverbial cat out of the bag, you can expect a host of responses, some of which may be difficult to handle. It’s understandable that you worry that every time you tell someone, they will stop seeing you; that you’ll become a “cancer patient” in their eyes. Remember, cancer doesn't define you, you’re still you! And because the news is so emotional, you may also get sad eyes and tears, hugs, confusion, etc. Sometimes, it can just be too much to bear everyone’s sadness, no matter how well-meaning. We all have those awkward stories when someone responds to our news in ways we just didn't even imagine. (Like the time a friend was trying to relate and find common ground by telling me she had an aunt that died from breast cancer). Many people will ask how they can help, so having a list of things you may need help with—meals, transportation to medical appointments, child care—can be handy. This isn't just lip serves, people genuinely want to help and they are looking for you to let them know what you need! It’s also perfectly acceptable to tell them you will let them know if you don’t have a list prepared. Additionally, it is helpful to spread out the support over the next few months. While there may initially be an overwhelming outpour of love and assistance, ask someone to put it in their calendar and to reach out in 30 or 60 days. You'll be glad you did! Others may say or do the wrong thing, not because they’re unkind, but simply because they don’t know how to respond. Try not to take these reactions personally, and instead focus on those who can give you the support you need. One thing you can count on is that you will probably encounter various responses to your news. It’s often unpredictable and sometimes shocking, but a few common reactions might include: Compassion and Support Some people will immediately offer their unconditional love, compassion, and support. It’s a welcome response. Yes, that’s wonderful, but it can also be a bit overwhelming if they instantly launch into control mode. Abandonment Some friends may disappear when learning that you have breast cancer. In one survey, as many as 65 percent of survivors said they had friends or relatives who cut contact or pulled away from them after being diagnosed, It’s a painful reality to face, but it happens. We all have limitations, and for some people, they include harsh reactions to the news that a friend has breast cancer. Survivor’s guilt, fear, helplessness, and denial cause some people to back away from bad news . Some people are just awkward and are afraid of saying the wrong thing, so instead, they go AWOL. The behaviors that cause people to become MIA can also be because of their deep-seated issues. It may be an excellent time to consider seeking new relationships in support groups or deepening relationships with friends who did stick by you. Inappropriate or Hurtful Comments Sometimes, when people are faced with fearful things, like the possibility of losing a friend to cancer, their brains go temporarily crazy and say stupid things. They’re not thinking clearly because they’re worried about you, and their responses aren’t meant to hurt you. You may hear: Various crackpot theories about how you can cure cancer with Tea Tree oil, baking soda, or by dancing naked in the tulips, you get the drift Similarly, comments and articles about the link between breast cancer and hair dye or that one time you got gel nail tips Unsolicited critiques about your treatment choices Criticism about your decision to not go broadly public about your diagnosis, with some people chastising you for keeping quiet, implying that your silence is not helping other women Cataloging a list for you every person they know of who died of breast cancer Telling you how “lucky” you are to have received a “gift” of breast cancer General invasive questions, such as “What are your odds?” We know firsthand that disclosing your diagnosis can be daunting. Our events, webinars and programs , and most of all, our community is always here to help you with those conversations and more.

The holiday season can be a magical, joyous time of year. There’s nothing quite like the period from Thanksgiving (for our friends in the U.S) through New Year's Day (to our friends around the world!) that generates feelings of warmth and togetherness. There’s a level of excitement in the air, and expectations are high. But the holidays can also be overwhelming for some people, creating added stress and pressure. It can be an especially difficult time for cancer patients, survivors, and caregivers who may be managing treatments, side effects, medical appointments, and the all consuming psychological and emotional toll of a cancer diagnosis. There isn’t a one-size-fits-all strategy. No matter what your situation, i.e., coming to terms with a recent diagnosis, going through treatment, or trying to adapt to a ‘new normal’, here are a few tips that may help you successfully navigate the holiday season and enjoy it! Be Kind to Yourself Accept that things may be different from your past holidays. You may not feel up to some time-honored traditions. That’s okay. You may have been the queen of over-the-top holiday celebrations in the past, but now you’re not even sure you can prepare a meal or wrap gifs. Sure, it’s frustrating not to do everything you did before, but try not to beat yourself up about it. You’ve had a challenging time. Be gentle with your post-cancer self. Communicate Your Needs Your health comes first. If your breast cancer makes it difficult to plan and implement the things you usually do for the holidays, let your loved ones know. These are people who love you and want the best for you. They will be happy to fill in for you. You may not be able to host the annual holiday get-together this year. Have guests bring a dish for a potluck type of meal. Use disposable plates and utensils (with apologies to the environment). Or ask another friend or relative to host the event this year. Adjust Your Expectations Even without dealing with breast cancer, everyone has a vision of the perfect holiday. When the holidays fail to measure up to our expectations, disappointment and stress can steal the season’s joy. Let go of the illusion of the ‘perfect’ holiday. Focus on what’s important, which means connecting with loved ones, being grateful, and looking forward to a new year. If you usually travel to spend the holidays with loved ones but cannot due to treatment side effects like fatigue and nausea, visit via a video chat service such as Skype, Zoom, or FaceTime for a memorable holiday call on a smartphone or laptop. Brace Yourself for Crazy Cancer Comments Patients and survivors can be subjected to stupid cancer comments at any time of the year. Well-meaning friends and relatives may take it to the next level during the holidays. When your distant aunt brings a gift basket of ‘cancer-curing’ treats for you, your first instinct may be to ask her why she isn’t sharing this with the experts at the Mayo Clinic. You will feel much better if you just thank her and move on (trust us on this). Even though your role might be limited compared to years past, the holiday season is vital to every cancer patient because it allows them to reconnect with what is important in their lives; their loved ones. Those social connections don’t just make us feel good; scientific research shows that they are vitally important to our health. There’s significant evidence that social support and feeling connected can keep us healthy in many ways, including improving cancer survival and overall mental health. The holiday season can be a wonderful opportunity to spend time with family and friends. If you find yourself stressed about the holidays or just want to connect with people who understand what you’re going through, check out our virtual Thursday night Thrivers MeetUp . We hope this magical season renews your spirit. Have a wonderful holiday!

Smile, though your heart is aching. Smile, even though it’s breaking. When there are clouds in the sky you’ll get by. If you smile through your fear and sorrow, smile and maybe tomorrow you’ll see the sun come shining through...” Music by Charles Chaplin, Lyrics by John Turner and Geoffrey Parsons. Last Thursday night our SurvivingBreastCancer.org our Thursday Night Thrivers virtual get together featured many beautiful, candid photographs of our attending community members. Interspersed with positive affirmations and members’ stories, these pictures invoked an insatiable desire to get through the darkest of tunnels and come out the other side. The omnipresent smiles and heartfelt emotions dominated the evening and left us uplifted. So it begets the following questions: how can you maintain a positive attitude and keep your head up and your heart open while fighting cancer? Is there power in positivity? And how much potential is there in a smile ? Let us start by acknowledging that you don't always have to be positive. Previously we have opined on allowing yourself to grieve and allowing time to vent your anger, frustration, and fears. Acknowledging your feelings and expressing oneself is critical. By doing so you can lessen the impact of Disenfranchised Grief and recognize that it is just as important as staying positive. Honor yourself. Surround Yourself with Positive Energy Just thinking of those positive friends, family members, and community should bring a smile to your face. When you are feeling the weight of the world on your shoulders, they bring a ray of sunshine and lighten your load. These supportive friend s are there to help support you when you need it, so don't back away. You may want to talk about those deepest fears. These friends inspire you to be courageous when you are feeling afraid (and we all are at some point) and that helps make difficult decisions and choices less daunting. [As much as possible avoid negative people, they are vexations to the spirit.] In addition to the positive people in your life, surround yourself with positive energy such as inspirational books, comedies, flowers and uplifting music - which can all help illuminate the way through the darkness. Similarly, positive affirmations - statements you repeat to reprogram your subconscious mind to visualize a situation in a more positive light - can be quite helpful. Nurture Yourself What makes you happy? What are you passionate about? Amidst the swirl of a medical diagnosis, second opinions, and active treatments, it is easy to forget that " You have a life ." Take the time to close your eyes and step back from the world of cancer - dream of things you would enjoy doing. Your thoughts may surprise you. If you are having difficulty picturing yourself feeling passionate about something think back over the past several years. What were the highlights? Where did they come from? What brought you the most joy ? Now think of things you have never done but at some point in your life have thought you would enjoy. Create a “Bucket List” and set off in pursuit of a new passion. After all, you have just gone through a tunnel. What brings you joy? Let us know at info@survivingbreastcancer.org

“Inspiration, move me brightly. Light the song with sense and color; Hold away despair, more than this I will not ask. Faced with mysteries dark and vast, statements just seem vain at last. Some rise, some fall, some climb, to get to....” --Jerome Garcia, Robert Hunter SurvivingBreastCancer.org founder and executive director Laura Carfang, myself, and best friend for life Braydon Germain recently experienced the most wondrous, inspirational vacation imaginable. Allow me to start this narrative at a point that seems so very long ago. Laura was diagnosed with breast cancer some 18+ months before this expedition @ the tender age of 34. Prior to that she and I (her most willing caregiver) would run up monthly to NH, from our base in Boston, MA to experience the wonder of the White Mountains. We would camp, hike, bicycle, swim, and marvel at the natural spectacle that surrounded us. Occasionally we would trek out to the Great Southwest to do the same at National Parks in Colorado, Utah, and Arizona. However, after she was diagnosed with breast cancer we were forced to scale back these activities to accommodate chemo infusions, surgery, more chemo, radiation, and finally, and most recently hormonal therapies and night sweats and more. Throughout her journey we would philosophically reminisce about how much we missed the enjoyment of participating in and getting back to nature. So we set a goal to once again head out to the wilderness to experience nature at her finest. We scheduled a date and place, July, 2018, Yosemite National Park, and invited our dear friend, Braydon Germain, to accompany us. Braydon, a young recording engineer in a famous LA studio, was up for the challenge. We informed him that our itinerary was to fly to LA, visit some old friends from NH who moved out that way (another cancer survivor), travel northeast 6 hours to Yosemite, explore for 8-10 days, then head over to San Francisco to finish up with a multi-day stay there before hosting a survivingbreastcancer.org meet and greet with our partners Driver.XYZ. If he so desired, we’d pick him up in LA and take him along for as much of the two-week vacation that he could tolerate. His response was “I’m in it for the entirety.” So off we went. Yosemite is right up there with some of the most must-see destinations in the world. It occupies John Muir’s “range of light” in the Sierras. It is a land of incredible diversity and features elevations that range from 2,000 to 13,000 feet above sea level. There are several groves of giant sequoias, the largest, and among the oldest living things on this beautiful earth. The magnificence of the mountains, valleys, rivers and lakes remind one of the Book of Genesis. El Capitan is beyond remarkable, Yosemite Falls is gigantic and the uniqueness of Half Dome is striking. Seeing all of this in person leaves you totally inspired. "I knew Yosemite was going to be spectacular, but nothing could have prepared me for the breadth of impactful moments it gave me. The scenery we experienced allowed me to tap into my childhood wonder, and the challenges I faced on my Half Dome hike unveiled deep layers of my subconscious mind. I will always look back at my time in Yosemite and how the Sierras turned my close friends into family." --Braydon Germain And it is exactly the experience of that inspiration that was so transformative. For 8 days we hiked, swam in the ice-cold Merced and Tuolumne Rivers, dove into Cathedral Lakes, camped along the rivers and cooked 4 star meals, including freshly caught brook trout, over a raging, hot fire. “Only by going alone in silence, without baggage, can one truly get into the heart of the wilderness. All other travel is mere dust and hotels and baggage and chatter.” –John Muir It was as if the Three Musketeers came to life in one of the most remarkable parks known to mankind. After dinner we’d clean up and then sit by the fire, waxing philosophic about life, music, literature, etc. The discussions were lively, entertaining and even businesslike on occasion. Of course, the focus would turn to survivingbreastcancer.org and how to build up the non-profit to be able to positively impact as many survivors and caregivers lives as possible. Following our stay at Yosemite we drove through California’s fertile plains and navigated our way to the picturesque Big Sur. This fantastic and rugged stretch of California coastline is stunning and reminds one of the Beats authors Kerouac and Brautigan coming to terms with life’s demons by confronting their internal struggles, ghosts and various states of consciousness. Through our time together we had this feeling of being in the presence of something vast or beyond human scale. Meditating on the beach, sleeping under the stars, hiking along the coast, diving into the icy Pacific, our togetherness transcended our current understanding of things. This truly electrifying experience, positively impacted our lives in measurable ways. It taught us to live in the moment. It inspired us to be better; To delve into our consciousness; To strive for excellence; To be at peace with who and what we are. The impact of experiencing such inspiration has vast potential to lift one’s spirits, improve health, and assist you with your developing mindfulness. Intentionally pursuing it will change your life for the better. Use the power of positivity to solidify your place in the world. “Ere dawn had kissed the level valley floor / He climbed to summits through the sleeping wood / By the inerrant guide of forest lore, / And found companionship in solitude / He feared no beast and by no beast was feared / And none was startled when his shape appeared.” -- Excerpted from the poem, “With Muir in Yosemite,” Robert Underwood Johnson

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

There’s no other word to describe the feeling when you or someone you love is diagnosed with cancer. On any given day, you might rotate between feelings of disbelief, anger, and grief. You may even feel like you’ve lost control over your own life. While your diagnosis might raise any number of negative feelings, here's the good news: you don’t have to feel lost or confused. In Cancer: The Journey from Diagnosis to Empowerment , Dr. Paul Anderson clearly outlines what you can expect throughout your cancer journey. More importantly, he demonstrates how to cultivate a mental outlook that will help you reach your best outcome. When it comes to healing, mind does matter. Drawing on decades of experience, Dr. Anderson offers practical advice to demystify the healing process, empower patients, and teach loved ones how to provide effective support. ♡ RESOURCES MENTIONED ⟡ Cancer: The Journey From Diagnosis to Empowerment: https://amzn.to/2NrybmM ♡ QUOTES WE LOVE ⟡ “Be as healed as you can be” Transcription: Laura Carfang 00:03 Hello and welcome to breast cancer conversations podcast brought to you by surviving breast cancer dashboard. I am Laura Carfang, breast cancer survivor and founder of surviving breast cancer dashboard, a nonprofit organization providing community education and resources to empower those diagnosed with breast cancer and their caregivers from day one and beyond. Hello, everybody, and welcome back to breast cancer conversations. It is so nice to be speaking with all of you today. If this is your first time tuning in, welcome. It's so nice to have you here. Please be sure to subscribe. We release our podcast once a week, usually on Mondays so you can always have something to look forward to as we begin our week together. Before we jump into today's conversation, I just want to give a quick shout out to all of the great amazing resources we have on our website surviving breast cancer.org. I got some feedback actually, that some of our listeners don't know about all of the amazing events that we have every week, every month, etc. So I want to make sure that you guys are aware. Every Thursday night, we host our Thursday Night Thrivers virtual meetup. It is our aka support group. But it's really anything but a support group. It's kind of like chill time to hang out at 7pm. Eastern, everyone is always welcome. I also kind of coin it our no agenda meetup because we talk about anything that comes to mind. Sure, breast cancer, but also anything else that we're going through in life, it's just a really nice time to hang out, chill and catch up. So if you want more information on that, you can visit us at our website surviving breast cancer.org forward slash events. You will also find on that website more information on all of the amazing webinars we have coming up our Sunday NBC series where we host webinars every other Sunday, plus our monthly book club where we read books that have nothing to do with cancer as well. So as we build this community, there are just so many ways to get involved. And speaking of books, I am excited to announce today's podcast topic where we are going to be speaking with Dr. Paul Anderson, who is the author of cancer, the journey from diagnosis to empowerment. As we know, there's no other words to describe the feeling when you or someone you love is diagnosed with cancer. On any given day, you might rotate between feelings of disbelief, anger or grief. You may even feel like you've lost control over your own life. We've all been there. While your diagnosis might raise a number of negative feelings, there's good news, you don't have to feel lost or confused. In Dr. Paul Anderson's book, he clearly outlines what you can expect throughout your cancer journey. More importantly, he demonstrates how to cultivate a mental outlook that will help you reach your best outcome. When it comes to healing. Mine does matter. Drawing on decades of experience, Dr. Anderson offers practical advice to demystify the healing process, empower patients, and teach loved ones how to provide effective support. Welcome to the conversation. Dr. Paul Anderson 02:57 I've been around medicine a long time. So I started in the laboratory end of things in 1976, actually, so it's been doing this a while, went back finished medical schools A long time ago. And what happened really just the very short version of the story is when I started practice, I really wanted to be a general practitioner, which is what I was. But I was also very interested in a lot of integrative medicine topics and palliative care things. So what started to happen almost right away when I opened was people realize that I was doing certain types of therapies that other doctors in the neighborhood weren't. And so we started getting a lot of cancer patients. So it really it didn't start out that I thought cancer would be the focus etc. But that's really very rapidly what happened very sick people with not with the chronic illness and cancer. And that really grew into you know, if you go back, say 25 years or more there, the idea of palliative oncology was almost non existent. The idea of integrative oncology was almost non existent. I mean, it was really, we, we were all learning a lot. But people needed help. So that's really where it started. And from there, there was a good part of 20 years where I did that a lot. I also have always taught I teach physicians as a large part of what I do now. And mentor doctors and so I was really involved in trying to, you know, move that part of medicine forward. And in and amongst all of that in about 2000. Let's just for sake of argument, say eight or nine you mentioned that I ah I had a university post where I was full time professor in a medical school and we I had a NIH funded study we were doing. And it was a collaborative between my university in the Seattle Cancer Care Alliance, which is University of Washington and Children's Hospital and Fred Hutchinson, and you know, some very big players. And what it started was I didn't start with study, but I joined it right away. And it was if we took people who had largely breast cancer, but there were a lot of other cancers as well, from this large, collaborative, those who wanted to do integrative therapies and palliative therapies, this stuff I've been doing, what if we track them, and then match them to people same age who did standard therapies, and so everyone did standard therapies, but we had good add ons. After five years, would we see better quality of life or survival, etc. And so we did that for five years, what got me involved was the study had an interventional part, that they couldn't start until they had somebody who had done that before. And that's what I was doing, the intravenous therapies and all of these other interventional things. So I was part of that for the five years, and I almost thought we got funded because they didn't think it would make a difference. And at the end, we actually got some very positive note that our patients did actually live longer, you know, compared to age matched, and it spawned another study that looks a lot at quality of life and some other things that are going on. So I've had a not planning at all, but I've had a very rich background with cancer patients. And so what really happened as far as writing about cancer, I've always written because I'm a teacher. But right after the study, I started to publicize some of the things that we had done, because if you've ever looked at studies, there may be parts of the studies that no one ever publishes, because there's so many things you discover, you didn't realize. So I went and started teaching. Well, I was doing that. And a doctor I hadn't seen in 25 years, who went to medical school together, came up to me at a conference and said, You should really tell this story. And you, he says, you have a hard time getting a publishing deal, though, because you're, you know, no one knows you except in the academic world. And he says, but I can get you a publishing deal. So we wrote a book together that was predates this book, which was really a lot about those other things, sort of the, you know, what I would call the what happens to you with cancer and what what are choices to make that are better and worse in the, you know, integrative space, etc. When we were done with that books, in many languages around the world, it's been very popular call outside the box cancer therapies. But we were done. I was mentoring my clinic and my doctors, and one of the things that I I felt like we did a great job with the, what do you do with cancer as far as your body goes, but what we kept I kept running into was, we talked a little about the mind body connection, and just the logistics of, oh, what do I do with this diagnosis, I didn't want it I you know, what I do with my family, what I do with, you know, everything. So the more I worked on that with my own doctors and mentored people, the more I thought, you know, agnostic of how you're treating cancer, what you're doing about your cancer, the internal part that you go through, and your closest loved ones go through and you get diagnosed, is so critically important. So that led to this book, cancer, the journey from diagnosis to empowerment, literally the point, it's, um, I designed it to be easy to read, not super heavy and academic was the first time I ever wrote something like that. But honestly, it was it. This, I mean, there is some research and some data and things that I, you know, looked at or whatever. But really, this came from just my day to day experience over those three decades. And looking people in the eye, getting diagnosis and walking them through that. So the point really, is, there is a way to go from the shock and whatever emotions go on that you feel to a place where you are more, you know, empowered, self-actualized, whatever you want to call that. But it doesn't happen automatically for most people. So that's, that's the short version of all those years. Laura Carfang 09:30 No, that's wonderful, such a rich introduction as well. And a, you know, decades of experience, which I'm so excited to have our listeners kind of take us on this journey, right from diagnosis to empowerment. I feel like anecdotally we speak about that a lot in our like support groups and our blogs and the work that we do, because we know that we anecdotally it makes us feel better, right when we exercise we feel better when we take time to focus on the breath and the mind body connection that you're talking to About, we know it helps, but we don't always know why it helps. And I would like to take a step back quickly to just so we can define terms for people who might who might not be aware when we talk about kind of like the traditional therapies, I think you're referring to like the surgery, the radiation and the chemotherapy. Whereas integrative care, which I think is a nice segue from what used to be referred to as alternative medicine, where it's no longer alternative, it's how can we put these therapies together? And really integrate them so that the quality of life and you know, is there for the person going through the treatment? Do I have that correct? Dr. Paul Anderson 10:34 Very much. Yes. Yeah. Excellent. It doesn't always work out that way. But that's the goal. Yeah. Exactly. Exactly. Laura Carfang 10:43 And I know when I was going through my own personal treatment to a lot of these integrative therapies were recommended to me, such as acupuncture to help with some of the side effects that I was going through. And, you know, it's, I think, just a mindset also. So what I love about your book, is that right from the beginning, you kind of paint this picture of the shock and the devastation that comes with a cancer diagnosis, and then how mentally we can start making this shift. And you kind of talk about two different characters in your book and kind of the diversion that these two characters take. Can you tell me a little bit about these personas? Dr. Paul Anderson 11:20 Yes. So there's, there's two characters that you get to meet Well, you get to meet some other people later, but Bob, and GM, and they're actually real people, obviously, it's not their names, and I change details, so no one knows who they are. But they're very real people. And that was a big part of the motivation to write the book, other than what I was seeing just with patients, and there was sort of a hole here in that space. But the the publishers in I came up with the idea of, could I tell two stories. And the publisher really encouraged that, because the rest of the book is useful from a technical point of view of Gee, I'm stuck and I'm angry, well, you know, where do I go or I, you know, I can't get my family on board or whatever it is. The stories really are there to give the two counterpoints two ways you deal with the, you know, that trip from being diagnosis, to either not empowered or being empowered. So each one of them embodies that. And it's real stories. It's a, you know, everything a book is very real, from real experience. So the point of that, though, is sometimes we you know, sometimes we learn from data and bulleted points, and there's that and sometimes just learned from stories, stories are wonderful. And my, the first thing I was like to say is I don't, I don't judge either point of view, I, of course, you never want a patient to become angry and stuck, and, you know, self-sabotage, but you know, one of them did. So it didn't make me happy that they did, but that's, that's the person's choice, everything's your choice. But if you want to do something other than that, you know, there is a trajectory. So those two stories really are, we see a lot of ourselves in them in different places, and the stories, you know, each, each chapter sort of as the technical parts of where to go, the story kind of unfolds in that, you know, in that order and direction. So yes, it's there to add some humanity to, you know, what otherwise could be a little technical book Laura Carfang 13:25 Absolutely. And I think sometimes we forget that our own diagnosis extends just beyond the self, that it impacts our families, our friends, and I use the term like we all the time, like we have cancer, we are going through cancer, we are going through treatment, because as I think you point out in the book is there's this grieving process, that we're all on a different journey in terms of those, like anger phase denial, phase acceptance, phase etcetera, but then our family and loved ones might be on a different path also. And so how do we deal with these different personalities or, you know, my experience, I love my mom to death, she's a nurse, and she, when I was going through breast cancer, she wanted to be the nurse. And I really had to turn to her and say, No, I need you to be my mom right now. And that was a challenging and hard conversation to have. But you know, I think you talk about that also in your book in terms of the role the family plays, and the grieving process too. Dr. Paul Anderson 14:22 Sometimes it's the patient with cancer, who is the one really struggling and may be stuck in, you know, denial or whatever stage of grief. And I did use those stages of grief, you know, to it's a framework we're all familiar with, usually and it is actually the order that people kind of process cancer diagnosis into but the other side of it though, is you can actually be doing pretty good as the patient but you have to understand and it's not your responsibility, but the people around you who love you and are close to you are just as shocked and just don't know what to do and they might be angry or they might have You know, what happens a lot like with your mother, as a nurse or any, you know, any medical person, their default is if I do something for you, medically as a nurse, or if I'm your doctor, I'm doing something to help you. And really, it's harder sometimes to take that roll off and just be the loved one, you know, the parent, the spouse, the partner, whatever. And that's really, we talked about that, in the book, those discussions of Look, this is, it's great, you want to do that, but this is what I need from you, you know, I need this primary relationship we have, and it's so important. And a lot of times, and I saw this, you know, weekly with with patient families, some, it's just like, it works out, and everyone sort of sorts out where they're at, and they get over, you know, the place they were stuck. But sometimes you really have these two divergent things, especially with like partners or spouses. And that's not a healthy, like, none of you the point of the book is, if we move more towards being empowered, in our small circle, including the patient, our outcomes are better, it's, you know, it's not great to have cancer, but it's, it's a more doable thing, and you actually get better outcomes when you do have that. So the fact your close circle is, is so huge. And, and they're going through it a different way. You know, what I usually remind people is when you hear that you have cancer, it activates your your fight or flight system, and it activates, you know, your partner's fight or flight system, but what that connects to is two different worlds, you know, they may have seen some, you know, very bad outcome with cancer had a primary, you know, loved one or relative go through something that they thought I'd never ever want to see that my life, well, then you hear, well, my wife has cancer, it's, it takes them there, then take him to some logical place. So there's a lot to, you know, it's not easy, but it's really worth it. And it's really worth it at least to get the people closest to you on board. Laura Carfang 17:09 I think you were hitting on some key points about you know, empowerment, how can the patient feel empowered to have those conversations with people to say, this is what serves me now, this is what's helpful to me and what's not helpful to me, I think a lot of times, you know, it's easy to just kind of harbor some of those emotions. And, and that really makes sense of it. And, and to feel that it's okay to disagree with someone, if it doesn't help you. What I love about your book is that you immediately say like, it's okay to be selfish Now is the time to put yourself first and yourself and your health are the only things that matter. Everything else is secondary. And I think just reading that was like, like, yes, like, I'm ready to go take on the world, like, I matter, I'm important. And I can say, like, yes to what I need, and whether that's a nap or whether that's a walk, you know, I sometimes feel like having those words and reading them, give us give us the permission to say that it's okay, it's your allowing us that permission just to be okay, on those good days. And to not be okay, on those bad days, Dr. Paul Anderson 18:10 As you well know, it's, most people are not socialized to a place where it's okay to, you know, be the center of what needs to happen. And, and that becomes a real, you know, stumbling block for a lot of people, which is why, you know, almost every, if not every chapter where there's sort of, you know, you can get stuck here and move on. The first thing I say is, it's okay to be that way. It's okay to be sad, it's okay to be angry, it's okay, whatever. The point is, that's a place in time and you want to move from there. But the other thing is, it's, it's more than okay for you to take care of yourself and say, whatever it is, you know, I, I can't do this activity anymore, I need to focus on this or I need time, so I can take care of my body or whatever it is. And most people just don't have that internal, the message they hear back is well, you should think about other people or you know, something like that. And, and, you know, we shouldn't think about other people but you, you are engaged with, you know, a process that's not got your best interests at heart. So you have to have your best interests at heart. Yeah. Laura Carfang 19:24 And you definitely make that connection between like the emotional piece, those thoughts we tell ourselves in our head, and the impact that it has on our outcome and diagnosis. A lot of the conversations that I have in some of my circles most recently, I am four years out from my original diagnosis, and I am still healing I am still now trying to let go of the pre cancer me work on the current version of me. And also trying to be gentle and practice that self care piece because there's still a lot of things that I can't do. And just last night in one of our support groups that we have Every Thursday night, we were talking about, like, we can't go, we can't ever go back, just like the grieving process, right? Like, we can't be in that hole of, Oh, I wish I could have done should have done, you know, used to be able to do. But look at all the amazing things now that I can do, because I've come out on this other side, whether it's, you know, I no longer practice the vigorous yoga I used to do, it's more of like a slow meditative practice and, and coming to terms with that, I would love to hear your opinion on kind of like the self care and the self healing piece. And what you say to someone who still may be a little bit stuck in, in that like, sad world of like, How did this happen to me, but I want to come out of it, how can I take better care of myself, Dr. Paul Anderson 20:42 And that's where the rubber meets the road really, for most people. The first thing, you know, that I think is most important with that discussion is allowing the person time to get to that place where they actually say it. Because if if some outside person just tells you, you know, look, you you need to stop thinking about the past, and you needed to do some self care or whatever. Sometimes people need that maybe to move off the dime. But really, that has to come from within. And I think the most important thing is it's not. It's the extremely rare human who wakes up one morning and says, Okay, today, I'm all about self care. And I'm going to forget about the pre cancer me, most people, it's just, I've come to realization, I want to go there, I have no idea how to do it. So I'm willing, but I'm, you know, unaware. That's the moment at which then, you know, the whoever is helping, whether it's a medical person, or family or therapist or whatever, or support group. That's the point at which you provide resources that are the next steps. And I think the most important thing is not overwhelming people. Because you can come to realization, you know, for people who don't have cancer, it's, sometimes they'll come to realization, I need to take better care of myself and exercise. Well, if you suddenly give them you know, a 400 point exercise plan, and they've never exercised it, they're not, you know, that's overwhelming. Same if you have cancer, and you realize you got to do something, and you have to move away, you know, from past thinking, etc, you got to start with just baby steps and move forward. So a lot of it is that holding a place for the fact that you're doing it this realizing you can only do so much at a time. And, and really the you know, you probably saw kind of the order the book is written in, what I say is that you might be great with the stuff in chapter one, but chapter two, you might be stuck at great spend some time there, you know, it's baby steps. And every day, just, you know, just like grieving or just like processing anything, every day is a new day to do that, too. So you don't necessarily wake up on day two or day 20 and say, you know, I've got all that handled, and, you know, most the time you wake up and say I still have cancer and I need to, you know, I need to be in this other place with it. So a lot of it is just being gentle, gentle motivation forward tools when they're needed, but not too many. Because I, I did see that a lot that that sort of stimulated some memories for me about when I was thinking of writing the book, mentoring doctors, especially, you know, newer ones, and they would get a cancer patient give them way too much all at once. And the patient's just like, you know, overwhelmed with, you know, so they have all this physical stuff they're doing and maybe they're doing, you know, chemo, or maybe they're getting surgery and recovering and doing 11 other things. And then they've got, you know, a 40 point list about changing their diet and their mental set and their other site. Without cancer, you can't do all that, you know, with it. So, you know, so let's, you know, let's start with one thing and move you forward and keep going. That's, I think that's the most humane way, but it's also the most sustainable way to do that. Laura Carfang 24:16 Yeah, I hear a lot of times that, you know, cancer can be that catalyst that wakes us up. And that ignites some sort of flame within us to make behavioral changes. And another piece that I love about your book too, as you give us all of these tools and allow us to linger in various chapters as we're doing the inner work to heal internally. I think that's incredibly important what you mentioned and resonates with me very much so to say that we have to want that change, we have to want to have that mentality and shift because if it doesn't come from within it's going to sound like one more thing on our to do list and potentially, you know, depending on your your behaviors and character like it might retract, right? You say well, I don't want this at all and I'm even going to hibernate even more so It's definitely a fine line and something that people need to tread lightly on for sure. And, you know, I think one of the tools that you you share in the book is the opportunity for us to control what is in our control, and then let go of what is not in our control, I think so much of a cancer diagnosis, when you feel like everything is ripped out of you, how can we make sense of what we can do on like, kind of the small chunks, and bite sized chunks of like, day to day, this is something that's in my control. And it could be that mindset, or it could be the diet, it could be taking a walk, or an exercise, like something that is tangible, because so much of it is unknown, especially in the cancer world, right, we have, treatments are constantly changing or evolving based on how you're responding to a particular drug. And, you know, I hear a lot of times too, you know, we think we're going in for one surgery, and then lo and behold, there's an infection or something happens, or you need for breast cancer, your exchange surgeries, like, there's so much, and there's a lot of unknown. And, you know, to kind of tie this back to those various phases of grief and loss and sadness, and then unknown, but we just want control, we want to know what we can do. And I used to tell my doctors to like you're in charge of the medical side, I'm in charge of like, the health and wellness side, and we can meet halfway, and I feel that way that I am empowered, and that I can take an active role in my health. I think you speak a lot about that in your book as well. Dr. Paul Anderson 26:30 Yeah. And it is so critically important, with, with cancer as a journey, but especially like with what you're describing where treatments can change, suddenly, surgeries Can you know everything can change suddenly, because your body is going to react the way your body reacts. And we see that all the time, you get 10 people with the same chemo regimen, and, you know, seven to one way and you know, three to three different ways. And so, you know, part of what I try to get to in the book is, those are things that you don't want to totally, like, just go on autopilot and say, Well, whatever, you know, but I mean, you only have so much control over how your surgery goes, that's, you know, you can prepare for it and all that stuff, but the rest is about the surgeon, your body and how it all works together. Same with chemo, you know, or a targeted therapy or something, your body and your immune system do the work and you may not have total control. And one of the things I've seen that gets people to stay stuck is if their focus is all on, you know, especially people that like a lot of control, that's probably that's a human condition. But, you know, some people are much more into control and other people. I've seen them get so tied up in those things that they can't really control, that there's no energy for this stuff, you can, you know, which are the harder things literally waking up and saying, you know, it's another day with cancer, but it's, you know, it's my day, it's, you know, this is, you know, this is going to whatever happens, however I feel, it's still my day, and this is going to be how it goes. And I think that that switch of doing inventory, because you know, every month is different, what's in your control, what's kind of in your control, like you could maybe choose your doctor, maybe choose whatever. But beyond that the medical side, like you say is it's going to do what it's going to do. So then you got a whole bunch of other stuff you're in control of and that and that, that is empowering and of itself, because people get to stay stuck in the area of stuff they can't control, you're automatically disqualified you like you, you're disempowered, because I can't be empowered about something I have no control over, you know, I can be empowered about how I am around that. But, you know, so focus on the stuff that you you're totally in control of. Yeah, Laura Carfang 28:57 You know, with a cancer diagnosis I was, you want a plan, you want that roadmap, and I had to quickly learn, I think it was my second appointment after chemotherapy. And I was like, that plan has to go out the window. Like I just can't hold on to that. And it's I think it's also hard to going back to the chapters on like family and friends. They turn to you to say like, well, what's next what's happening next, they want a road map also. And so all of a sudden, it can be compounded with you know, I was given some information, the information changed. And now as I'm talking to new, the newly diagnosed it's it's very similar type of peer to peer advice of, you know, you have to be flexible and nimble and just kind of go with the flow sometimes because it'll save you some stress and heartache. Dr. Paul Anderson 29:46 You really have to hold it with an open hand because there's just, you know, there's so many things that can change and not even go wrong. Just change you know, and People obviously we don't, you know, if we don't have cancer, we're not usually sitting around focusing on how cancer is treated and things. But, you know, I was trying to tell people look, you know, your radiation oncologist or your medical oncologist or surgical oncologist, they have huge jobs that have almost no margin for error. And so their whole world is tied up in doing dosing your radiation, or figuring out your chemo or changing your chemo or doing the right surgery for the moment. To keep you as safe and healthy as possible. So like, that's their world, they're really tied up in it. And you just don't know how many variables they have to sift through. So changes are part of the deal, usually. So, you know, pick good doctors, let them do their work, keep on top of what they're doing, ask questions, but then, you know, focus on being as prepared as possible to either do or not do treatment or be as prepared as possible to deal with what you can it's, it's a huge thing. If you think, Oh, you know, cuz I'll use this analogy. Most of us have been to the doctor because we got, you know, strep throat or we had a broken leg. Those are pretty linear treatments, you know, there's X amount of time, there's this medicine, and you're better sometime, that in the future. Cancer doesn't work that way. You know, every day, there's sort of all these variables you have thrown up in the air, and then, you know, you see which balls hit the floor first. And that's what you do. Very different. So it, it's Yeah, that's really good peer to peer advice. Laura Carfang 31:38 100%. And I think that's a great way to reframe it as well, taking it like you're not changing it because I'm just going to be very candid. Like, I think sometimes too, it could be like the trust that we have with our doctors, right, it's like, you're given one thing. And now you're changing it on me. And I think the way you just reshaped that was like, okay, it's a positive, you're changing this because you're tailoring it. But it's my own symptoms and my reactions that I'm having, which is completely different than somebody else. And so I love that, that's great positivity, I want to pick your brain a little bit more on the mindfulness and kind of taking a deeper dive into the integrative therapies and complimentary care that you were discussing in your book. And I know you also mentioned a little bit about palliative care. And I think sometimes we think about palliative care as like, end of life and sometimes use it interchangeably with hospice, but it's not necessarily and to utilize the palliative care and integrative cares as quality of life. How, how can we speak about quality of life? And how do you define that? Dr. Paul Anderson 32:40 I think that's a really good. And sometimes I, I forget, because I think of palliative care is really encompassing, but a lot of people do they hear palliative, and they think, Oh, no, you know, it's the same as hospice or something. Now, it can include that. But really, as I was mentioning earlier, you know, 2030 years ago, the idea of palliative oncology was just end of life care. It has come a very long way since then. So now what that really means and maybe a better term, although it's not the term people normally uses is, you know, quality of life and health enhancement is really what you're talking about in modern times. Now, he going back to just what I said earlier about, you know, you've got your surgical oncologists and medical and radiation oncologists there, their world is wrapped up in their treatments, which are so complex, they understand the need for this other stuff, but that's not their job. That's not what they do. You know, it's people like me who do the quality of life and other care. What I usually tell people is there, there's really four steps in a cancer journey. The first step is you don't know you have cancer, and its primary prevention. Most people are always making cancer cells, but they don't develop cancer don't do too later. The next step is what the book is talking about, which is diagnosis and initial treatment. And then the next step is actually recovery from treatments so that you know, you stay in remission or you get towards your mission, etc. And then the next step is secondary prevention, which is, let's not have it come back or get worse or you know, whatever. And the reason I divide it that way for people's minds is the amount of effort and energy you as a patient, have, time wise, energy wise, etc. to put into working on those things is very different at each step. primary prevention, preventing things it's that can be 100%. If you are just starting with some surgery and chemo or radiation or whatever, you aren't going to have time and energy for very much you're going to do you like to say baby steps just to shore up everything. But in the recovery part in what I would call palliative or quality of life recovery care. It's not about hospice or any of life normally, it's about let's get you recovered from, you know, all of all of this treatment you just had. It's, you know, there, there's no, uh, maybe there is I can't think of a cancer therapy of any kind. That is any fun and you come out the other side feeling healthier than you did when you started. It's, it's, you know, there's this job you're doing of treating cancer and now you know you want to recover? Well, one of the things and I get to the mental emotional part in this book, the prior book, we talked a lot about it medically, but the more you do on the other end of recovery from surgery, radiation, chemo, etc. Actually, the more calm your cancer stem cells are, and the less chance of recurrence later on. So when we're talking about palliative oncology, yeah, it's the whole spectrum. And while it might include more end of life things, that's, you know, 5% of what we're trying to do, mostly what we're trying to do is make you as healthy as possible, so that you have the lowest index of cancer wanting to come back or be aggressive, etc. So it's a, and there's, there's so you know, if I think of just what we didn't know, five or 10 years ago, but if we go back 25 years ago, was like, well, we can do something. I mean, it was, it was really, it just, you know, it's it's been logarithmically expanding. And, and the research has to, I mean, you know, the first book we had, like, over 1000, scientific, you know, resources. This book isn't so much about that, but but the mindset part, I guess, you know, big reason for the book, this, this book about the mindset is and empowerment, you can do all the, the perfect medical oncology, you can do all the perfect recovery and palliative and quality of life stuff. But if your brain is stuck in that place, where you're still angry, you, you know, don't want this cancer, you're mad at it, it's, you're a victim, your body doesn't feel the same. And so it's it's part and parcel with the external things you do, such as, you know, fixing your body after surgery, or, you know, recovering from chemo or whatever. It's also your brain being on board with that. So it, you know, moves you forward. Laura Carfang 37:25 I couldn't agree more, I think the mental side is the muscle we have to work also, right? It's not just the physical, you know, the exercise, but how could we mentally help ourselves grow after such a traumatic diagnosis. And I completely agree, I think when we talk about the secondary prevention piece, and I do kind of want to reframe this also, because I'm also very sensitive to a lot of women in our community who were diagnosed with metastatic breast cancer de novo. And so there is some anger there where you don't have that initial early stage, to have that option. You think you're being preventative, and there's a variety of reasons why that happens. But you know, when we an app, I don't want to put words in your mouth or look for your buck. But as I was reading about the secondary prevention piece, it wasn't just a second recurrence of breast cancer, but it was that no evidence of disease or no progression of disease, right? Like, how can we take this and again, still feel empowered, and even with a terminal diagnosis still move forward. And, again, be empowered with the choices and the control that we have? Every single day that we wake up? Dr. Paul Anderson 38:36 You did a good job putting words in but the idea was secondary prevention, of course, is you there, there are things you can do to get to a certain place there. But as you say, some people and this was a large portion of our patients started out de novo with, you know, metastatic disease, and they, you know, there isn't the first two or three steps, you know, it's just boom, here it is, and here's what we're gonna do about it. So secondary prevention, the nice thing about the more modern way of looking at it is, it's not just for people with no evidence of disease or into remission. It's also for people who are either really, we had other two other areas, one was progressive, but but slow progressive disease, and the other was stable disease. And so you may have metastatic, you know, stage four cancer, but you can do everything you can to keep it either very slow, progressive or stable. So it's not in remission, but it's remission. Like, there's a lot of things you can still do there to manage all of that because, you know, you're just as shocked but I would say yes, probably a little more anger comes up because you feel like gosh, why couldn't I have been diagnosed? Stage One, you know, like my friend did or stage two, in here I was diagnosed at stage four, which is a lot of people nowadays. You don't even, that's not part of your choices, which is terrible, it's too bad, but that's the way you know it is. So for that person, they have to rewind to the place where you process the anger and the loss of total control over everything. Plus, you're grieving the fact that you didn't get it stage one diagnosis to deal with or, or a stage two or something. And it's the same steps, it's just you, you're going to deal with different emotions, because you literally had a whole bunch of options you never got important part is, it's still so critical to to do the mental emotional and Mind Body connection, work, etc, to get beyond that, because we've literally had people with metastatic disease, who, you know, through whatever combination of therapies and, and supportive things stayed stable and had very good quality of life for years and years and years. And, yeah, they never, you know, stage four, cancer didn't go away, you don't really see that very much. But they had, you know, what they said, were wonderful life, you know, wonderful quality of life, dealt with it as it came in. And I think, you know, it's, it's, that's it, those are the elephants in the room, which are, nobody wants to talk about that real harsh reality that, you know, and again, you're not telling the person will get over it, you know, because that's, that's not, it's, you know, you don't have to get over it, you have to, you have to recognize you have every right to be angry, because this, there's nothing fair about this. But staying in the anger won't make you healthier, you know, processing it will moving forward. And we had, you know, in the, in the NIH research, the large majority of people that were doing interventional things, I was in charge of all but one where stage four people most stage for a diagnosis. And they were which makes you more amenable in research to do all sorts of things, which is what we did. But they were, they had all mostly come to the place where they were so they were an empowered group. And they didn't like having stage four cancer, and, you know, they didn't like the effects and all of that. But the reason they were part of this research project, and we're we're in my section where they knew that at some point, it would help somebody down the road. Laura Carfang 42:48 100% response I totally agree. Dr. Paul Anderson 42:50 Those are the people that motivate me, many of them are no longer with us, but a lot of them still are, you know, we we had one lady that was diagnosed at 85. Doctor said, she wouldn't live to see 86 and we celebrated her 90th birthday in our office, and she made it to 96 years, and she lived 10 years. And it was all her like, just the way she dealt with it. So, yeah, it's not, you know, none of the things are easy. You know, these aren't easy conversations to have with yourself, let alone with you know, people in your circle, but they're so necessary for your mind to be free to let you be as healed as you can be. Laura Carfang 43:38 I think the positive affirmations and you know, not letting someone else dictate time, that how much time you have left to live, no one can say that, right. So right and wake up in the morning saying, today's a new day, I'm going to live it to the fullest. And you know, it's it definitely has a positive outcome and relation on your own mental health and on your body and on your outcome. So it's really great to hear. Dr. Paul Anderson 44:05 Very much Yes. Laura Carfang 44:06 You'll be able to buy this book cancer, the journey from diagnosis to empowerment via Amazon. It's also available on Kindle, as well as an audiobook. I will link to all of this in our show notes below. So this has just been wonderful. Thank you so much. Dr. Paul Anderson 44:21 Thank you. It's a perfect organic conversation. Laura Carfang 44:24 Yeah, exactly. That's how I love them too. Thank you for tuning in and listen to our podcast. If you'd like to find out more about our organization and upcoming events and ways to connect. You can find out more by visiting our website at surviving breast cancer.org. And we'd like to acknowledge that all of the information on our podcast is from personal experiences and it is not a substitute for professional medical advice. You should always consult your medical care team. If you're looking for specific topics or would like to be a guest on our show, feel free to contact me directly at Laura at surviving breast cancer.org. And of course, we have a couple social media handles. You can follow us Sat as well. For example, surviving breast cancer org all one word, as well as our podcast, specifically breast cancer conversations. Until next time, keep on thriving.

TRANSCRIPTION: Laura Carfang 00:03 Hello and welcome to breast cancer conversations podcast brought to you by surviving breast cancer dashboard. I am Laura Carfang breast cancer survivor and founder of surviving breast cancer dashboard, a nonprofit organization providing community education and resources to empower those diagnosed with breast cancer and their caregivers from day one and beyond. Hello, everybody and welcome back to breast cancer conversations. It is so nice to be speaking with all of you today. If this is your first time tuning in, welcome. It's so nice to have you here. Please be sure to subscribe. We release our podcast once a week usually on Mondays so you can always have something to look forward to as we begin our week together. Before we jump into today's conversation, I just want to give a quick shout out to all of the great amazing resources we have on our website surviving breast cancer.org. All of our podcast listeners are invited to join us on Thursday nights for our Thursday night drivers meetup. We meet on zoom every Thursday at 7pm. Eastern you can RSVP from our website, and a zoom link will be emailed to you. We also send out weekly newsletters on Mondays and Fridays. We have an every other Sunday metastatic breast cancer series that we produce, as well as a once a month breast cancer book club that we host. The best part about the book club is that we don't read any books that have to do with cancer. It's pure escapism, a lot of fun. And we meet on the first Sunday of every month. You can check out what book we're reading again on our website. Today on the podcast, we are speaking with Karla who is not new to breast cancer conversations. She actually provided us with a beautiful 45 minute long episode where she shares with us everything she knows with regards to nutrition education around clean eating and living with metastatic breast cancer so I'll link to that full episode below. However, I wanted to pull out a short excerpt from that longer series because we want to focus on Phyto estrogens. If I breast cancer is ER positive, it can be very confusing to understand if we should be avoiding soy eating soy products, avoiding Phyto-estrogens etc. I am so excited to have Karla back on the episode to help us answer some of these questions. Welcome to the conversation. Karla Mans Giroux 02:17 Now let's talk about Phyto estrogens and breast cancer and Laura and I talked a little bit about this ahead of time and I do like to share this information and it is controversial. But there are studies that show of course you'll always find on any topic study that's forward a study that's against but Phyto estrogens are plant based compounds that mimic estrogen because their chemical structure is very similar to that of estrogen from the body. They have been found to be beneficial in combating symptoms and conditions caused by estrogen deficiency. Therefore, this may be a particular benefit to pre and post-menopausal women who are having their hot flashes. Phyto-estrogens may also play a role in fighting cancer. However, it is still controversial and more research is absolutely needed to understand this. Unfortunately, they do not spend a lot of time and money on researching something that can't be patented. But there we are. There are studies that have revealed that high consumption of soy products is associated with low incidences of whore hormone dependent cancers, including breast and prostate. Soybeans contain the large amounts of isoflavones. Previously, it's been demonstrated that genistein, one of the predominant soy isoflavones can inhibit several steps involved in carcinogenesis. So it can inhibit the development of cancer. It is suggested that genestein possesses mechanisms of action, including inhibition and modulation of different signaling pathways associated with the growth of cancer cells. Moreover, genestein is also a potent inhibitor of angiogenesis. Uncontrolled angiogenesis is considered a key step in cancer growth, invasion and metastasis. I see Dr. Keith Block of the Block Center for Integrative Cancer Treatment in the Chicago area. I've talked to Dr. Block many times about soy and breast cancer and fighter estrogens and breast cancer. Dr. Block has told me that processed soy foods such as soy burgers typically contain very low amounts of that genestein and other soy items such as miso and soy sauce contain even less. In fact, he says a whole bottle of soy sauce contains only about six or seven milligrams of isoflavones, which would have no effect at all on breast cells, though it would be quite a lot of salt. So Dr. Bullock counsels that there is no need to pass on the tofu or the tempeh, so long as you're eating soy foods in moderation, just like anything else, and be sure your soy is non GMO. Dr. Block also stated in a 2016 article that he wrote, he stated in 2016, the studies suggested that eating moderate amounts of soy foods is safe for breast cancer survivors. In fact, in studies conducted by Dr. Anna H. Wu, and others at the University of Southern California, show that women who consume approximately one to two servings of soy food each day are not isolated soy supplements, you want to avoid those. But if you eat soy food each day, you actually have a reduced risk of breast cancer recurrence, or being diagnosed with the disease. And moreover, these studies, there were three studies in China and two in the US that provided further evidence that women who ate more soy have better survival after breast cancer diagnosis than those who ate the least soy. Laura Carfang 06:20 Karla, as always, this has been so helpful, I am definitely going to look on PubMed, and I will link to some of these studies in the show notes below so that our readers and listeners will have access to this information. Thank you again, for everything that you do for our breast cancer community. It is always a pleasure having you on the podcast. Thank you for tuning in and listen to our podcast. If you would like to find out more about our organization and upcoming events and ways to connect. You can find out more by visiting our website at surviving breast cancer.org. And we'd like to acknowledge that all of the information on our podcast is from personal experiences and it is not a substitute for professional medical advice. You should always consult your medical care team. If you're looking for specific topics or would like to be a guest on our show, feel free to contact me directly at Laura at surviving breast cancer.org. And of course, we have a couple social media handles you can follow us that as well. For example, surviving breast cancer org all one word, as well as our podcast specifically breast cancer conversations. Until next time, keep on thriving.

Originally published by Dependable Cleaners here . In honor of October being Breast Cancer Awareness Month Dependable Cleaners wanted to put the spotlight on an entrepreneur making strides to support those who are and have faced a breast cancer diagnosis. So here we are! The spotlight is turned inward so here we go! Laura Carfang started SurvivingBreastCancer.org as a platform to provide support, education, and a community for those that have been diagnosed and their caregivers. Laura took her personal journey with breast cancer and turned it into a way to inspire, encourage and support others. As Executive Director she has set out a vision and is a strong believer that everyone’s voice should be heard. We spoke with Laura to learn more about her journey and her vision for SurvivingBreastCancer.org How can we offer support and compassion to both individuals fighting a breast cancer diagnosis and survivors of breast cancer? There are various and sundry ways family, friends, and caregivers can offer support to those diagnosed with breast cancer. I think the most important thing to keep in mind is that everyone is different, so take the time to ask the person what would be helpful to them. You may think it is helpful to bring over food, but a person diagnosed with breast cancer may have a particular aversion to certain foods due to the side effects of the chemotherapy; some people lose their taste buds, others may develop mouth sores – making meals a challenge and a reminder that they are ill. One thing I noticed is that everyone has an opinion when it comes to your health care. Unless the person with breast cancer is asking you to recommend a doctor, or specific advice, sometimes these options are better kept to yourself. Finally, going back to the first point, I think it is also important to ask the person what their boundaries are, how open they want to be about their diagnosis, I.e., which family members get all of the details and which people get the high-level updates. In my experience, my boyfriend and caregiver came to all of my appointments and he was the one family members were able to call and ask questions allowing me to catch up on much needed rest.   What are some key initiatives SurvivingBreastCancer.org is working on this coming year? We have some exciting plans coming up this year. We are transiting to more of a virtual platform to enable our organization to help as many people as possible. Secondly, we are seeking grants, corporate sponsorships and cause related marketing alliances that will enable us to work full-time for the non-profit. Was there a specific moment in your breast cancer journey that set the stage for what you wanted the mission of your organization to be? Absolutely! Living in Boston, one of the world’s great health care Meccas, and being a major metropolitan city, I thought it was going to be easy to find other women, similarly diagnosed with breast cancer and make connections. I honestly thought that if I typed into google “breast cancer survivors in Boston” I would find a thriving community ready to connect and share their experiences. In hindsight, I guess I was looking for a breast cancer mentor so to speak. Boston offers several support groups and forums which are great resources, but they are usually spearheaded by the hospitals. However, if you are working, it is hard to attend weekday afternoon sessions. It was through my own experience navigating breast cancer that I launched my 501(c)(3) non-profit, Survivingbreastcancer.org . I wanted to create a virtual platform that provides community, education and resources for those diagnosed with breast cancer and their caregivers. A breast cancer diagnosis does not end when treatment ends, there is a lot of aftermath that comes with it. If you are diagnosed with early stage breast cancer, you are never truly 100% “Cancer Free.” Oncologists use the term “No Evidence of Disease” or “NED”. There is always a lingering fear that the breast cancer may return. That is where our organization comes into play. We are there when your medical care team says they will see you in 12 weeks, or 6 months or next year, and PTSD slowly creeps into the fabric of your life. This is when the community and support systems are needed the most. Tell us about a mentor who has been influential to you as a leader. I have to say that my mom and dad have been my biggest mentors and influential leaders. They are my rock! I am very fortunate to be very close with my family. My father started his own business in the financial industry 35 years ago, so in a sense I’ve grown up around entrepreneurship. From a young age I was exposed to the dedication and hard work that goes into running a business and that the hours are hardly 9-5. My mother works in the healthcare sector. I remember early on, she would find opportunities to educate her patients and their families. She incorporates nutrition and lifestyle medicine in her approach making it easy for her clients to understand the complexities associated with illness, food allergies, and autism, for example. She now leads the Carol Carfang Nursing and Healthcare Ethics conference where leaders, educators, and philosophers come together to discuss the most pressing issues in the field. I guess you can say, it’s in my genes and I couldn’t be more grateful for the mentorship and leadership I receive from my parents.   Do you have any tips for entrepreneurs to help them maintain a healthy work/life habit? Most entrepreneurs will tell you that you have to have an unwavering passion for and belief in the work you are doing. There are times when entrepreneurship can be quite lonely. There are moments of doubt and insecurity along the way. However, it is in those moments that I remind myself, “if it were easy to put your life and souls’ work out there to be a success, then everyone would do it.” It takes a specific mindset and drive to be willing to take chances, to be judged (because everyone has an opinion), and to risk failure and still persevere, that distinguishes an entrepreneur. The work/life balance is a challenge and it comes down to prioritization. A simple black and white question I ask myself is, will this give me joy, will this help me get from point A to point B. And if the answer is “yes”, then it is worth doing. If the answer is “no”, then I move along to the next thing.  The other technique that I use is dedicating one day a week for “me-time”. I have chosen Monday as that day where I do not book meetings, schedule podcasts, or work on blog posts. For me this is a guaranteed day where I can find a yoga class, go for a run, grab a dinner with girlfriends, or simply sit on the couch in pj’s and scroll through social media posts. Whatever you need to do to unwind, relax and refresh, it’s important to carve out that time each week. In the work that I do running a non-profit, I am reminded that it is not a race but a marathon. Like all non-profits, we are called to solve some of the world’s most challenging problems. We are not going to cure breast cancer tomorrow. However, if we can help one person, move the needle one point, and provide support, education and community to those diagnosed with this disease, then I know we are going in the right direction. Thank you Dependable Cleaners for publishing our story and supporting breast cancer awareness, programing, and resources. Want to learn more about Laura's story, here are some additional features: Channel 7 News & On the Podcast

Kerensa Nathele Irvin, 25, of Maple Valley, passed away on December 9th at 3:14 am in her mother’s arms. She had a 1½ year battle with stage 3 breast cancer, which become metastatic last November 2018. She was courageous and an example of hope through her strength, smiles and positive attitude. Kerensa was born on February 28th, 1994 in Seattle where she lived her early formative years in diverse communities. She embraced the rich culture she was exposed to with love and acceptance. Her childhood experiences developed her into a person who respected and accepted diversity. In grade school, she was first to welcome new students or include students left out to participate in activities. She was known for her inclusive and collaborator skills at a young age. As she matured, her compassion, genuine care for others, along with her infectious smile became her beloved traits. As a youth she was always willing to experience new activities such as karate, dance, racquetball, basketball and baseball. She played soccer for several years before discovering swimming. During her junior and high school years Kerensa loved performing in plays and was fortunate to be in a variety of roles. She had a love for the water and enjoyed swimming for King Aquatics and Tahoma High School. She had a connection to water that gave her comfort and peace. Her favorite places included Kalaloch, Pacific Beach, Long Beach, Big Island Hawaii and Puerto Rico beaches walking and playing in the surf. She had an unfulfilled dream of visiting the Greek Isles to walk the white sands and swim the turquoise waters. Kerensa graduated in 2015 from the University of Washington with a bachelor’s degree in psychology. She had a passion for helping people through difficult situations. She had a special interest and love for adolescents, especially young people experiencing depression. She wanted to prevent teenage suicide and assist those at risk. Her goal was to complete her master’s degree in either psychology or social work. In late 2015 Kerensa made the journey to Massachusetts where she spent 4 years sharing her love, light, and laughter making everyone's lives infinitely better. During her time in Massachusetts, Kerensa was an active Human Rights advocate, and won the hearts of executives and politicians while helping create diversity and inclusion programs. She passed along her love and knowledge of baking to "her boys" as she danced in the kitchen while making her secret recipe cookies and cakes. She was an unconditional supporter of education and would effortlessly help with schoolwork. The lessons she taught will be cherished, remembered, and passed down. Kerensa is survived by her parents, Diane Irvin Marines and Osbardo Sosa, stepfather Gonzalo Marines, papa Glenn Irvin and Grandma Victoria Sosa. Her late nana Barbara Irvin adored her along with her “second mom” Laurie Yarbrough who passed in 2017. She will be missed by her brothers Gonzalo Jr., Joaquin and Lorenzo. Uncle Kevin Irvin, Aunt Glenda McQueen and cousin Amber Hoyt. Kerensa leaves behind her loving husband of just over 1 year, Glenn, two adoring stepsons Liam and Finnbarr, nephews Grayson and Oliver, niece Maisie, as well as countless family, friends and coworkers at Granite Telecommunications where she was admired as a valued employee with lists of accolades. Husband Glenn shares memories of the late Kerensa Irvin on our Podcast Breast Cancer Conversations L ose the Tumor Keep the Humor Let's Get Married Recurrence, Progression, and Passing Stay in Touch If you have a memory, story, or photo you'd like to share, please email it to info@survivingbreastcancer.org and we will add it to this page.

TISCHLER--Alyson, beloved wife of John Eberhart, adored and adoring mother of Simon, cherished daughter of Beth and Warren Tischler, loving sister of Jonathan Tischler and his wife, Eiko, dear aunt of Emi and Nina, niece, cousin and friend to all she met. She passed away peacefully at home in Woodbridge, CT on April 9, 2021. A 1995 Phi Beta Kappa and High Honors graduate of Wesleyan University, Alyson earned her MA and Ph.D. from the University of Michigan in English Literature in 2000. She was a Vice President of Material Plus, a marketing firm, with her primary focus being pharmaceutical and healthcare research. In recent years, she became a patient advocate in the triple negative breast cancer community, a source of support and strength to others on the same journey. Hear Alyson on our Podcast Breast Cancer Conversations What Treatments Are Available for TNBC (as of 2020) Clinical Trials 101 How to Build Trust with your Medical Team If you have a memory, story, or photo you'd like to share, please email it to info@survivingbreastcancer.org and we will add it to this page.

Emily Rees Garnett died on March 29, 2020, 28 months after being diagnosed with metastatic breast cancer. She was 35 years old. Emily was born in Phoenix on March 19, 1985, the first child of Brian and Barbara Rees. She graduated from Xavier College Preparatory in 2003 where she was a 4-year state finalist in the breaststroke and co-captain of the swim team. She continued swimming at Scripps College and was named the Scripps Alumnae Athlete of the year upon graduation. Always seeking adventure, Emily moved to Manhattan after college and began working as a case manager for Housing Works, an AIDS/HIV advocacy group. This work led her to law school and she graduated from CUNY School of Law in 2012. Emily was admitted to the New York Bar after graduation and worked in NYC as an elder law attorney focusing on guardianships, capacity issues, special needs issues, and public and private benefits. Emily was known in the New York Surrogate Court as a detail-oriented, dedicated professional. In 2012, Emily married Christian Garnett and they welcomed their son, Felix, in November, 2015. In 2017, Emily, Christian, and Felix moved to suburban Mt. Kisco after a decade of living in the city. In November 2017, two days after her son's second birthday, Emily was diagnosed with stage 4 breast cancer and given a life expectancy of 2-3 years. After her diagnosis, Emily became a relentless advocate for breast cancer awareness. Emily began documenting her illness, treatments, and life in her blog, Beyond the Pink Ribbon, to foster dialogue surrounding metastatic breast cancer. In addition to her blog, her writing on health issues was published by Women's Media Center, Scary Mommy, Coffee+Crumbs, CURE Magazine and Healthline. In February 2019, she walked the runway for AnaOno in New York Fashion Week to bring awareness to metastatic breast cancer raising $100,000 for research. Emily was a member of the Metastatic Breast Cancer Alliance's Patient Advisory Advocacy Group and served as an ambassador for the Breast Cancer Research Fund. In this capacity, she appeared in a New York Times ad campaign and was featured on a billboard in Times Square. This last year, she was named WEGO Health's Rookie of the Year for advocacy work across numerous social media channels. In addition to her blog and advocacy work, Emily hosted a podcast, The Intersection of Cancer and Life, which featured candid, honest and often funny accounts of the realities of life with cancer. She appeared on Entertainment Tonight with Giuliana Rancic to talk about cancer and was featured in a YouTube episode of Binging with Babish. Last October, she traveled to Washington DC to lobby congress for increased funding for breast cancer. But Emily's real legacy lay with the countless individuals with whom she connected daily. Persons who read her blog or listened to her podcast sought her out and she always made time to speak to them, offering advice and counsel. Emily is survived by her husband, Christian, their son, Felix, parents, Brian and Barbara Rees, her brother, Patrick Rees, paternal grandparents, Paul Rees and Donna Rees Canfield, maternal grandmother, Beverly Morgan, numerous, aunts, uncles, cousins and their children. In her last effort to shed light on this devastating disease, Emily donated her tissue to Memorial Sloan Kettering for research. No funeral arrangements were possible due to the Covid 19 quarantine. A reception honoring Emily's life took place in NY once it was safe to gather. Hear Emily on our Podcast Breast Cancer Conversations When Two Podcasters Finally Connect Stay in Touch If you have a memory, story, or photo you'd like to share, please email it to info@survivingbreastcancer.org and we will add it to this page.