By Kiara Ford  In our series on the financial side of breast cancer, we have already examined the breast cancer to poverty pipeline, and the economic toll a breast cancer diagnosis carries with it . But missing from this conversation is the question: what happens if you are already experiencing poverty when you are diagnosed with breast cancer ? More specifically, how would someone experiencing homelessness be able to detect, treat, and recover from breast cancer?  Continue reading to learn more about how homelessness can complicate breast cancer screening, diagnosis, and treatment. Homelessness: Breaking the Stigma Before answering this question, let’s define what it means to be a person experiencing homelessness. There are numerous toxic narratives attached to the word “homeless,” but it is important to remember that many of the prejudices are based on stereotypes and are not representative of the population. We must avoid making generalizations about people experiencing homelessness, because the circumstances that lead to homelessness can vary so greatly.  The Social Security Administration   defines a person experiencing homelessness as “an individual with no permanent living arrangement, i.e., no fixed place of residence.” This could be a family staying in transitional housing, a person fleeing domestic violence , or someone struggling with unemployment. The circumstances that lead to homelessness are most often complex and unique to the individual, so sweeping statements about the entire homeless population can be harmful. What can be said, however, is that most people experiencing homelessness will have to navigate financial hardship, limited resources, and instability. Breast Cancer Screening Barriers These difficulties are contributing factors to why unhoused people with breast cancer are almost twice as likely  to die as those with consistent housing. One of the greatest barriers is access to preventative care and early detection. For women at average risk, mammograms are recommended over the age of 40  every other year, in the hopes that the cancer can be found and treated as early as possible. One 2014 study   found that only 59% of unhoused women surveyed had had a mammogram in the past two years, and that 53% of those who had had one did not know the results.  The Toll of Delayed Cancer Detection and Treatment This lack of regular screening makes it more likely that cancer will be diagnosed later, which is compounded further by the fact that people experiencing homelessness may be forced to delay treatment. Doctors typically recommend   starting treatment soon after diagnosis in order to improve survival odds, but the barriers created by homelessness can make this impossible. One study   from Boston Medical Center found that 90% of patients in the sample deferred care by at least 30 days, and the average time between diagnosis and treatment was 98 days. The most common reasons given for these delays were comorbidities and mental illness interfering with treatment, having no place to recover after surgery, and inability to cover the cost of care.  Cancer Care is Prohibitively Expensive Covering the cost of care is one of the greatest barriers to healthcare in America, especially for those without insurance. Research   has shown that around 60% of people experiencing homelessness are not insured. Although many of this group would be eligible for coverage under Medicare or Medicaid, acquiring the necessary documentation and filling out the forms without an address can prove challenging. This leaves uninsured, unhoused people with limited options.  There are safety net hospitals , which receive federal funding to provide service to any patient in need, regardless of ability to pay. There are also medical respite facilities, which provide accommodation for individuals experiencing homelessness who are too sick to stay in a shelter or on the street, but not sick enough to be admitted to the hospital. While both these services provide vital care, they can also be difficult to locate and are not always accessible to people who may need them.  Homelessness is a complex issue, and it cannot be solved overnight, especially with a breast cancer diagnosis further complicating the situation. What we can do is meet people where they are, withhold judgments, and invest in screening programs such as mobile mammograms for lower-income individuals. Read more about safety net hospitals: https://healthcareconsumernavigatorcenter.com/consumer-information-navigator/section-4/safety-net-hospitals-resource-healthcare-consumers/ On the Podcast: Breast Cancer Conversations Breast Cancer and the Law: Resources for Patients and Caregivers About the Author: Kiara Ford is a graduate of Emerson College, where she majored in communication studies and minored in health and society. She is a certified community health worker and has worked extensively in disability advocacy. She is passionate about health equity, and hopes to raise awareness and increase understanding of patients’ rights through her work. From the Same Author: Metastatic Breast Cancer: Understanding the Significance of Stage IV Breast Cancer and Healthcare Access Within the Hispanic Community Inflammatory Breast Cancer: Breaking Down the Basics Datopotamab Deruxtecan Shows Promise in Clinical Trials Getting through the Holidays with Breast Cancer Overlaps Between Breast Cancer and Domestic Violence The Cost of Breast Cancer SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetup s Free Events

By Kiara Ford  A breast cancer diagnosis brings about many losses. These may include the loss of ability to work and engage in family and social life as you once did, the fear of loss of life, and the loss of self-image. Breast cancer often leads to changes in appearance in ways that can feel dehumanizing or outside of traditional aesthetic standards.  While to some this loss may seem small compared to everything else being impacted by the disease, the blow to self-esteem these losses can cause is devastating, and contributes further stress to an already difficult situation. It is important to normalize the discussion of these losses and acknowledge that the pain they cause is valid. Continue reading to learn how side effects such as weight gain, hair loss, and surgical changes can impact those with cancer and how to acknowledge and process the emotions that come along with them. Treatment-Related Weight Gain Weight gain is a common side effect of breast cancer treatment . This can be caused by numerous factors. It may be more difficult to exercise  during cancer treatment due to pain, fatigue, and nausea. Additionally, some medications and treatments can cause weight gain, such as steroids or corticosteroids, which can increase appetite. Corticosteroids in particular can also increase fatty tissue, which may additionally cause loss of muscle mass.  Chemotherapy is another common cause of weight gain. Despite the nausea often associated with chemotherapy, some people find that treatment causes them to crave sweets and carbohydrates. Additionally, it can bring on early menopause , which can slow metabolism and cause weight gain around the stomach. On average, women gain between 5 to 14 pounds  over the course of a year during chemotherapy.  While these treatments can be life-saving, the side effects are incredibly difficult to experience. It is important to remember that our society, in particular, glorifies a “ thin ideal ,” which can make any amount of weight gain feel distressing. For those who are used to their body looking a certain way, this sudden loss of control can be deeply upsetting and cause major blows to their confidence and self-worth.  Chemotherapy and Hair Loss Another side effect of chemotherapy affecting an individual’s self-image is hair loss . Hair is something many people take for granted until they start losing it, at which point they realize what a major role it played in their confidence. Chemotherapy targets any fast-growing cells in the body in the hope of eradicating cancer cells, but this means it also targets the fast-growing cells in the roots of the hair. This typically causes hair to fall out about two to four weeks after the beginning of treatment. The amount lost and how quickly it falls out will depend on individual treatment, but any amount can feel overwhelming.   For women in particular, a long head of hair can be associated with beauty and femininity, and the loss of it can bring these two things into question. A bald head in women is also often identified as a sign of cancer, information which an individual may want to remain private. While there may be some comfort found in remembering that hair loss is usually temporary and that wigs can be worn during treatment, it is also important to acknowledge that even with these reassurances, hair loss can be upsetting. Mastectomies: A Permanent Physical Change One final and particularly important matter to discuss in relation to self-image is mastectomies. A mastectomy  is a surgery that removes all breast tissue, and may include some breast skin and the nipple in some cases. Unlike weight gain and hair loss, the bodily changes caused by a mastectomy are permanent, and may feel like a much heavier decision than other treatment options.  Although mastectomies and other breast surgeries can have benefits for both treating breast cancer and reducing the risk of recurrence, surgical recovery is physically difficult and can alter the way a woman regards her body. Reconstructive surgery  is an option that can help restore breast shape through the use of implants, tissue reconstruction, or a combination of both. This may help improve self-esteem for some people post-mastectomy, and may, in particular, help to restore feelings of femininity for those who desire it. That being said, breast reconstruction is a very personal decision, and many people opt instead for aesthetic flat closure . No one should feel obligated to have reconstructive surgery if they do not want it, and beauty is not contingent on breast tissue. Nevertheless, no matter the reconstruction decision, many people mourn the loss of their pre-surgery body. Physical Changes Compound Cancer Challenges Nothing about breast cancer is easy. Physical changes are just one more challenge that people with breast cancer face every day . When a health situation like cancer is out of someone’s control, it can be particularly painful to also lose control of physical appearance – something they had previously been able to craft and decide for themselves.  For people experiencing these changes, it’s important to acknowledge any challenging emotions as they come up and process them in your own time.  If someone you love is experiencing these physical changes, you may feel the urge to reassure them that they are beautiful no matter what. However, it’s also important to validate that what they are going through is hard, without dismissing their feelings. Listen to your loved one express themselves about these changes , and let them know that you’re there for them through it all. Read more: Metabolic Changes After A Breast Cancer Diagnosis A Patient-Centered Approach to Plastic Surgery Reconstruction The Choice to Go Flat On the Podcast: Breast Cancer Conversations Breast Reconstruction and Plastic Surgery Explained About the Author: Kiara Ford is a graduate of Emerson College, where she majored in communication studies and minored in health and society. She is a certified community health worker and has worked extensively in disability advocacy. She is passionate about health equity and hopes to raise awareness and increase understanding of patients’ rights through her work. From the Same Author: Metastatic Breast Cancer: Understanding the Significance of Stage IV Breast Cancer and Healthcare Access Within the Hispanic Community Inflammatory Breast Cancer: Breaking Down the Basics Datopotamab Deruxtecan Shows Promise in Clinical Trials Getting through the Holidays with Breast Cancer Overlaps Between Breast Cancer and Domestic Violence The Cost of Breast Cancer Homelessness and Breast Cancer SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetup s Free Events

Understanding a Stage IV Diagnosis with Compassion, Clarity, and Hope Being told you have metastatic breast cancer (MBC) is life-altering. Whether this is your first diagnosis (known as de novo MBC) or a recurrence after early-stage treatment, hearing the words “stage IV” or “metastatic” can bring a whirlwind of emotions—fear, confusion, disbelief, and questions about what happens next. This blog is for you. It’s here to help you understand what metastatic breast cancer is, how it’s treated, and what living with MBC can look like, all grounded in evidence-based information and compassionate care. What Does “Metastatic” Mean? Metastatic breast cancer—also called stage IV breast cancer—means that the cancer has spread beyond the breast and nearby lymph nodes to other parts of the body. Common sites of metastasis include the bones, liver, lungs, and brain. When breast cancer cells travel through the blood or lymphatic system to other organs, they can grow and form new tumors. Important to know : Even when breast cancer spreads to another part of the body, such as the liver or bones, it is still considered and treated as breast cancer—not liver or bone cancer. This is because the cells remain breast cancer cells. De Novo vs. Recurrent Metastatic Breast Cancer There are two ways someone can be diagnosed with MBC: De Novo Metastatic Breast Cancer This means that the cancer is stage IV from the very beginning. You may not have known you had breast cancer at all before the metastatic diagnosis. About 6–10% of women  in the U.S. are diagnosed de novo, according to the American Cancer Society. Recurrent Metastatic Breast Cancer This happens when breast cancer returns after treatment for an earlier-stage diagnosis. It may recur months or even years later and appear in a different part of the body. It’s important to know that recurrence is not your fault —cancer biology is complex, and even with the best treatment, some cells can remain hidden and later become active. Understanding the Biology of MBC Breast cancer is not one disease—it’s many, with different subtypes and behaviors. To understand your treatment options, you and your medical team will look at several key factors: Hormone Receptor (HR) Status HR-positive  means the cancer cells grow in response to estrogen and/or progesterone. These cancers can often be treated with hormone (endocrine) therapies . HER2 Status HER2-positive  cancers make too much of the HER2 protein, which promotes cell growth. They may respond to targeted therapies  like trastuzumab (Herceptin), pertuzumab, or newer agents. Triple-Negative Breast Cancer (TNBC) These tumors are negative for estrogen receptors, progesterone receptors, and HER2. TNBC tends to be more aggressive and may be treated with chemotherapy  or immunotherapy , depending on biomarkers like PD-L1. Knowing your cancer’s subtype helps guide your treatment plan and gives insight into how the disease might behave. Where Can Metastatic Breast Cancer Spread? Breast cancer can metastasize to many areas of the body, but the most common include: Bones : The most frequent site. Symptoms may include bone pain or fractures. Liver : May cause pain in the upper right abdomen, fatigue, or abnormal liver tests. Lungs : May cause a persistent cough or trouble breathing. Brain : Less common but may lead to headaches, vision changes, or balance issues. Your doctor may order scans such as CT, PET, MRI, or bone scans to assess the extent of spread. This process is called staging , and it’s crucial for determining your treatment options. How is Metastatic Breast Cancer Treated? Unlike early-stage breast cancer, the goal of MBC treatment is not cure but control . Many people live for years with MBC, managing it as a chronic condition . Treatment aims to: Slow the cancer’s growth Relieve symptoms Maintain or improve quality of life Several plans can provide personalized treatment. Systemic Therapies These are drugs that treat the whole body: Hormone therapy : For HR-positive cancers Targeted therapy : For HER2-positive or BRCA-mutated cancers Chemotherapy : Especially for fast-growing or hormone-resistant cancers Immunotherapy : For certain TNBC patients with PD-L1 expression Radiation Therapy Used to relieve pain or control tumors in specific areas, like bones or the brain. Surgery Rarely used in MBC, but in some cases, it may help control symptoms or remove a primary tumor if it's causing problems. Clinical Trials Clinical trials offer access to emerging therapies and are a key part of advancing treatment. Ask your doctor or visit clinicaltrials.gov  for options. Living With Metastatic Breast Cancer A metastatic diagnosis changes your life—but it doesn’t define you. Many women live full, meaningful lives while managing treatment. Here's what helps: Building Your Care Team This includes your oncologist, oncology nurse, radiologist, social worker, palliative care team, and perhaps a counselor or therapist. You deserve a team that listens, respects your goals, and partners with you in decision-making. Symptom Management Also called palliative care, this includes pain relief, managing fatigue, and treating side effects like nausea or neuropathy. It’s not about giving up—it’s about living better. Mental and Emotional Health It’s normal to feel overwhelmed, anxious, or even numb. You’re not alone. Support groups, therapy, expressive writing, and connecting with others who understand can be lifelines. Tip: Organizations like SurvivingBreastCancer.org  offer free programs, peer support, and weekly community meetups just for MBC thrivers. Planning for the Future Planning can bring peace of mind. This might mean talking about your hopes, bucket lists, or creating an advanced care plan. Having these conversations can help you feel more in control and supported. Common Myths About MBC Let’s bust a few myths, including: Myth 1 : Metastatic breast cancer is a death sentence. Truth : While it is not curable, many people live for years—some for a decade or longer—with MBC thanks to advances in treatment. Myth 2 : If the cancer spread, something went wrong with my treatment. Truth : No. Cancer can be unpredictable. Metastasis can occur even after doing everything “right.” Myth 3 : I must start chemotherapy right away. Truth : Treatment depends on many factors, and not everyone starts with chemo. There may be less aggressive options with fewer side effects. Hope and Progress in MBC Research There has never been more progress in understanding and treating metastatic breast cancer than there is today. Some recent advances include: CDK4/6 inhibitors  (like Ibrance, Kisqali, Verzenio) for HR-positive MBC Antibody-drug conjugates  like Enhertu and Trodelvy Immunotherapies  like Keytruda for certain TNBC patients PARP inhibitors  for those with BRCA mutations More clinical trials are focused on personalized medicine, liquid biopsies, and novel pathways to outsmart cancer cells. Researchers are listening to patient voices more than ever, driving innovation with humanity at the center. You Are Not Alone A metastatic diagnosis can be isolating, especially if others in your life don’t understand what “stage IV” really means. But there is a powerful community of people—other thrivers, caregivers, advocates, researchers, and healthcare providers—walking this road with you. Take things one step at a time. Ask questions. Seek support. And give yourself permission to grieve, hope, rest, and live—however that looks for you. You are more than your diagnosis. You are resilient, powerful, and not alone. Resources You Can Turn To Metastatic breast cancer is complex, but understanding your diagnosis is the first step toward taking back some control. As you move forward, remember: you don’t have to have all the answers today. You just have to keep showing up for yourself, one day at a time. You are worthy of support, quality care, and love. And we’re here for you—every step of the way. SurvivingBreastCancer.org : Free MBC meetups, blogs, meditations, and expressive writing programs Metastatic Breast Cancer Network : mbcn.org Living Beyond Breast Cancer : lbbc.org METAvivor : metavivor.org

A Deep Dive into Targeted Therapies for HR+, HER2-low, Triple-Negative, and BRCA-Associated MBC If you’ve recently been diagnosed with metastatic breast cancer (MBC), it can feel like you’re suddenly thrust into a new world filled with acronyms, treatment decisions, and unfamiliar terminology. One of the most empowering things you can do right now is to begin learning about the tools available to you. We take a deeper look at four innovative categories of treatment that are changing the landscape of metastatic breast cancer care: CDK4/6 inhibitors for hormone receptor-positive (HR+) MBC Antibody-drug conjugates like Enhertu and Trodelvy Immunotherapies for some triple-negative breast cancers (TNBC) PARP inhibitors for people with inherited BRCA mutations Each of these therapies offers new hope, especially as treatment becomes more personalized based on tumor biology. Let’s break each one down. CDK4/6 Inhibitors: Targeting Cell Cycle in HR+ MBC What are They? CDK4/6 inhibitors are a class of drugs that target two proteins—cyclin-dependent kinases 4 and 6—which are involved in cell division. In many HR+ breast cancers, these proteins are overactive, causing cancer cells to grow uncontrollably. By blocking CDK4/6, these drugs slow or stop the growth of cancer cells while allowing normal cells to recover. Common CDK4/6 inhibitors include: Ibrance (palbociclib) Kisqali (ribociclib) Verzenio (abemaciclib) Who Gets Them? These therapies are used in people with hormone receptor-positive, HER2-negative metastatic breast cancer, which is the most common subtype of MBC. They are typically used in combination with hormone therapy such as letrozole or fulvestrant, especially for those who are newly diagnosed with MBC or whose cancer has recurred after initial endocrine therapy. What To Expect: CDK4/6 inhibitors are taken orally (as pills), often in 3-week-on, 1-week-off cycles, depending on the specific drug. Common side effects include: Low white blood cell counts (neutropenia) Fatigue Nausea Diarrhea (more common with Verzenio) Hair thinning Routine blood work is important to monitor how your body is responding. Why They Matter: CDK4/6 inhibitors have significantly extended progression-free survival—and in some cases, overall survival—for patients with HR+ MBC. Kisqali, for example, has shown particularly strong overall survival data in clinical trials. Antibody-Drug Conjugates: Precision Medicine in Action What are They? Antibody-drug conjugates (ADCs) are a new generation of cancer therapies that combine the targeting power of monoclonal antibodies with the cancer-killing power of chemotherapy—but delivered with precision. Think of ADCs like a “smart bomb”: The antibody seeks out cancer cells with a specific protein. Once attached, the chemotherapy payload is delivered directly into the cancer cell, sparing more of the healthy tissue. Groundbreaking ADCs include: Enhertu (trastuzumab deruxtecan): Targets HER2-low and HER2-positive breast cancers. Trodelvy (sacituzumab govitecan): Approved for triple-negative breast cancer (TNBC) and HR+/HER2- MBC that has already been treated with endocrine and chemotherapy. Who Gets Them? Enhertu is for people with HER2-positive MBC and more recently for HER2-low breast cancers, which now includes many patients previously considered “HER2-negative.” Trodelvy is used in TNBC after two prior therapies or in HR+ MBC after hormone and chemo treatment. What To Expect: These drugs are given by IV infusion every few weeks. Your team will monitor your blood counts, heart function, and watch for any lung-related symptoms (especially with Enhertu). Common side effects: Nausea Hair loss Fatigue Diarrhea Neutropenia (low white blood cells) Enhertu also carries a risk of interstitial lung disease (ILD), so early detection of coughing, shortness of breath, or chest tightness is important. Why They Matter: ADCs represent precision-targeted therapy that gives more treatment options for people whose tumors don’t respond well to traditional chemo. Enhertu, in particular, has transformed care for the newly defined category of HER2-low breast cancer—a group that includes nearly 50% of patients with MBC. Immunotherapy: Boosting Your Body’s Defense Against TNBC What is It? Unlike chemo or targeted drugs that attack the cancer directly, immunotherapy helps your own immune system recognize and attack cancer cells. In breast cancer, immunotherapy has shown the most promise in triple-negative breast cancer (TNBC), which tends to be more aggressive and harder to treat. Key Immunotherapy Keytruda (pembrolizumab) is a PD-1 checkpoint inhibitor that works by removing the "brakes" from immune cells, allowing them to detect and fight cancer. Who Gets It? Keytruda is used in TNBC that is PD-L1 positive, a marker found via biopsy or molecular testing. It is often given in combination with chemotherapy as a first-line treatment for metastatic TNBC. What To Expect: Immunotherapy is usually given as an IV infusion every 3 or 6 weeks, often alongside chemo. Common side effects include: Fatigue Rash Nausea Because immunotherapy revs up the immune system, it can also lead to immune-related side effects like: Inflammation in the lungs (pneumonitis) Colitis Thyroid issues Your team will monitor you closely and may use steroids to manage side effects. Why It Matters: Immunotherapy has extended survival in some TNBC patients and offers a much-needed option for a group that previously had few targeted therapies. PARP Inhibitors: Targeting BRCA-Mutated Cancers What are They? PARP inhibitors work by exploiting a weakness in cancer cells with BRCA mutations—a kind of inherited mutation that affects the way cells repair DNA damage. In BRCA-mutated cancer cells, the DNA repair machinery is already compromised. PARP inhibitors make it even harder for these cells to fix themselves, leading to cancer cell death while sparing normal cells. Common PARP inhibitors include: Olaparib (Lynparza) Talazoparib (Talzenna) Who Gets Them? These are used in people with HER2-negative metastatic breast cancer who also have an inherited BRCA1 or BRCA2 mutation. If you haven’t already had genetic testing, talk to your oncologist. Finding a BRCA mutation can open the door to these treatments and inform family risk. What to Expect: PARP inhibitors are oral pills, typically taken once or twice a day. Common side effects include: Fatigue Nausea Anemia Low platelet or white blood cell counts Routine blood work helps monitor for side effects. Why They Matter: These drugs offer a targeted alternative to chemotherapy and have been shown to improve progression-free survival in people with BRCA-associated MBC. For many, they’re also better tolerated than traditional chemotherapy. Bringing It All Together Navigating metastatic breast cancer is complex, but you don’t have to do it alone—and you don’t have to understand it all at once. What matters most is that you begin to learn about your options and feel empowered to ask questions.

Why Am I Still Here When Others Are Gone? You’re still here—living, breathing, laughing, grieving. But in the quiet spaces between treatments or in the wake of hearing about someone’s passing, there’s a question that creeps in: “Why Them and Not Me?” If you’ve ever felt this way, you’re not alone. Many people living with metastatic breast cancer (MBC) or in remission/no evidence of disease/no evidence of active disease after treatment experience a complex emotional weight known as survivor’s guilt . Let's explore survivor’s guilt is, why it shows up, how it affects our emotional health, and what we can do to cope with it—together. What is Survivor’s Guilt? Survivor’s guilt is a form of emotional distress that occurs when someone survives a traumatic event—or outlives others who did not—especially when death or suffering feels arbitrary or unfair. In the context of metastatic breast cancer, survivor’s guilt may arise when: You outlive the prognosis given to you or others Friends from support groups or online communities pass away You respond well to treatment, while others do not You’re no longer in active treatment, while others are struggling You feel joy, relief, or “normalcy” after witnessing someone else’s decline Survivor’s guilt doesn’t mean you’re ungrateful or that you don’t value your life. It means you’re human—and you have the capacity to hold both grief and gratitude at the same time. Why Do We Feel Survivor’s Guilt? There’s no single cause. Survivor’s guilt is often tied to: 1. Empathy and Connection You form strong bonds with others in the MBC community. When someone dies, it’s deeply personal. Their loss isn’t abstract—it’s someone you laughed with, shared treatments with, or saw parts of yourself in. 2. A Sense of Injustice MBC is unpredictable. Two people with similar diagnoses can have very different outcomes. Survivor’s guilt can stem from the unfairness of that randomness. 3. Fear of Being Next Sometimes guilt is tangled up with fear. Watching others die from metastatic disease is a constant reminder of your own mortality. Survivor’s guilt becomes a way to brace for what might happen to you. 4. Cultural Messages We’re often told to “fight” cancer and “stay strong,” which can falsely imply that those who die somehow didn’t fight hard enough. This toxic narrative feeds guilt and shame, even though outcomes are determined by biology—not effort. What Are the Symptoms? Survivor’s guilt can show up emotionally, physically, and psychologically. It may overlap with anxiety, depression, or post-traumatic stress. You might notice: Persistent sadness  or feelings of heaviness Irrational thoughts  like “I didn’t deserve to live” or “I’m just lucky” Avoidance  of joy, happiness, or planning for the future Withdrawal  from your support community or social circles Increased anxiety , especially around scans or treatment updates Insomnia  or trouble concentrating Emotional numbness  or feeling disconnected from your own survival It’s important to name these feelings—not to pathologize them, but to validate them. You are not “wrong” for feeling this way. You are processing something deeply human. What Does It Mean to Be Surviv-ING? The word "survivor"  can feel complicated, especially in the MBC community, where the disease is considered incurable. Some people with metastatic breast cancer resist the term altogether, while others embrace it with pride. Whether or not you identify with the word, being alive— still here —means you're navigating the emotional complexity of survivorship. That includes living with the loss of others who walked beside you. Remember: There is no right or wrong way to be a survivor. Whether you live for five years, ten, or longer, your life matters. You don’t have to “deserve” your survival. You just are. And that is enough. How Do We Cope With Survivor’s Guilt? Coping starts with acknowledging your feelings and allowing yourself to experience them without judgment. Here are some ways to navigate survivor’s guilt with care: 1. Talk About It Speak with a therapist, a support group, or trusted friends. Many people in the MBC community understand this feeling and are relieved to know they’re not the only ones carrying it. SurvivingBreastCancer.org offers weekly metastatic breast cancer support groups, expressive writing sessions, and community meetups that can be safe spaces to open up. 2. Name It Without Shame Say it aloud or write it down: “I feel guilty that I’m still alive when others aren’t.” Naming it can reduce its power and give you space to explore what’s underneath. 3. Honor Those You’ve Lost Creating rituals to remember friends—lighting a candle, saying their names, dedicating a walk or a creative piece—can help channel grief into connection. You can live for  them, with  them in your heart, without carrying the guilt of their absence. 4. Give Yourself Permission to Enjoy Life Joy and grief can coexist. Allowing yourself to feel joy, make plans, or celebrate milestones does not mean you’re forgetting others. In fact, it honors life—theirs and yours. 5. Practice Self-Compassion Speak to yourself the way you would to a friend: “It’s okay to feel this way. I miss them. I don’t have to justify my survival. My life matters.” 6. Seek Meaning Some people find meaning by getting involved in advocacy, supporting others, fundraising, or sharing their story. Others find solace in quieter forms of reflection, like journaling or creating art. You don’t have to “do” anything to earn your place—but finding a sense of purpose, however small, can be healing. You Are Not Alone Survivor’s guilt can feel isolating, but it’s a shared experience across the MBC community. It’s a sign of your depth of care, your empathy, your humanity. There is room for you to mourn and rejoice, to grieve and celebrate, to remember and move forward—all at the same time. You are still here. And that matters. Survivor’s guilt is not a sign of weakness or ingratitude—it is a mirror of the deep emotional bonds and losses that come with living alongside metastatic breast cancer. Your feelings are real and valid. As you navigate this complex path, remember: your life has meaning, your story matters, and you don’t have to carry your grief alone. The MBC community is walking this road with you—with open arms and open hearts. If you need support, please reach out: SurvivingBreastCancer.org Support Groups Cancer Support Community Metastatic Breast Cancer Alliance Crisis Text Line : Text HOME to 741741 for free 24/7 support

By Elisa Herrera Facing Cancer Far from Home A cancer diagnosis is an immense challenge, and for those who have migrated to another country, the struggle can be even more complex. Being far from family, navigating a foreign language, and facing limited access to healthcare are just some of the obstacles Latino migrants diagnosed with cancer encounter. At Después de un Diagnóstico  (a service of SurvivingBreastCancer.org ), we understand these difficulties and are committed to providing support every step of the way. Barriers to Healthcare Access Latino migrants often face significant challenges when trying to access quality medical care. Some of the most common barriers include: Language barriers: Not all hospitals and clinics have Spanish-speaking staff, making it difficult to understand diagnoses and treatments.  Note: In the United States, federally-funded healthcare facilities are required to provide language access support, including professional translation and interpreting services, by request, under Title VI of the Civil Rights Act of 1964, and Section 1557 of the Affordable Care Act. Learn more from the U.S. Department of Health and Human Services . Lack of health insurance: Many individuals with uncertain immigration or documentation status lack adequate health insurance coverage, limiting their treatment options. Navigating an unfamiliar healthcare system: Understanding and accessing care in a different country can be overwhelming and confusing. Emotional impact of isolation: Being far from family and a familiar support system intensifies the emotional distress of an individual’s cancer diagnosis and treatment. Resources and Support for the Latino Community In response to these challenges, resources are available to help migrants facing cancer. At Después de un Diagnóstico , we provide Spanish-language information, virtual support groups , and guidance to ensure that no one faces this disease alone. Some of the most valuable resources include: Spanish-language support groups : Safe spaces where individuals diagnosed with cancer can share their experiences and receive encouragement from others who understand their experience. Emotional well-being and self-care : Strategies to manage anxiety, depression, and stress related to both cancer and migration. Educational webinars with experts : Reliable information for patients, caregivers, and families to help them navigate treatment and care. The Power of Community Support Building a strong support network is essential while facing cancer. While being physically distant from loved ones can be difficult, connecting with online support groups and cancer communities can make a significant difference. At Después de un Diagnóstico , we foster connections among Latino patients and caregivers to create a meaningful and supportive network. Find Help at Después de un Diagnóstico If you or someone you know is facing cancer far from home, you’re not alone. Después de un Diagnóstico  offers information, resources, and a Spanish-speaking community of support. Visit www.despuesdeundiagnostico.org  to discover how we can help you in your experience with cancer. Together, we are stronger. 💕 More Resources: Spanish-language blog Twice-monthly Spanish-language support groups Después de un Diagnóstico YouTube Spanish-language podcast, Después de un Diagnóstico

Breast cancer treatment is a physical, emotional, and mental challenge. Facing cancer and its side effects demands extraordinary physical, emotional, and spiritual stamina. One of the most common side effects is the overwhelming fatigue that can accompany not only cancer but also many treatments, like chemotherapy. This fatigue is more than just feeling tired after a long day; it’s a deep exhaustion that rest alone doesn’t always fix. If you’re feeling this way, you’re not alone. Managing fatigue is crucial, not only for your body but also for your overall well-being and recovery. Continue reading to learn why this fatigue occurs, everyday tips to help you conserve energy, and how to work closely with your healthcare team to feel more like yourself again. Why Does Fatigue Occur During Breast Cancer Treatment? Fatigue during breast cancer treatment can stem from various causes, including: Cancer-related biological changes: Some types of breast cancer affect hormones like estrogen and progesterone  that influence energy levels and can put an energy-intensive strain on your immune and other systems.  Nutritional deficiencies:  A loss of appetite or dietary restrictions can lead to low energy levels. (Check out SBC’s resources on managing nutrition  through treatment.) Chemotherapy and radiation therapy:  These treatments can cause anemia and inflammation, leading to exhaustion. Medications:  Drugs used during treatment, such as pain relievers and anti-nausea medications, may cause drowsiness. Emotional stress:  Anxiety and depression associated with cancer can also contribute to fatigue. Sleep disturbances:  Pain, stress, or treatment effects can interfere with sleep . What Does Cancer-Related Fatigue Feel Like? Cancer-related fatigue differs from everyday tiredness. It is a persistent, overwhelming sense of physical, emotional, and mental exhaustion not relieved by rest or sleep. Unlike typical tiredness, this type of fatigue can significantly impact a person’s ability to carry out daily activities. Cancer-related fatigue often affects quality of life, making it difficult for individuals to concentrate, engage in social activities, or maintain a sense of well-being.  7 Practical Tips to Conserve Energy During Treatment 1. Prioritize Your Energy Focus on the activities that matter most to you. Make a list of daily tasks and rank them by importance. Delegate less critical tasks to family and friends. Tip:  Try using a planner to schedule activities when you feel most energetic. 2. Practice the “4 Ps” of Energy Conservation The National Comprehensive Cancer Network  recommends these techniques for managing cancer-related fatigue. The four Ps — plan, prioritize, pace, and position — can help you manage daily activities without overexerting yourself. Plan:  Combine errands and rest between activities. Prioritize:  Focus on must-do tasks. Pace:  Don’t rush. Break tasks into manageable steps. Position:  Sit while doing chores like cooking or brushing your teeth. 3. Stay Physically Active (But Gently) While it might seem counterintuitive, light exercise can help combat fatigue . Activities like short walks, gentle yoga, or stretching can boost energy levels. Talk to your doctor before starting any exercise routine. Check out SBC’s upcoming yoga and Pilates classes on our event calendar , or check out our On-Demand library  for recordings! 4. Optimize Your Sleep Routine A good night’s sleep can make a significant difference. Try these sleep-friendly habits: Keep a consistent bedtime and wake-up schedule Create a calming bedtime routine — read a book, take a warm bath, or practice meditation Avoid caffeine and heavy meals before bed 5. Eat Nutritious Foods Eating balanced meals  fuels your body. Focus on: High-protein foods like eggs, nuts, and beans Fresh fruits and vegetables Whole grains A registered dietitian can help you develop a meal plan that supports your energy levels during treatment.  6. Manage Stress and Emotions Emotional exhaustion can worsen fatigue. Try: Mindfulness or meditation to calm your mind Counseling or support groups — talking to others who understand can help. Join SBC for Thursday Night Thrivers , our weekly virtual support group with special meetups for metastatic breast cancer, early-stage breast cancer, inflammatory breast cancer, and a Spanish-language group! 7. Communicate With Your Healthcare Team Persistent fatigue should never be ignored. Discuss these questions with your care team: Could my fatigue be related to anemia or thyroid issues? Could my medications be adjusted to relieve my fatigue? Would physical or occupational therapy  help me with my fatigue? Your care team can tailor treatments to manage your fatigue better. Sudden or severe fatigue can sometimes indicate a medical emergency. Contact your healthcare provider immediately if you experience: Shortness of breath Dizziness or confusion Rapid heartbeat Difficulty staying awake These could signal complications like infection or heart issues requiring additional care, so be sure to reach out if you notice sudden changes. Count On Us for Information, Resources, and Support  Managing fatigue during breast cancer treatment is about balance — knowing when to rest, how to conserve energy, and when to ask for help. Every person’s experience is unique, so be kind to yourself and adjust your routines as needed. Remember, you’re not alone. Rely on your healthcare team, loved ones, and support networks to help you through this time. Whether you’re newly diagnosed with breast cancer , are navigating survivorship, or are the loved one of someone experiencing breast cancer, you can count on SurvivingBreastCancer.org to keep you informed. We provide educational information to help you better understand symptoms , testing, treatment options , surgery, etc., and podcasts  that feature professionals, advocates, and caregivers who share valuable information. Your donations  enable SurvivingBreastCancer.org — a community dedicated to empowering those affected by breast cancer with knowledge, understanding, and a network of care — to offer resources and support every day, every month, and every year.  Note: This article offers general information and does not replace professional medical advice. Make sure to discuss your options with your healthcare provider. Read More: Improving Diet and Sleep During Cancer Treatment Exercise and Breast Cancer Nutrition After a Cancer Diagnosis What is Breast Cancer Rehab? On the Podcast: Breast Cancer Conversations Understanding Nurse Navigation: Support and Resources for Cancer Patients Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetup s Free Events

By Kiara Ford  For most people, their breast cancer experience begins with a diagnosis from a screening or the onset of symptoms. It can come as an icy shock that feels impossible to anticipate. But others may spend years anticipating a diagnosis, aware that they are at an increased risk long before they even have symptoms. For these individuals, genetic testing has shown mutations that are associated with increased cancer risk, such as mutations of the BRCA1 and BRCA2 genes . These people are often called “ previvors ,” a term coined by Sue Friedman, the founder of Facing Our Risk of Cancer Empowered ( FORCE ), a group which aims to support individuals and families facing hereditary cancer. In medical terms, it is more common for practitioners to refer to a specific risk factor a patient carries but has yet to present symptoms of, such as “ unaffected BRCA mutation carrier .” But for many previvors, the idea that they have been “unaffected” by their genetic risk rings false. For those who know they have an elevated lifetime risk of developing breast cancer , this awareness can be life-altering. Not only can it change their personal perception of their health, but many previvors choose to take steps to mitigate their risk  of developing cancer. This may include genetic testing for additional family members, increased screening, and preventative surgery.  Continue reading to learn more about genetic testing for cancer risk, and what measures someone can take to reduce their chances of developing cancer associated with a genetic mutation. Who Should Have Genetic Testing? Genetic testing aims to identify if an individual is a carrier for certain genetic mutations  which can increase the lifetime risk of developing breast cancer, as well as other cancers. Prior to testing, many individuals will first meet with a genetic counselor  to decide if testing is beneficial for them or their family.  According to the Centers for Disease Control and Prevention ,  some of the factors for which genetic testing is recommended include: Family history of breast or ovarian cancer Ashkenazi or Eastern European Jewish ancestry personal history of breast, ovarian, fallopian tube, or primary peritoneal cancer Known mutation in the breast cancer (BRCA) genes in someone in your family This being said, each person’s history and risk will vary based on a multitude of factors. A genetic counselor can help assess and personalize testing recommendations.  If the test results are positive, indicating that there is a mutation in the BRCA genes, further steps can then be taken to increase the likelihood of early detection or reducing the risk of breast cancer. Reducing Risk with Chemoprevention There are a few medications which can be taken to possibly reduce risk of cancer. Known as chemoprevention , these drugs are the subject of ongoing research, but do show some promising results . Medications such as tamoxifen, raloxifene, and aromatase inhibitors work by blocking or inhibiting the body’s ability to produce estrogen, a hormone which can potentially help grow many different kinds of breast cancers. Each of these medications functions differently, and like any medical intervention, carry with them risks of side effects. However, many previvors, after discussing with their healthcare providers , have decided that chemoprevention is a worthwhile treatment for them.  Early Detection is Key One of the most key determinants in treating breast cancer is early detection. When caught early, while the cancer is still localized, the five-year survival rate for breast cancer is 99% . This is why for many previvors who are aware of their genetic risk, increased cancer screening is crucial. This may include  mammograms, breast MRIs, breast CTs, ultrasounds, molecular breast imaging, thermography, biopsy, or manual breast exams, in which a patient or provider manually feels for differences or abnormalities in the breast (also called a breast self-exam or clinical breast exam).  Healthcare providers will often recommend more than one of these tests to confirm a breast cancer diagnosis . The provider’s choice of test(s) will depend on factors such as age, family history, breast density, and available technology. Ultimately, a biopsy will typically be used to fully confirm the pathology of anything suspected to be malignant (cancerous). While none of these screenings will prevent the development of breast cancer, they can be instrumental in catching and treating it early.  Reducing Risk with Prophylactic Mastectomy For previvors looking for options to reduce the risk of breast cancer before it develops, prophylactic (preventative) surgery  may be an option worth considering. The most common surgery used to address high susceptibility to breast cancer is mastectomy, a procedure in which all breast tissue is removed from the breast. There are different types of mastectomy , some of which may opt not to remove the nipple and areola (called “nipple-sparing”). This option is associated with slightly lower risk reduction , but allows for a more natural look post-recovery. On the other hand, a skin-sparing mastectomy removes the nipple and areola in addition to breast tissue. Bilateral mastectomy, or removal of both breasts, has been shown to be very effective in reducing one’s risk of breast cancer. For carriers of a BRCA gene mutation, bilateral mastectomy has been shown to reduce risk by over 95% . For people with a strong family history of breast cancer, it can reduce risk by up to 90%. Mastectomies are not a guarantee that cancer will never develop, but for many previvors, the risk reduction can be greatly beneficial to them.  Previvorship is Personal Not everyone with increased risk of breast cancer identifies as a previvor, and everyone will choose a different treatment path , if any, to address their genetic predisposition. The relationship between a person and their increased risk of cancer is deeply individual, and they should be allowed space to navigate in their own time , in a way that feels right for them. However, for those who do decide they want to take steps to address their heightened risk, there are many screening and treatment options, as well as a community of other previvors there to support them.  Note: This article offers general information and does not replace professional medical advice. Make sure to discuss your options with your healthcare provider. Read more: Understanding Genetic Testing for BRCA1 and BRCA2 Mutations The Power of Knowledge (My BRCA Story) My Previvor Story From Fear to Freedom: Embracing a Risk Reduction Mastectomy On the Podcast: Breast Cancer Conversations Michelle Sandlin, Living Her Best Life with BRCA 1 About the Author: Kiara Ford is a graduate of Emerson College, where she majored in communication studies and minored in health and society. She is a certified community health worker and has worked extensively in disability advocacy. She is passionate about health equity, and hopes to raise awareness and increase understanding of patients’ rights through her work. From the Same Author: Metastatic Breast Cancer: Understanding the Significance of Stage IV Breast Cancer and Healthcare Access Within the Hispanic Community Inflammatory Breast Cancer: Breaking Down the Basics Datopotamab Deruxtecan Shows Promise in Clinical Trials Getting through the Holidays with Breast Cancer Overlaps Between Breast Cancer and Domestic Violence The Cost of Breast Cancer Homelessness and Breast Cancer The Impact of Breast Cancer on Self-Image SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetup s Free Events

Cancer treatment is often fraught with physical, emotional, and psychological challenges. Amidst the whirlwind of appointments and treatments, one of the most critical yet frequently overlooked aspects of recovery is nutrition . What we consume is pivotal in supporting healing and empowering survivors and thrivers to reclaim their health, redefine their lives, and reject the limiting mindset of a "new normal." Nutrition Matters for Cancer Recovery First and foremost, attention to macronutrients —protein, carbohydrates, and healthy fats—is essential during and after cancer treatment. Protein  in particular, has emerged as a cornerstone of recovery, helping rebuild tissues, support immune function, and combat the severe fatigue often associated with treatment. Adequate intake of protein isn’t just about dietary preference—it’s about giving the body the essential tools it needs to heal and thrive. Unfortunately, nutrition is sometimes downplayed during treatment, with patients being told they can "eat whatever they want." Yet, a substantial body of research links diet quality  to better health outcomes for those diagnosed with cancer. What and how we eat truly matters. Equally important are micronutrients  like antioxidants  and fiber . Berries, for instance, are rich in antioxidants that combat oxidative stress, while fiber is known to play a role in lowering the risk of cancer recurrence. Prioritizing whole, nutrient-dense foods over processed options can significantly enhance the body’s ability to recover and reduce the risk of future disease. Nutrition is not one-size-fits-all. People diagnosed with cancer are encouraged to develop personalized nutrition plans  that take into account their unique needs, preferences, and health goals. Self-reflection on dietary habits—transitioning away from convenience foods and toward intentional, mindful eating—is an important and empowering step on the path to recovery. Breast Cancer Conversations, the podcast, Eps. 256 Beyond the New Normal: Building Strength After Cancer Through Nutrition and Empowerment with Dr. Amy Morris. Listen Now Rejecting the "New Normal" Mindset Beyond the physical aspects of healing, cancer survivors and thrivers often face a profound internal struggle: adjusting to a "new normal." While this phrase is meant to acknowledge the changes that come with cancer survivorship, it can also subtly reinforce a mindset of resignation—accepting fatigue, joint pain, or limitations as inevitable. However, you do not have to settle for a diminished quality of life. The post-cancer phase can instead be seen as an opportunity for transformation . By rejecting the "new normal" mindset, individuals can choose to pursue vitality, strength, and fulfillment . Progress may come in small, incremental steps, but each one is a powerful testament to resilience. A key part of this shift involves embracing small victories : choosing nourishing foods, committing to regular physical activity, seeking emotional support, or simply celebrating the return of energy and strength. Every positive choice builds momentum toward a life that is not defined by cancer, but empowered beyond it. Resources and community support also play a critical role. Educational materials, health coaches, support groups, and nutrition experts offer practical strategies and emotional encouragement. No one has to navigate this new chapter alone—building a personalized health team can make a profound difference. Community and Empowerment Navigating a cancer diagnosis can feel isolating, but you can often find strength and motivation through connection with others . Community support fosters accountability, provides inspiration, and reminds individuals that they are not alone in their pursuit of health and healing. Moreover, genetic counseling   can offer valuable insights for people diagnosed with cancer concerned about hereditary risks and future family planning. Discussions with healthcare providers about nutrition, lifestyle, and genetic factors empower survivors and thrivers with knowledge to make informed choices for themselves and their loved ones. Ultimately, thriving after cancer requires both internal and external resources : self-empowerment, community connection, informed choices, and holistic health strategies. Conclusion: Thriving, Not Just Surviving Recovery from cancer is not just about surviving—it's about thriving . Nutrition is a powerful tool for healing, and mindset is an equally vital force for transformation. By prioritizing intentional eating, rejecting the resignation of a "new normal," and embracing small victories, you can chart a new course toward strength, vitality, and joy. The path forward is not defined by limitations, but by the endless possibilities of a life reclaimed. Through education, community, nutrition, and empowerment, individuals can redefine what it means to live after cancer—building futures filled with hope, resilience, and vibrant health.

By Joseph J. Pinzone, MD, MBA, FACP Imagine a world where we can give tumors in the breast and elsewhere a literal “fever” and make our conventional therapies like chemotherapy and radiation work even better . Sounds like science fiction? Well, it’s not! It’s a reality with an advanced, ultrasound-based technique called hyperthermia therapy . As a physician, I’m thrilled to shed light on this remarkable therapy that’s been FDA-approved since 1987 but has been flying under the radar so that even many oncologists and radiation oncologists are not familiar with it. What is Hyperthermia Therapy? Hyperthermia therapy is a cutting-edge technique that treats breast cancer and other solid tumors by heating them to temperatures between 106°F and 109°F (41°C to 43°C). Rather than burning the tissue, the goal is to use heat to make cancer cells more receptive to other treatments. Think of hyperthermia as a way to supercharge your cancer treatments. By raising the temperature within the tumors, we make them more vulnerable to the powerful effects of chemotherapy, radiation, and even some advanced targeted therapies. How Can Hyperthermia Enhance Your Breast Cancer Treatment? Here’s the scoop in simple terms: Cancer cells can be under stress from rapid growth and poor blood supply. Heating these cells can amplify the impact of your other therapies in a few key ways: Boosting Therapy Delivery Many tumors have poorly developed blood vessels, which can make it hard for drugs like chemotherapy and targeted therapies to reach the center. Hyperthermia increases blood flow to the tumor, ensuring these treatments can penetrate more deeply. For radiation, increased blood flow delivers more oxygen to the tumor; this helps radiation work even better since radiation uses oxygen to damage DNA, thereby marking the cancer cells for programmed cell death. Strengthening DNA Damage Both radiation and many types of chemotherapy damage the DNA in cancer cells. Hyperthermia helps keep this damage intact, making it more likely that the cancer cells will undergo programmed cell death, also known as apoptosis. Activating Your Immune System Heating the tumor releases heat shock proteins (HSPs), which help reveal mutated cancer proteins to your immune system. This process boosts your body’s ability to target and destroy cancer cells more effectively. Minimal Side Effects: The Beauty of Hyperthermia One of the most exciting aspects of hyperthermia therapy is its gentle nature. Unlike many cancer treatments, it doesn’t involve harsh chemicals or damaging radiation. Most patients experience only mild effects, such as a warm sensation, slight reddening of the skin, or minor discomfort. These effects are usually short-lived and easy to manage, making hyperthermia a friendly addition to your treatment plan. Who Can Benefit from Hyperthermia? Hyperthermia isn’t a standalone treatment but works best when combined with other therapies. It can benefit many patients with breast cancer, including those with metastatic spread to deep or hard-to-reach locations. While hyperthermia holds tremendous promise, it’s not yet available everywhere. It requires specialized equipment and expertise, so you’ll need to find medical centers that offer this treatment. Fortunately, a growing number of clinics and research centers are now embracing this innovative approach.  Looking Ahead: The Future of Hyperthermia Therapy The future of hyperthermia therapy is incredibly bright. Ongoing research and technological advancements are making this treatment more precise and effective. Combining hyperthermia with other cutting-edge therapies could lead to even better outcomes for breast cancer patients. As we push the boundaries of cancer treatment, therapies like hyperthermia are making a real difference. By enhancing the effectiveness of existing treatments while aiming to keep side effects to a minimum, hyperthermia therapy is truly a game-changer in the fight against breast cancer. So, when you hear about the latest advancements in cancer care, remember that hyperthermia is not just a hot topic—it’s a fantastic way to make your treatments work even better. With minimal side effects and growing evidence of its effectiveness, hyperthermia therapy is poised to be a valuable ally in your cancer journey. Stay informed, stay optimistic, and let’s embrace these groundbreaking therapies that are paving the way for a brighter future. Warm regards (pun intended!), Joseph J. Pinzone, MD, MBA, FACP Chief Medical Officer Hyperthermia Cancer Institute www.hcioncology.com Note: This article offers general information and does not replace professional medical advice. Make sure to discuss your options with your healthcare provider. About the Author Dr. Joseph Pinzone is Chief Medical Officer of Hyperthermia Cancer Institute (HCI). He received his M.D. from NYU, completed residency in Internal Medicine at Columbia-Presbyterian Medical Center in N.Y. and fellowship in Endocrinology, Diabetes & Metabolism at Massachusetts General Hospital and Harvard Medical School where he secured an NIH grant to study pituitary tumors. He was on faculty at George Washington University School of Medicine and The Ohio State College of Medicine with a 5-year NIH grant to study breast cancer. Then at Amgen he was Director of Medical Affairs for the launch of XGEVA® a medication for patients with cancer and bone metastases. Dr. Pinzone has taught numerous students, physicians, & scientists and published scientific papers. He wrote & hosted a PBS TV show Innovation in Biologic and Biosimilar Medications  and appeared multiple times on the CBS TV series The Doctors . He was previously Assistant Professor of Clinical Medicine at David Geffen School of Medicine at UCLA. Hyperthermia Cancer Institute delivers FDA-approved therapy to heat tumors up to 109o F which kills cancer cells, induces an immune response and increases the effectiveness of chemotherapy and radiation therapy. Read More: Empowering Yourself: Questions to Ask Your Doctor After a Breast Cancer Diagnosis Why a Second Opinion Matters for Breast Cancer What is Breast Cancer Rehab? Nutrition, Mindset, and Empowerment: Thriving Beyond Cancer Managing Fatigue During Breast Cancer Treatment: Tips for Conserving Energy On the Podcast: Breast Cancer Conversations The Role of Advanced Imaging in Breast Cancer Diagnosis and Treatment Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetup s Free Events

In the world of fitness and cancer rehabilitation, Pilates has emerged as a powerful tool for healing, especially for those navigating life during and after a breast cancer diagnosis. Known for improving core strength and flexibility, Pilates also supports emotional resilience and provides a gentle, effective path back to physical activity. This blog explores how Pilates supports breast cancer recovery, promotes mobility, and offers a holistic mind-body approach to wellness. Listen on the podcast: Breast Cancer Conversations. What Every Breast Cancer Survivor Needs to Know About Pilates What is Pilates? Originally developed by Joseph Pilates in the early 20th century, Pilates is a low-impact exercise method that focuses on core engagement, controlled movement, and mindful breathing. It draws inspiration from yoga, physical therapy, and bodyweight training, making it safe and adaptable for all fitness levels, including those recovering from illness or surgery. What sets Pilates apart is its focus on the "powerhouse," or the deep core muscles, including the abdominals, lower back, hips, and glutes. A strong core supports balance, posture, and overall stability, all of which can be compromised during cancer treatment. How Pilates Builds Strength After Cancer Unlike traditional strength training that often isolates large muscle groups, Pilates builds functional strength by engaging multiple muscle groups simultaneously —including the often-overlooked stabilizing muscles. Exercises like The Hundred , Leg Circles , and The Teaser  not only target the abs but also activate the arms, legs, and back for a full-body, integrated workout. For breast cancer survivors and thrivers, who may experience muscle atrophy, fatigue, or a limited range of motion following surgery or radiation, Pilates provides a gentle, effective way to rebuild strength without overexertion. It emphasizes quality over quantity, making it accessible even for those managing chronic pain or just beginning to reintroduce movement into their routine. Increasing Flexibility Through Pilates Flexibility loss is a common side effect of both cancer treatments and prolonged inactivity. Pilates helps restore range of motion with gentle stretches, spinal mobility exercises, and postural alignment. Movements like Spine Stretch Forward , The Saw , and Mermaid Stretch  lengthen muscles and open up tight areas, promoting better movement and comfort. For breast cancer patients, especially those who have undergone lymph node removal or mastectomies, this type of mindful stretching can help alleviate tightness, scar tissue discomfort, and joint stiffness, offering a safe way to regain confidence in their bodies. The Mind-Body Connection: A Holistic Approach to Healing Beyond the physical benefits, Pilates encourages mindfulness, emotional grounding, and stress relief—all essential during cancer recovery. Focusing on breath and alignment helps practitioners reconnect with their bodies after trauma or treatment. In a recent episode of Breast Cancer Conversations , podcast host and survivor Laura Carfang explored how movement became a lifeline during her own recovery. She emphasized that Pilates is more than just exercise—it’s an act of self-compassion and a tool to reclaim agency during a time when the body can feel unfamiliar or out of control. Building Community Through Movement Many cancer survivors find Pilates classes—whether in-person or virtual—to be a source of community and support. Moving together, sharing progress, and being seen in a safe space can boost motivation and emotional resilience. This shared experience helps reduce feelings of isolation and encourages regular practice. Whether it’s a local class or a free virtual session offered by nonprofits like SurvivingBreastCancer.org , movement becomes a gateway to connection, healing, and hope. Final Thoughts: Pilates as a Path to Empowerment Pilates is more than a workout—it’s a pathway to healing, strength, and flexibility for those living with and beyond cancer. With its gentle approach, focus on breath and control, and deep physical and emotional benefits, Pilates offers survivors a way to rebuild their bodies and reclaim their lives. Whether you're newly diagnosed, in treatment, or years into survivorship, Pilates can meet you where you are—empowering you to move with grace, strength, and purpose.

By Jayant (JP) Parthasarathy Listen to JP on the SBC podcast, Breast Cancer Conversations : Revolutionizing Breast Cancer Detection with JP Parthasarathy, founder and CEO of Astrin Biosciences “Do you have a family history of cancer?” is a standard question doctors ask all their new patients. It’s a crucial indicator of when, how often, and for which cancers a person should be screened. But there’s another question that both doctors and patients should consider when it comes to breast cancer: “Do you have dense tissue?” If you’re not sure what that means, or how you can find out if you have dense breasts, don’t worry. This article will tell you what you need to know about dense tissue and why this information is important for breast cancer detection.  Breast density describes the type and amount of tissue someone has. While some women have almost all fatty tissue, others can have more or entirely fibrous tissue, making their breasts more dense. Breast density is not something that can be felt; it’s only determined during a woman’s first mammogram . While it’s incredibly common – over half  of women over 40 have dense breasts – it can multiply someone’s chances of developing breast cancer by up to six times  – more than family history. For those with fatty tissue, a typical mammogram will clearly reveal any existing tumors as white marks. For those with dense tissue, however, the fibers also appear white, obscuring doctors’ view of any tumors. In women with extremely dense breasts, the whole breast may appear white. Today, doctors use ultrasounds and MRIs as supplemental screening for people with dense breasts since they provide higher sensitivity and clarity than mammograms, but this is a band-aid on a bigger problem. Women with dense breasts need a more effective and sustainable screening option.    How to Screen Dense Breast Tissue for Cancer   Detecting and treating breast cancer as early as possible is one of the best ways to save lives. The American Cancer Society (ACS) reports  that nearly 100 percent of women diagnosed with localized breast cancer survive five years past their diagnosis, compared to 32 percent for those diagnosed with distant spread. Screening is a powerful early detection tool, and the ACS recommends  that most women start annual mammograms after they turn 40.  Once they’re eligible, all women should get a mammogram – not only for early cancer detection, but also to learn whether they have dense breasts. From there, most women with dense breasts need supplemental screening. Unfortunately, this isn’t as seamless a solution as it should be.  Most people with dense breasts are referred for a breast ultrasound , which can search through dense tissue to identify tumors using high-frequency sound waves. An ultrasound may find two to three  more cancers per 1,000 women than mammograms, but can still miss  several cases. Additionally, while ultrasounds are low-risk, painless, and usually covered by insurance, they lead to false positives more than 90 percent  of the time. This can cause unnecessary distress for patients.  A smaller portion of women may be referred for a breast MRI, which uses magnets and radio waves to create an image of the breast. These are even more sensitive than mammograms; however, they’re also more invasive , more expensive , more likely to yield false positives   and less likely to be covered by insurance . Beyond the individual-level impact, our healthcare infrastructure and the shortage of radiologists  isn’t prepared to schedule, perform, and pay for the 40 million women who would need them each year.  How Blood Tests Can Improve Breast Cancer Outcomes While mammograms and ultrasounds remain the go-to standard of care for women with dense breasts, innovation in cancer screening is essential. Advances in cancer science and technology are creating new opportunities to catch breast cancer earlier than ever. Rather than waiting for a tumor to form to find it via imaging, highly sensitive blood tests can identify cancer at stage 0 by analyzing a small blood sample before any signs or symptoms are felt. While researchers have attempted to detect cancer through blood tests in the past, breast cancer has specifically been one of the most difficult to uncover. Unlike lung or colorectal cancers, experts estimate that detecting breast cancer in the blood would require technology 10  times more sensitive than what is currently available. Now, thanks to breakthroughs in machine learning, catching breast cancer through blood tests may now be made a reality through proteomics – the proteins that breast cancer cells use to communicate with one another. Proteins are the functional units of cells, meaning they reveal what cells are doing in real time. If cells are acting in a way that indicates cancer, proteins will be the first signals. Using artificial intelligence (AI), scientists have been able to sort through signals that are now 1,000 times more sensitive than previously possible to find the ones relevant to cancer, then inform the next best steps in a care plan. For women who have dense breasts, and even those who don’t, highly specific blood tests can be a revelation, increasing access to the early detection they need for better breast cancer outcomes. More accessible and less invasive than today’s screening options, highly sensitive blood tests could be the missing piece of the breast cancer detection puzzle.  These innovative testing technologies are currently in development and will become more widely available to oncologists and patients over the next few years. In the meantime, it’s important to continue to advocate for better screening options for women with dense breasts. Understanding breast density and available screening options is a great place to start; then you can take those learnings to your next doctor’s appointment.  Ask your doctor about your breast cancer screening options and eligibility. If you’re eligible for a mammogram, it’s time to schedule one. Whether or not you have dense breasts, talk to your doctor about blood test options that may work well for you.  Note: This article offers general information and does not replace professional medical advice. Make sure to discuss your options with your healthcare provider. About the Author: Jayant (JP) Parthasarathy is the founder of Astrin Biosciences, a St. Paul, Minneapolis-based cancer intelligence company transforming detection and treatment via deep proteomics and AI. Motivated by his father’s cancer diagnosis and passion for research, he left his role as deputy chief science officer at UnitedHealth Group to launch Astrin in 2021. JP serves on the board at the Hennepin Healthcare Research Institute and holds a Ph.D. in Brain Machine Interfaces from the University of Minnesota. Read More: What Are Dense Breasts Addressing the Unique Challenges of Breast Cancer in People Under 40 Unleashing the Potential of AI in Breast Cancer Screening, Diagnosis, and Treatment Understanding Your Pathology Report: A Comprehensive Step-By-Step Guide On the Podcast: Breast Cancer Conversations Revolutionizing Breast Cancer Detection with JP Parthasarathy, founder and CEO of Astrin Biosciences Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetup s Free Events

Crisis Text Line : Text HOME to 741741 for free 24/7 support. A breast cancer diagnosis is more than a physical challenge—it’s an emotional one, too. Fear, anxiety, and uncertainty can be overwhelming, often leading to distress or depression. It’s okay to feel scared or frustrated, but remember that you don’t have to face it alone. Support from loved ones, counseling, and peer-to-peer groups  can make all the difference. Understanding the Link Between Breast Cancer and Mental Health Emotional Toll of a Diagnosis A breast cancer diagnosis can be overwhelming. Feelings of fear, uncertainty, and sadness are common, especially in the early stages of diagnosis and treatment planning. If this sounds familiar, you’re not alone. Studies show that nearly 25% of breast cancer patients experience clinical depression , while up to 50% report heightened anxiety  at some point. Effects of Treatment on Mental Health Cancer treatments such as chemotherapy, radiation, and hormonal therapy can contribute to mood changes . Side effects like fatigue , hormonal fluctuations, and chronic pain  may increase your feelings of helplessness and distress. Talk to your doctor to learn whether any of your prescribed medications may also impact your mental health. Survivor’s Guilt and Fear of Recurrence As breast cancer survivors, many of us experience guilt about surviving  while others do not. Additionally, the fear of recurrence can lead to persistent anxiety, making it challenging for you to enjoy post-treatment life. Maybe you’ve experienced “scanxiety,” or high stress levels before your oncology follow-ups and scans. Recognizing Signs of Depression and Anxiety As someone experiencing breast cancer treatment, survivorship, and/or living with metastatic breast cancer, you can team up with your caregivers and oncology team to recognize signs of clinical depression and anxiety disorders. Some common signs include: Persistent sadness, hopelessness, or numbness Loss of interest in activities you once enjoyed Sleep disturbances (insomnia or excessive sleeping) Changes in your appetite or weight Fatigue that doesn’t improve with rest Increased irritability, anger, or frustration Difficulty concentrating or making decisions Feelings of worthlessness or excessive guilt Panic attacks or constant worrying about your health and the future If you experience these symptoms for over two weeks, seeking professional support is essential. 5 Strategies for Addressing Mental Health Challenges 1. Seek Professional Help Psychologists, psychiatrists, and oncology social workers specialize in cancer-related mental health challenges. Therapy options like cognitive behavioral therapy   (CBT) have been proven effective in managing depression and anxiety in people experiencing breast cancer. If you have severe symptoms, your healthcare team may recommend antidepressants or anti-anxiety medications  alongside therapy. It’s important to discuss medication options with your entire oncology team as well as mental health professionals to avoid interactions with your cancer treatments. 2. Build a Support Network Social support plays a significant role in mental well-being. Connecting with support groups   can provide emotional relief and shared experiences, which can help individuals feel less isolated. Join SurvivingBreastCancer.org  every Thursday for breast cancer support groups, including special meetups for metastatic breast cancer, early stage breast cancer, and inflammatory breast cancer: https://www.survivingbreastcancer.org/thursday-night-thrivers-meetup 3. Incorporate Mind-Body Practices Research supports the benefits of yoga , meditation , and mindfulness practices in reducing stress and improving mood among people with breast cancer. These activities can offer relief from emotional distress. Join SurvivingBreastCancer.org  for our numerous yoga, Pilates, meditation, writing, and art programs: https://www.survivingbreastcancer.org/events 4. Maintain Physical Activity Engaging in regular physical activity, even in small amounts, has been shown to reduce symptoms of depression and anxiety in cancer patients .   The American Cancer Society recommends at least 150 minutes of moderate weekly exercise to improve overall well-being. 5. Practice Self-Compassion Being kind to yourself is essential . Adjusting to life with or after breast cancer takes time, and it’s okay to have difficult days. Journaling, engaging in creative outlets, and resting can help cultivate a positive mental outlook. Breaking the Stigma Around Mental Health and Cancer Many people with cancer hesitate to talk about their mental health struggles due to stigma. However, mental health is just as important as physical health . Advocacy and awareness can help change this narrative. If you or a loved one are experiencing depression or anxiety due to breast cancer, reaching out for help is a sign of strength, not weakness . Count On Us for Information, Resources, and Support Breast cancer and mental health are deeply interconnected. Recognizing and addressing depression and anxiety  is a crucial part of holistic cancer care. By seeking support, incorporating wellness strategies, and advocating for mental health awareness, you can improve your emotional well-being and overall quality of life. Remember, you’re not alone. Rely on your healthcare team, loved ones, and support networks like SurvivingBreastCancer.org  to help you through this time. Whether you’re newly diagnosed with breast cancer , are navigating survivorship, living with metastatic breast cancer, or are the loved one of someone experiencing breast cancer, you can count on SurvivingBreastCancer.org to keep you informed. We provide educational information to help you better understand symptoms , testing, treatment options , surgery, etc., and podcasts  that feature professionals, advocates, and caregivers who share valuable information. Your donations  enable SurvivingBreastCancer.org , a community dedicated to empowering those affected by breast cancer, with knowledge, understanding, and a network of care, to offer resources and support every day, every month, and every year.  Crisis Text Line : Text HOME to 741741 for free 24/7 support. Note: This article offers general information and does not replace professional medical advice. Make sure to discuss your options with your healthcare provider. Read More: The Psychological Impact of Breast Cancer: Strategies for Coping Managing Fatigue During Breast Cancer Treatment Survivor’s Guilt and Metastatic Breast Cancer The Impact of Breast Cancer on Self-Image On the Podcast: Breast Cancer Conversations Why Every Breast Cancer Survivor Should Try Pilates with Guest Nina Prol Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetup s Free Events

In a world where medical treatments are often fast-paced, clinical, and isolating, many cancer patients are seeking complementary practices that address the emotional, spiritual, and mental toll of a diagnosis. One increasingly recognized method is forest bathing, also known by its Japanese name shinrin-yoku—a therapeutic, mindful immersion in nature. While it may sound poetic, the science and impact behind forest bathing are profound. For individuals navigating breast cancer or other types of cancer, forest bathing offers a grounded, evidence-based approach to holistic healing that supports the body, mind, and spirit. What Is Forest Bathing? Forest bathing (shinrin-yoku) originated in Japan in the 1980s as a public health initiative to counteract the negative effects of technology, urbanization, and work-related stress. Unlike hiking or jogging, forest bathing is not exercise—it’s the act of mindfully experiencing the forest through your senses. You slow down, breathe deeply, and intentionally observe the sights, sounds, textures, and smells of your surroundings. You may sit quietly in a “sit spot,” walk slowly, or engage in gentle guided meditations. There’s no destination—only presence. Studies conducted by Dr. Qing Li, a physician at Tokyo’s Nippon Medical School and one of the world’s leading researchers in forest medicine, show that forest bathing: Reduces cortisol (a stress hormone) Lowers blood pressure and heart rate Improves sleep and concentration Boosts immunity by increasing natural killer (NK) cells, which help fight cancer Reduces anxiety and depression symptoms For cancer patients, these benefits are especially meaningful. Why Forest Bathing Matters for Cancer Patients Receiving a cancer diagnosis is life-altering. Whether you're managing chemotherapy side effects, navigating post-surgical recovery, or living with metastatic disease, the emotional burden can be heavy. Forest bathing offers a restorative pause. As many cancer survivors on the Breast Cancer Conversations  podcast have shared, nature provides more than a backdrop—it becomes a partner in healing. Here’s how: Reduces Stress and Anxiety Cancer treatment often brings persistent stress, which can weaken the immune system and worsen fatigue. Forest bathing lowers cortisol and helps regulate the nervous system, supporting a calm, parasympathetic state where the body can rest and repair. Boosts Immune Function One of forest bathing’s most compelling benefits is its ability to enhance immune defense. When we breathe in the forest air, we’re also inhaling phytoncides—natural essential oils released by trees to protect themselves from bacteria and insects. These compounds stimulate the production of natural killer (NK) cells, which are crucial in the body’s fight against infections and tumor cells. In Dr. Li’s research, participants who engaged in two days of forest bathing had increased NK cell activity for up to 30 days post-visit. This is especially promising for people with compromised immunity during chemotherapy or immunotherapy. A Mind-Body-Spirit Approach: Forest Bathing as Holistic Healing Forest bathing isn’t just a physiological practice—it reconnects us to something deeper: meaning, presence, and purpose. For many cancer patients, a diagnosis can prompt a spiritual crisis. The podcast guest from the Breast Cancer Conversations  episode titled “Nature’s Healing Fosters Human Connection”  described how forest bathing allowed her to reconnect with the wholeness of her identity beyond diagnosis. She shared how the trees felt like witnesses—offering silent companionship when she needed it most. “When I couldn’t recognize myself in the mirror after surgery, the forest reminded me who I was. There was no judgment there, just stillness and love.” This relational quality of nature—where individuals feel seen and supported—is a hallmark of forest therapy’s healing potential. How to Practice Forest Bathing During or After Cancer Treatment Whether you live near a lush forest or an urban park, forest bathing is accessible to nearly everyone. You don’t need hiking gear, stamina, or a guide—just willingness and time. Here’s a step-by-step guide to get started: 1. Choose Your Space Local forest preserve, botanical garden, park, or even your backyard Look for spaces with trees, gentle paths, and minimal noise 2. Leave Devices Behind Unplug to fully engage your senses Avoid distractions like headphones or podcasts 3. Slow Down and Tune In Begin with deep, slow breaths Use your senses: Sight: Watch how light filters through leaves Smell: Inhale the earthy, piney air Sound: Listen to birds, wind, and rustling leaves Touch: Feel the texture of bark or moss Taste: Bring a herbal tea or simply savor clean air 4. Use the S.O.A.R. Method A common forest therapy guide acronym: Settle – Physically arrive and breathe Open – Let go of distractions Attune – Tune in to surroundings Receive – Notice what nature offers you 5. Reflect (Optional) Journal your experience Note any thoughts, feelings, or sensations Share with a support group or therapist if helpful Adapting Forest Bathing for Accessibility For patients who are immunocompromised, fatigued, or have limited mobility, virtual forest bathing or indoor nature immersion are effective alternatives. Ways to bring nature inside: Nature sound recordings (waterfalls, birdsong, wind) Live houseplants or fresh flowers Nature videos or forest-view screensavers Essential oils like pine and cedarwood You can also: Sit by a window and observe trees or the sky Touch natural objects like stones, leaves, or shells Create a dedicated “nature corner” at home with calming objects What the Research Says: The Science Behind Forest Bathing and Healing Here are some additional evidence-based insights: A 2010 study in the International Journal of Immunopathology and Pharmacology  showed that forest bathing significantly increased NK activity and anti-cancer proteins in women with breast cancer. A 2020 Korean study found that just 90 minutes of forest exposure decreased cancer-related fatigue and improved mood in patients undergoing chemotherapy. A 2019 review in Frontiers in Psychology  concluded that forest bathing is a powerful tool for trauma recovery, emotional regulation, and spiritual integration—making it ideal for post-diagnosis survivorship support. Nature Is Not a Luxury—It’s a Lifeline Forest bathing is far more than a wellness trend; it’s a scientifically backed, soul-nourishing practice that reminds us of who we are beneath the layers of stress, illness, and expectation. For cancer patients and survivors, it provides something that’s often missing from conventional treatment: a space for emotional safety, self-reflection, and spiritual renewal.

By Dennis Mensah, BSN, RN Cancer treatments such as chemotherapy, radiation, and surgery often lead to side effects like nausea, weakness, and appetite loss. A well-structured diet can help counteract these effects , promote healing, and strengthen your immune system. This guide explores the importance of nutrition in breast cancer recovery, the benefits of plant-based diets, essential supplements, and expert tips to enhance well-being. Tips from Nutrition Specialists for Recovery Cancer treatment is hard enough; what simple strategies can you apply to support your nutrition? To enhance recovery and well-being, nutrition specialists recommend the following strategies: Focus on whole foods: Prioritize whole, nutrient-dense foods over processed options to maximize health benefits. If you receive outpatient treatment at a cancer center or hospital, consider bringing healthy snacks with you on treatment days. Stay hydrated: Drink at least eight glasses of water daily. Herbal teas and broths can provide additional nutrients while keeping you hydrated. A personal reusable water bottle is your best friend! Plan meals in advance, or ask loved ones to start a meal train for you: Meals prepared ahead of time will ensure you have access to nutritious options, even on low-energy days. Seek professional guidance: A registered dietitian specializing in oncology nutrition can provide personalized meal plans and expert recommendations, including nutritional counseling tailored to your individual needs. Managing Side Effects Side effects like nausea and fatigue  can make eating challenging. What should you do if you start to dread mealtimes during cancer treatment? Nutritionists recommend consuming small portions of nutrient-dense meals , such as smoothies, soups, and soft fruits, throughout the day. Staying hydrated is equally important, as dehydration can contribute to fatigue and impact overall well-being. Antioxidants for Your Immune System A strong immune system is essential for recovery. Antioxidants  from fruits and vegetables that contain nutrients such as vitamins A, C, E, and D, along with minerals like zinc and selenium, help your body combat infections and promote healing. Incorporating a variety of fruits, vegetables, whole grains, and lean proteins ensures essential nutrients for immune support. Berries, leafy greens, and cruciferous vegetables like broccoli and kale are particularly beneficial. The Importance of Protein Your body requires ample protein to rebuild tissues and maintain muscle mass. Lean protein sources such as chicken, fish, beans, and legumes support this healing process. The Benefits of a Plant-Based Diet Studies suggest that a plant-based diet rich in fruits, vegetables, whole grains, nuts, and seeds may reduce cancer recurrence risk and improve overall health. Benefits include: Fiber: A plant-based diet  provides ample fiber, which supports digestive health, regulates blood sugar, and promotes a balanced gut microbiome, which is essential for a strong immune system. Weight management: Maintaining a healthy weight is crucial, as excess weight can increase the risk of cancer recurrence. A plant-based diet is nutrient-dense yet lower in calories, making it a healthy choice for weight management. Heart health: Breast cancer survivors, particularly those who have undergone certain treatments, may be at higher risk for heart disease . Plant-based diets help lower cholesterol and regulate blood pressure, supporting overall cardiovascular health. What About Nutritional Supplements? While whole foods should be your primary source of nutrition, supplements may be necessary in some cases. Consult with your oncology team before starting any supplements. Some options include: Multivitamins: For patients with dietary restrictions or poor appetite during treatment, a daily multivitamin   may help fill nutritional gaps. Vitamin D: This vitamin plays a role in immune function   and blood pressure regulation. Since many individuals have a deficiency, supplementing vitamin D under medical guidance can be beneficial. Omega-3 fatty acids: Found in fish oil and flaxseed, omega-3 fatty acids possess anti-inflammatory properties and support heart health , which is particularly important for breast cancer survivors. Nutrition as a Key to Recovery Nutrition plays a vital role during and after breast cancer treatment. Adopting a plant-focused diet, incorporating essential nutrients, and following expert recommendations can help you improve your overall well-being and long-term health. Remember, every meal is an opportunity to nourish your body and promote healing. Note: This article offers general information and does not replace professional medical advice. Make sure to discuss your options with your healthcare provider. About the author: Dennis Mensah, BSN, RN is a columnist and freelance writer. Read More: Breast Cancer and Heart Health: The Connection You Need to Know About The Sunshine Vitamin: Harnessing the Power of Sunlight for Your Health Nutrition, Mindset, and Empowerment: Thriving Beyond Cancer Managing Fatigue During Breast Cancer Treatment: Tips for Conserving Energy After Your Breast Cancer Diagnosis: Planning Your Next Steps Treatment Tips & Questions to Ask Your Medical Oncology Team Navigating Cancer Treatment: Top Tips from an Oncology Pharmacist On the Podcast: Breast Cancer Conversations What a Holistic Nutritionist Wants Every Cancer Patient to Know About Food & Wellness with Cindy Fortuna Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetup s Free Events

In Italy today, breast cancer remains the most commonly diagnosed cancer among women, accounting for 31% of all female cancer cases. While Italy’s overall cancer mortality is 6% lower than the EU average, and its cancer survival outcomes are among the best in Europe, the picture is far from uniform across the country. A Strong Public Health System With Uneven Access Italy’s National Health Service provides comprehensive cancer care free of charge, a major distinction from the U.S. healthcare model, where access often hinges on insurance coverage. Yet access in Italy is not entirely equitable. Regional disparities are pronounced, especially between the wealthier north and the south and islands. Northern regions boast better access to radiotherapy, higher screening rates, and more consistent adoption of genetic testing (e.g., for BRCA mutations), while southern areas lag in both infrastructure and participation. Screening and Early Detection: A Work in Progress Population-based breast cancer screening is offered to women ages 50–69 (with some regions expanding to 45–74), but only about 54–56% of eligible women participated in 2022—below pre-pandemic levels. Participation varies widely by region: in Calabria, fewer than 12% of eligible women took part, while northern regions approach near-universal coverage. Opportunistic (non-programmed) screening is higher in underserved areas, but this introduces inconsistencies in quality and follow-up. Importantly, Italy is working to implement genetic screening pathways for those at high risk of hereditary breast cancer. The goal is to make BRCA testing available nationwide by the end of 2025, aligning with Europe’s Beating Cancer Plan. What Influences Breast Cancer Risk in Italy? Italy performs better than most EU countries on several modifiable risk factors for cancer. The Mediterranean diet—rich in vegetables, fruits, legumes, and olive oil—combined with relatively low alcohol consumption and lower obesity rates, contributes to Italy’s favorable breast cancer outcomes. In fact: Adult obesity in Italy is the lowest in the EU Overweight and obesity are more common in lower-income and southern populations, highlighting health equity concerns Alcohol consumption is 20% lower than the EU average Daily fruit and vegetable intake is high by European standards However, there are several concerning trends, including: Air pollution remains a major issue , with Italy ranking in the highest quartile among EU nations for exposure to PM2.5 particles—an environmental risk factor increasingly linked to breast cancer. Teen smoking and binge drinking rates are on the rise , especially among girls, potentially foreshadowing future increases in cancer incidence. HPV vaccination coverage remains inconsistent across regions, though national recovery plans are underway. Survivorship and Quality of Life Italy has one of the highest five-year cancer prevalence rates in Europe—about 6% higher than the EU average. This reflects the country’s aging population, earlier detection, and relatively strong survival outcomes. However, support for survivors varies, and gaps persist in psychological support and rehabilitation services—particularly in regions with fewer resources. Is Treatment Different from the U.S.? Yes and no. Italy and the U.S. both employ evidence-based approaches to breast cancer treatment, including surgery, radiation, chemotherapy, targeted therapies, and hormone therapies. However, differences emerge in delivery, including variation in: Access and equity : In the U.S., out-of-pocket costs and insurance gaps often limit access. In Italy, treatment is universally covered—but regional inequities affect access to timely, specialized care. Genetic testing : While both countries are expanding BRCA testing, the U.S. has broader commercial availability, whereas Italy is standardizing access through its public health plan. Screening uptake : The U.S. has higher mammography rates overall, though often linked to opportunistic screening rather than structured programs. What’s Next? Italy’s National Oncology Plan 2023–2027 is a bold effort to close these gaps. It aims to expand screening, increase HPV vaccination rates, implement BRCA testing across all regions, and improve the quality of survivorship care. However, delays in implementation and uneven regional commitment pose challenges. A new national Steering Committee was announced in 2024 to help accelerate progress. As Italy continues to advance in cancer care, ensuring equitable access across its diverse regions—and addressing environmental and behavioral risk factors—will be key to shaping a future where all individuals receive the timely, high-quality care they need.

By Laura Carfang A cancer diagnosis is life-changing. For individuals navigating breast cancer, the focus often centers on survival—completing treatment, managing side effects, and getting back to “normal.” Unfortunately, for many survivors, what follows is far from familiar. The emotional, physical, and relational impacts of cancer can linger long after treatment ends, especially when it comes to sexual health and intimacy. The Silent Struggle of Sexual Health Post-Cancer Breast cancer treatments such as chemotherapy, radiation, hormone therapy, and surgeries like lumpectomies or mastectomies can have profound and lasting effects on a person’s body and self-image. Additionally, people may experience fatigue, joint pain, scarring, or premature menopause, all of which can contribute to a decrease in sexual desire and satisfaction. Equally as impactful are the emotional scars; feelings of vulnerability, grief, or anxiety about being desirable or worthy of love. This often-overlooked aspect of survivorship deserves more attention. People diagnosed with breast cancer are frequently left to cope with these changes in silence, uncertain how they can talk about their experiences with healthcare providers, partners, or even themselves. Hormones, Identity, and Emotional Well-Being Hormonal treatments used to reduce the risk of cancer recurrence can abruptly induce menopause , even in younger patients . Sudden hormonal changes can affect not just vaginal dryness and libido, but also mood, mental clarity, and emotional resilience. The result is a complex interplay of physical symptoms and psychological shifts that many are unprepared for. Many individuals describe this experience as a loss of identity where the person they knew in the mirror feels unfamiliar . These changes can deeply affect confidence, especially when re-entering intimate relationships or dating post-treatment. For partners, it can also shift the dynamics of a long-standing relationship, leaving both individuals unsure how to reconnect. The Power of Support and Communication One of the most effective ways to navigate this new terrain is through open communication—both with oneself and with partners. Survivors and thrivers can find comfort and strength in talking to partners about their changing needs, fears, and desires. Emotional intimacy—feeling seen, heard, and valued—lays the groundwork for physical closeness to return on new terms. Supportive partners can play a crucial role in the healing process. Gestures of care, empathy, and acceptance, like offering comfort during hair loss or affirming beauty beyond scars, can be deeply meaningful. However, these conversations don’t always happen organically, and many survivors benefit from structured support like therapy, couples counseling, or peer-led support groups . Healthcare professionals  also have a responsibility to initiate and normalize discussions about sexual health. Too often, these conversations are left out of survivorship care. Providing education about what to expect physically and emotionally during and/or after cancer treatment empowers patients to prepare for and navigate what’s ahead. Breaking the Silence, Finding Community Sexual health during and after cancer is not a niche concern—it’s a central component of healing and quality of life. Those diagnosed with cancer deserve access to evidence-based resources, compassionate care, and community spaces where they can share their stories without shame or stigma. Whether you’re in a new relationship, rebuilding a connection with a long-time partner, or rediscovering your relationship with your own body, know that you are not alone. Sexual health is a valid and vital part of your recovery. It’s okay to seek support. It’s okay to grieve, and it’s okay to hope for joy, closeness, and connection again. Note: This article offers general information and does not replace professional medical advice. Make sure to discuss your options with your healthcare provider. Read More: The Impact of Breast Cancer on Self-Image Breast Cancer and Fertility Breast Cancer in Young Women: Common Questions Answered Empowering Yourself: Questions to Ask Your Doctor After a Breast Cancer Diagnosis On the Podcast: Breast Cancer Conversations Rebuilding Intimacy Post-Diagnosis: A Conversation on Sexual Health and Relationships with Tiffini Sharifi Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetup s Free Events

Hearing the words “ You have breast cancer ” marks the beginning of a life-altering experience filled with uncertainty, fear, and countless decisions . However, that experience doesn’t end when treatment is complete. Survivorship brings its own set of challenges, whether treatment has finished or continues indefinitely.  For many, including those living with metastatic breast cancer  who may never be done with treatment, a new reality unfolds — one that involves ongoing emotional, physical, and psychological healing . Fatigue, anxiety, body image concerns , and lingering pain can persist, regardless of where someone is in their process. It’s during this deeply personal and often overwhelming time that some individuals turn to something unexpected yet profoundly supportive: hypnosis. Once viewed with skepticism, hypnosis has gained credibility in recent years as a complementary therapy that offers relief and empowerment . More than a party trick or stage act, clinical hypnosis is a focused, guided process that helps individuals tap into their subconscious mind to ease stress, manage pain, and promote healing. For those diagnosed with breast cancer, hypnosis is emerging as a compassionate tool to help heal from this experience. By fostering a sense of calm, control, and resilience, hypnosis can play a significant role in helping individuals reconnect with themselves and begin to feel whole again. What Is Hypnosis? Hypnosis , also known as hypnotherapy, is a state of deep, focused relaxation  that enables individuals to access their subconscious mind. Guided by a trained practitioner, people in a hypnotic state can develop increased awareness, manage pain, and reduce anxiety. While hypnosis has sometimes been misunderstood or portrayed inaccurately in popular media, clinical hypnotherapy   is evidence-based  and increasingly used in medical settings to help patients cope with serious illnesses, including cancer. Hypnosis is a state of focused awareness that allows you to remain awake while being deeply calm and still. In this relaxed state, people often feel more at ease and open to positive suggestions. Guided by professionals trained in hypnotherapy, hypnosis can help you explore and shift emotions, perceptions, sensations, memories, thoughts, or behaviors in ways that support healing and well-being . How Hypnosis Can Help With Breast Cancer Managing Pain and Side Effects: Research shows that hypnotherapy reduces the perception of pain during and after surgery . A study published in 2024 found that cancer patients who used hypnosis before surgery reported less pain, less fatigue, and less nausea compared to those who did not . Reducing Anxiety and Depression: A cancer diagnosis can trigger overwhelming fear, anxiety, and even depression. Hypnotherapy promotes deep relaxation, helping the mind unwind and release stress. According to the National Library of Medicine , hypnosis has been found effective in reducing anxiety and improving emotional well-being for cancer patients . Supporting Emotional Healing: People diagnosed with breast cancer often carry invisible scars — feelings of grief, changes in body image, or fear of recurrence. Hypnosis can be a tool to process trauma   and rebuild self-confidence, especially during survivorship. Improving Sleep and Energy Levels: Insomnia and chronic fatigue  are common among individuals in treatment and/or recovering from breast cancer. Hypnotherapy encourages the body’s natural relaxation response, helping improve sleep quality and overall energy. Enhancing Treatment Outcomes: When combined with traditional therapies, hypnosis may help patients feel more in control of their healing process. Some hospitals and cancer centers now offer hypnotherapy as part of integrative oncology programs. SurvivingBreastCancer.org Offers Free Online Hypnosis Recently, SurvivingBreastCancer.org expanded our robust lineup of support offerings by introducing a free online hypnosis program, specifically designed to help you navigate the emotional and physical challenges of a breast cancer diagnosis and treatment. The next program, Hypnosis: Move Your Body , takes place from 8:00-9:00 PM EDT on July 23. The following session, Hypnosis: Eating Mindfully , is scheduled for August 20. SurvivingBreastCancer.org ’s hypnosis program complements a wide range of other thoughtfully curated resources designed to promote healing and resilience. You can access guided meditations  to ease anxiety, participate in expressive art therapy sessions  that foster creativity and emotional release, and join the Reiki circle of care  to experience energy-based healing in a supportive, community-oriented setting.  These free offerings provide a valuable lifeline for anyone navigating life before, during, or after breast cancer treatment, making comprehensive care more accessible and empowering survivors to take an active role in their healing journey. Is Hypnosis Safe? Yes. When performed by a certified hypnotherapist or a trained medical professional, hypnosis is considered a safe practice. It’s non-invasive, drug-free, and tailored to each individual’s needs. However, it’s essential to note that these hypnosis courses do not constitute medical advice or replace medical treatment. Count on Us for Information, Resources, and Support  Hypnosis is not a cure for breast cancer, but it can be a profoundly healing tool for recovery. From pain management to emotional support, hypnotherapy offers individuals a way to reconnect with their inner strength and promote holistic healing. If you or a loved one is navigating breast cancer, consider speaking with your care team about adding hypnosis to your wellness plan. Whether you’re newly diagnosed with breast cancer , are navigating survivorship, or are the loved one of someone experiencing breast cancer, you can count on SurvivingBreastCancer.org to keep you informed. We provide educational information to help you better understand symptoms , testing, treatment options , surgery, and other related topics. Additionally, we offer podcasts  featuring professionals, advocates, and caregivers who share valuable insights and perspectives. Your donations  enable SurvivingBreastCancer.org — a community dedicated to empowering those affected by breast cancer with knowledge, understanding, and a network of care — to offer resources and support every day, every month, and every year. Note: This article offers general information and does not replace professional medical advice. Make sure to discuss your options with your healthcare provider. Read More: Empowering Yourself: Questions to Ask Your Doctor After a Breast Cancer Diagnosis How Cancer Trauma Can Impact Your Life – and Ways to Move Forward The Impact of Breast Cancer on Self-Image Managing Fatigue During Breast Cancer Treatment: Tips for Conserving Energy On the Podcast: Breast Cancer Conversations Beyond Medicine: Forest Therapy and Cancer Recovery with Regan Stacey Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetup s Free Events

By Abida Taher, MD, PhD The American Cancer Society estimates that about 316,950 new cases of invasive breast cancer will be diagnosed in women in 2025 . More than 30-35% of patients undergoing cancer treatment will suffer from oral complications . A number of breast cancer treatments, including chemotherapy, and some targeted therapies like Herceptin (trastuzumab) and newer treatments like bispecifics (Datroway) can cause painful oral side effects, including mouth sores, teeth sensitivity, and dry mouth.  Apart from cancer treatment, many other medications, including antidepressants, antihistamines, decongestants, diuretics, blood pressure medications, and certain pain relievers, can cause oral issues. Regardless of the type of treatment you are getting, maintaining good oral health goes a long way in easing your treatment experience and supporting your body as it constantly adjusts to your new reality. The Oral Cavity (Or Mouth) is All About Balance A healthy mouth is a balance of saliva flow and consistency, bacteria, diet , cleanliness, and minimal plaque. Cancer treatment can disturb this balance and cause complications that interfere with your treatment and adversely affect your quality of life.  Establishing an optimal oral care routine and being prepared with knowledge and products to help deal with the side effects of treatment is important. Too many patients wind up with complications ,  ultimately leading to tooth loss. Your dentist can help you maintain tooth structure and keep you comfortable through treatment . They will make treatment recommendations based on your caries risk assessment, as well as your type of cancer and cancer treatment. Delaying dental treatment and leaving problem areas may result in a delay of cancer treatment in the future. The American Dental Association  lists the following common oral side effects from cancer treatment: Cavities, also known as caries Teeth and gum sensitivity Changes in taste Dry mouth Jaw stiffness Oral sores or mucositis These side effects can cause difficulty in eating, talking, or swallowing. The changes in your immune response will also make it harder to fight oral infections. Having a preventative protocol can help significantly decrease the severity of these side effects and help you maintain a good quality of life. Oral Health Recommendations for Cancer Patients Here are some recommendations that can help with your oral health during cancer treatment: Decrease cavity risk by brushing with a fluoride or hydroxyapatite toothpaste at least twice a day. Flossing will reduce your chances of developing cavities on the interproximal surfaces or in between your teeth. However, if you have never flossed before, do not start during cancer treatment. Avoid foods and drinks that are high in sugar. Sugar-free candies or chews, especially those made with Xylitol, will help stimulate saliva flow. Not only does the flavor stimulate saliva flow, but just chewing does as well. Limiting refined sugars as well as the length of exposure to sugary foods is important. You are at more risk of developing decay if you have a piece of candy or sugary gum in your mouth all day versus eating it all at once and then drinking water. The combination of a sugary diet and bacteria leads to a lower pH or acidic environment in the mouth, which demineralizes the enamel. Keeping your oral cavity hydrated and reducing dry mouth will help bathe the teeth and help fight decay. Mouth rinses such as salt and baking soda mixes help keep the oral tissues moist and help combat the development of oral ulcerations. A basic pH mouth rinse (such as a salt and soda rinse) neutralizes the pH and can even help remineralize your tooth enamel. Use a super soft toothbrush, especially when your oral mucosa is irritated. Visit your dentist every 3 months for an exam and for any personalized treatment based on your oral health to prevent complications later. As always, make sure your cancer care team  and your dentist are communicating with each other regularly to optimize your care. Take charge of your oral health to assist your body as it adapts to your cancer treatment. Note: This article offers general information and does not replace professional medical advice. Make sure to discuss your options with your healthcare provider. About the Author: Abida Taher, MD, PhD Founder, uncancer.com Read more about our team and products at www.uncancer.com Read More: Osteonecrosis of the Jaw: A Little-Known Side Effect of Breast Cancer Treatment Empowering Yourself: Questions to Ask Your Doctor After a Breast Cancer Diagnosis Packing a Care Bag for Cancer Treatment Nutrition After a Cancer Diagnosis On the Podcast: Breast Cancer Conversations What a Holistic Nutritionist Wants Every Cancer Patient to Know About Food & Wellness with Cindy Fortuna Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetup s Free Events

By Jennifer Caspari, Ph.D. As a clinical psychologist living with cerebral palsy, a group of disorders that affect movement and muscle tone, I understand firsthand what it is like to live daily life with uncomfortable and unpleasant symptoms. I walk with a limp and experience chronic pain and fatigue. In addition to my lived experience, much of my career as a psychologist has focused on health psychology, helping individuals with acute and chronic health conditions, including breast cancer, enhance their functioning and quality of life. A lot of loss can come with breast cancer. You may not be able to do certain activities you enjoy, or have to do them differently. Your role around the house or at work may change for a variety of reasons, such as undergoing treatment or having limited energy. At times, it may feel nearly impossible to live well with breast cancer and have a daily routine that feels meaningful.  Yet, it is possible to live well, which I define as spending time doing activities that are connected to your values, not struggling with or fighting against things that you cannot control or change in the moment, coming back to the present moment when caught up in unhelpful thoughts or future worries, slowing down, and cultivating a balanced perspective that acknowledges the complexity of your experience. 6 Tips for Living Well With Breast Cancer Slow Down You may be a “human doer,” constantly pushing to complete task after task, and struggling to slow down and rest, to feel OK with rest. Yet, humans are not robots. You have a finite amount of energy , and slowing down and taking time to rest and decompress allows you to refill your tank so you can do things that are meaningful to you. For example, sit, take some slow breaths, making the exhale part of the breath slow and long. Play some music you like, or take a brief 2 to 5-minute break between tasks and stretch or drink some water. Taking longer breaks is helpful too. You are allowed to just be. Engage in Values-Based Behaviors Life can feel smaller when living with breast cancer. You may feel isolated and less able to do activities. When your energy is limited, it’s natural to focus on the “have tos” of life. “What do I have to get done today?” Pause and consider what is meaningful and important to you, your values, and align your behavior with your values. Ask yourself, “What is meaningful to me to focus on today?” and take action that moves you in the direction of our values. And remember, you don’t have to do it all or complete activities. Practice taking small steps in the direction of your values.                    Drop the rope in the tug-of-war with things that you cannot control or change in the moment   It is natural to fight against what is unpleasant and what you don’t like. However, doing so tends to just amplify distress, because you become caught in an unwinnable tug-of-war. Accepting the present moment means allowing the moment to exist as it already is and not fighting it. Acceptance doesn’t mean you have to like it, or that you don’t take steps to change unhelpful behavior. Rather, you are freeing up energy, as you are not using energy fighting against reality, which allows you to engage in helpful and values-based behaviors. Come back to the present moment when you feel caught up in unhelpful thoughts or future worries It can be helpful to deliberately and purposely think about the past or future so that you can learn from your behavior and plan for future events. Yet, it is problematic when your mind is thinking about the past or future in a nondeliberate and spinning manner, thinking about the same thing over and over without a helpful outcome . This type of mental spinning can lead to increased stress, exhaustion, irritability, anxiety, and distress. Practicing coming back to the present moment allows you to deliberately direct your attention to your experience in the present moment, versus being stuck in your head. You can do this by taking a slow breath and noticing the sensation of the air moving in and out of your body. Or, looking around and naming 5 things you can see. Tip: Join SurvivingBreastCancer.org for live meditation sessions , or visit our on-demand meditation library ! Cultivate a balanced perspective that acknowledges the complexity of your experience You may zoom in and only focus on certain aspects of your experience, particularly aspects that are unpleasant or that you feel frustrated or upset by. However, multiple things, even contradictory things, can occur at the same time. If you practice acknowledging all aspects of your experience, you can make a more intentional choice about how you want to act versus focusing on only one aspect of your experience and acting out of habit or comfort. One way to practice this is by using the word “and” instead of “but.” Intentionally using the word “and” allows for complexity and dichotomy in your experience. “And” acknowledges, includes, and expands what precedes it. For example, you may say to yourself, “I am tired AND I would like to see my friend,” and then consider what feels most helpful to you right now.  Practice Body Neutrality Body neutrality includes cultivating a neutral attitude toward the body that is realistic, mindful, and flexible. It involves appreciating the broad functionality of the body and recognizing that self-worth is not based on appearance . You can practice this by respecting and taking care of your body, reminding yourself what your body can do (e.g., breathe), even when coping with body changes and challenges, and holding your thoughts about your body lightly and flexibly, as they will likely change over time.  Note: This article offers general information and does not replace professional medical advice. Make sure to discuss your options with your healthcare provider. About the Author: In my new book,  You Are More Than Your Body: 30+ Evidence-Based Strategies for Living Well With a Chronic Illness—By a Clinical Therapist Living With Cerebral Palsy , I offer a variety of coping skills that aim to increase acceptance, empower you to engage in values-based action, and enhance quality of life. Jennifer Caspari, Ph.D., is an Associate Psychologist with Cognitive Behavior Therapy Associates of Denver (CBT Denver – cbtdenver.com ). Dr. Caspari specializes in delivering evidence-based psychotherapies to adults with acute and chronic health issues, including chronic pain, chronic fatigue, sleep difficulty/insomnia, cancer, body image issues, disordered eating, and other health concerns (e.g., diabetes, tinnitus, adjustment to disability, etc.). She also provides evidence-based psychotherapies for stress/adjustment issues, grief, anxiety disorders, depression, mood disorders, relationship concerns, and trauma. Dr. Caspari has expertise in health psychology, helping clients to live full and meaningful lives with acute and/or chronic illness and chronic pain.  Her collaborative, warm, and empathetic approach focuses on enhancing functioning, the ability to engage in values-based behaviors, and overall quality of life. Dr. Caspari aims to support clients in gaining awareness of their thoughts, emotions, and behaviors and to translate that insight into helpful and personally worthwhile changes in their daily lives. She views much of her role as helping clients enhance their cognitive, emotional, and behavioral flexibility to improve their well-being. Dr. Caspari has an extensive skill set in evidence-based psychotherapies with diverse populations. For example, she is trained in Cognitive Behavior Therapy (CBT), CBT for Insomnia (CBT-I), CBT for Chronic Pain (CBT-CP), Behavioral Activation (BA), Acceptance and Commitment Therapy (ACT), Mindfulness-Based Cognitive Therapy (MBCT), Cognitive Processing Therapy (CPT), and Skills Training in Affective and Interpersonal Regulation (STAIR). She earned her undergraduate degree in psychology from American University and a master’s degree in community counseling from George Washington University. She earned her Ph.D. in counseling psychology from the University of Denver. Dr. Caspari is the author of You Are More Than Your Body: 30+ Evidence-Based Strategies for Living Well with Chronic Illness – By a Clinical Therapist Living with Cerebral Palsy , and has provided multiple trainings for mental health professionals, including a national course with PESI on Acceptance and Commitment Therapy for Chronic Pain. Read More: Managing Fatigue During Breast Cancer Treatment: Tips for Conserving Energy Breast Cancer and Mental Health: Recognizing and Addressing Depression and Anxiety The Impact of Breast Cancer on Self-Image Harnessing the Power of Hypnosis for Breast Cancer On the Podcast: Breast Cancer Conversations Beyond Medicine: Forest Therapy and Cancer Recovery with Regan Stacey Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetup s Free Events

If you or someone you love is navigating breast cancer treatment, the possibility of developing lymphedema can feel overwhelming. The thought of facing another challenge may bring a mix of fear, confusion, and frustration. Fortunately, you’re not alone. Many individuals with breast cancer experience lymphedema, and with the right knowledge and support, you can manage it effectively. Taking the time to understand what lymphedema is, why it happens, and how it progresses through different stages can make the condition feel less intimidating. More importantly, learning about proven strategies to reduce swelling, prevent flare-ups, and stay active can help you or your loved one regain control. With the right tools and resources, it’s possible to live comfortably, protect your health, and move forward with confidence. What Is Lymphedema? Lymphedema  is a chronic condition that occurs when the lymphatic system can no longer circulate lymph fluid effectively, leading to a buildup of protein-rich fluid in the soft tissues. This accumulation causes painful swelling, most commonly in the arms or legs, but it can also affect the chest, hands, trunk, abdomen, face, or genitals. Over time, lymphedema can lead to skin thickening, tissue changes, and increased discomfort. Breast cancer-related lymphedema (BCRL) often develops after treatments that involve removing or irradiating lymph nodes, particularly under the arm. These interventions disrupt normal drainage, causing fluid to back up in the arm, breast, chest, or hand. While lymphedema can range in severity, early diagnosis and proper management are essential to reduce symptoms and prevent progression. To learn more, listen to the Breast Cancer Conversations  podcast episode “ What Is Lymphedema? ” Who’s at Risk for Lymphedema? Doctors don’t yet fully understand why some individuals develop lymphedema while others don’t. However, the risk increases significantly for those who have undergone the removal of multiple lymph nodes and received radiation therapy to the axillary (underarm) area during cancer treatment. Lymphedema affects approximately one in five people treated for breast cancer and can appear at any point, sometimes even years after treatment has ended. This unpredictability highlights the importance of ongoing awareness and monitoring. There are also a few individual risk factors, including: High body mass index (BMI) Infection or inflammation in the limb Injury, vascular disease, or skin conditions Gene-related vulnerability (primary lymphedema is rare) Lymphedema Symptoms Lymphedema can cause a variety of symptoms, which may develop gradually and worsen over time. Common signs include: Swelling in part or all of the arm or leg, including the fingers or toes A sensation of heaviness, tightness, or aching Reduced range of motion Recurring infections Hardening or thickening of the skin (a condition known as fibrosis) If left untreated, lymphedema can interfere with daily activities and increase the risk of complications. Severe cases may limit mobility, lead to frequent infections such as cellulitis, and cause long-term skin changes or breakdown. Early diagnosis and medical care  are key to managing symptoms and preventing progression. Lymphedema Treatment Options While lymphedema currently has no cure, a range of surgical  and nonsurgical treatments can help manage symptoms, reduce swelling, and improve quality of life. Lymphaticovenous Anastomosis (LVA) — Also Known as Lymphovenous Bypass Surgeons perform a minimally invasive outpatient procedure to reroute lymphatic fluid by connecting lymphatic vessels directly to tiny veins, effectively bypassing damaged or removed lymph nodes. It requires only small incisions and involves minimal blood loss. LVA can significantly reduce swelling and, in some cases, restore normal function to the affected limb. Vascularized Lymph Node Transfer (VLNT) In this outpatient procedure, surgeons use green dye to locate healthy lymph nodes — usually from the abdomen — and transplant them into the area with lymphatic obstruction. These transplanted nodes promote the growth of new lymphatic pathways and can improve drainage over time. Laparoscopic Omental Lymph Node Transfer (Omental Transplant) Surgeons use the omentum — a fatty layer in the abdomen rich in lymph nodes — in a minimally invasive procedure to help restore lymphatic circulation. Surgeons access and transfer omental lymph nodes through laparoscopic techniques, reducing recovery time and scarring. Nonsurgical Treatment Options Exercise Gentle, targeted exercises  can stimulate lymphatic flow and prepare the affected limb for daily tasks. A certified lymphedema therapist can create a personalized routine focused on low-impact muscle contractions. Avoid strenuous activity unless advised otherwise by your healthcare provider. Consult the National Lymphedema Network  to find a certified lymphedema therapist near you. Manual Lymphatic Drainage (MLD) A specialized form of massage encourages the movement of lymph fluid out of the swollen area. However, doctors advise against it for individuals with active infections, blood clots, or certain underlying conditions. Always consult your healthcare team before starting MLD. Pneumatic Compression Therapy A sleeve worn on the affected arm or leg connects to a pump that periodically inflates, applying pressure to help move lymph fluid away from the extremities. Compression Garments Custom-fitted sleeves or stockings apply consistent pressure to the affected limb, improving lymph fluid flow. These garments are essential during exercise. A healthcare professional can help determine the right fit and whether a custom garment is needed. Bandaging Multilayer bandaging encourages lymph fluid to move back toward the core of the body. Bandages should be snug around the fingers or toes and gradually looser toward the torso.  Complete Decongestive Therapy (CDT) CDT  is the gold standard in lymphedema care. It combines several approaches — manual lymphatic drainage, compression therapy, targeted exercise, and skin care — into a comprehensive treatment plan tailored to the individual. Tips to Lower Your Risk of Developing Lymphedema While no method can guarantee lymphedema prevention, specific proactive steps may reduce your risk or help manage symptoms if they appear: Stay alert to changes:  Notify your doctor right away if you notice any changes in size, color, temperature, or sensation in the area of your body that received cancer treatment, including the skin. Exercise safely:  Ask your cancer care team or a certified lymphedema therapist about exercises tailored to your condition . The correct movements can promote healthy lymph flow and may reduce your risk or help manage lymphedema if it develops. Maintain a healthy weight:  Excess body weight increases your risk of lymphedema and can make symptoms more complicated to control. Healthy eating and regular physical activity are essential parts of long-term management. Avoid unnecessary pressure:  Refrain from wearing tight-fitting clothing, jewelry, or undergarments that put pressure on the chest, arms, wrists, waist, legs, or genitals. Compression garments are the exception, but be sure they fit correctly, and follow your care team’s guidance when using them. Count on Us for Information, Resources, and Support If you’re living with or supporting someone with breast cancer, knowledge is power. While lymphedema may feel daunting, it’s manageable. Seek guidance early, lean on professionals and the community, and know that with the right tools, you can thrive. Whether you’re newly diagnosed with breast cancer , are navigating survivorship, or are the loved one of someone experiencing breast cancer, you can count on SurvivingBreastCancer.org to keep you informed. We provide educational information to help you better understand symptoms , testing, treatment options , surgery, and other related topics. Additionally, we offer podcasts  featuring professionals, advocates, and caregivers who share valuable insights and perspectives. Your donations  enable SurvivingBreastCancer.org — a community dedicated to empowering those affected by breast cancer with knowledge, understanding, and a network of care — to offer resources and support every day, every month, and every year.  Note: This article offers general information and does not replace professional medical advice. Make sure to discuss your options with your healthcare provider. Read More: Understanding Lymphedema Surgical Methods for Treating Lymphedema Treatment for Lymphedema Lymphedema is a Chronic Condition & Why I Love Swimming What is Breast Cancer Rehab? Exercise and Breast Cancer Recovery On the Podcast: Breast Cancer Conversations The Prehab Plan Surgeons Wish You’d Start Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetup s Free Events

Recovering from breast cancer is deeply personal, and for many survivors, regaining strength, confidence, and energy is a key goal after treatment. The good news? Exercise is one of the most effective tools to support your physical, emotional, and mental recovery. Keep reading to explore how exercise supports breast cancer recovery , how to get started safely, and what types of movement offer the most significant benefits. Why Exercise Matters After Breast Cancer Research shows that regular physical activity is vital after breast cancer treatment. A 2019 study highlighted by the National Cancer Institute found that breast cancer survivors who engaged in regular physical activity had a 42% lower risk of death from any cause compared to those who were inactive . Exercise can: Reduce fatigue Improve physical functioning Support emotional well-being Lower the risk of recurrence Improve overall survival According to the American Cancer Society, survivors should aim for at least 150 minutes of moderate-intensity activity each week . Physical and Emotional Benefits of Exercise Exercise offers a powerful boost to both physical health and emotional well-being. Regular physical activity strengthens the body, supports heart health , and improves energy levels, whether through a brisk walk, a dance class, or strength training. Importantly, it helps reduce stress, elevate mood, and enhance mental clarity, making it a vital tool for overall wellness. Physical Benefits: Reduces cancer-related fatigue Strengthens bones and muscles, especially important for those on hormonal therapies Improves cardiovascular health Helps manage weight gain, which treatments like chemotherapy or steroids often cause. Emotional and Mental Health Benefits: Eases anxiety and depression Boosts self-esteem and body image Helps manage stress Improves sleep quality Is It Safe to Exercise After Treatment? Exercise is usually safe but highly recommended, even during treatment. However, you should always: Get clearance from your health care provider , especially if you’ve had surgery, lymph node removal, or are undergoing treatment. Work with a cancer exercise specialist  or physical therapist  who understands your unique needs. Start slow and listen to your body — you don’t need to go from zero to 5K overnight. If you’ve had lymph nodes removed, take steps to prevent lymphedema . Learn more about lymphedema here . What Kinds of Exercise Are Best? 1. Walking Walking offers a low-impact option, provides easy accessibility, and actively boosts energy and mood. Need some extra motivation to get those walking shoes on? Join SurvivingBreastCancer.org  at our annual Tell Cancer to Go #TakeAHike  fundraiser on October 25 – you can participate from anywhere in the world! 2. Strength Training Strength training is a good way to rebuild muscle lost during treatment. It’s best to use light weights or resistance bands under supervision first. 3. Stretching and Flexibility Exercises These exercises support recovery after surgery or radiation. Gentle yoga or guided physical therapy can improve mobility. Join us for free virtual yoga programs !  4. Aerobic Exercise It supports heart health and fights fatigue. Examples include cycling, swimming, and low-impact aerobics. 5. Mind-Body Practices Yoga, tai chi, and pilates are excellent for managing stress and restoring balance. Check out SurvivingBreastCancer.org ’s upcoming movement classes . Getting Started: Tips for a Safe Exercise Routine Starting a new exercise routine is an exciting step toward better health, but it’s essential to prioritize safety from the very beginning. Whether you’re returning to fitness or trying it for the first time, taking a few precautions can help prevent injury and set you up for long-term success.  Here are practical tips to help you safely ease into your routine: Begin with short sessions  (10-15 minutes) and increase gradually. Focus on consistency over intensity . Wear supportive footwear  and stay hydrated. Track your progress  and celebrate small victories. Join a survivor-focused fitness group — SurvivingBreastCancer.org offers movement programs  specifically designed for the cancer community. Count on Us for Information, Resources, and Support  Every person’s cancer experience is different. Whether you’re just starting to regain strength or already back in your sneakers, every step counts . Exercise isn’t just about recovery — it’s about reclaiming your body, energy, and joy. Start where you are, do what you can, and keep going. You’re not alone — and you’re stronger than you think. Whether you’re newly diagnosed with breast cancer , are navigating survivorship, or are the loved one of someone experiencing breast cancer, you can count on SurvivingBreastCancer.org to keep you informed. We provide educational information to help you better understand symptoms , testing, treatment options , surgery, and other related topics. Additionally, we offer podcasts  featuring professionals, advocates, and caregivers who share valuable insights and perspectives. Your donations  enable SurvivingBreastCancer.org — a community dedicated to empowering those affected by breast cancer with knowledge, understanding, and a network of care — to offer resources and support every day, every month, and every year.  Note: This article offers general information and does not replace professional medical advice. Make sure to discuss your options with your healthcare provider. Read More: Exercise and Breast Cancer What is Breast Cancer Rehab? Managing Fatigue During Breast Cancer Treatment: Tips for Conserving Energy Breast Cancer and Heart Health: The Connection You Need to Know About The Impact of Breast Cancer on Self-Image On the Podcast: Breast Cancer Conversations From Diagnosis to Downward Dog: How Yoga Can Heal Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetup s Free Events

“How are you sleeping?” It may seem like a simple check-in, but for oncology teams, this question carries weight because the quality of your sleep can directly impact how your body responds to cancer, treatment, and recovery. Sleep and Breast Cancer: Why Rest Is More Than Just Beauty Sleep At SurvivingBreastCancer.org , we know that getting a good night’s sleep is easier said than done, especially when you're juggling the emotional, physical, and mental toll of a diagnosis. However, there's an encouraging reminder: while lack of sleep doesn’t cause cancer, good-quality sleep helps your body heal, restore, and fight . Let’s dive into why sleep matters, how it connects to breast cancer, and twenty sleep strategies to help you reclaim your rest. The Science of Sleep and Cancer Emerging research shows a strong relationship between sleep and overall health, including cancer outcomes. In particular, non-respiratory sleep disorders and disrupted circadian rhythms  (your internal body clock) have been linked to cancer progression and impaired immune function. Sleep disturbances can disrupt the balance of two key hormones: 1. Cortisol Known as the "stress hormone," cortisol should naturally decrease at night to allow your body to rest. Chronic elevation of cortisol levels, often due to poor sleep, can suppress the immune system and increase inflammation, creating an environment where cancer cells may thrive. 2. Melatonin This hormone plays a role in regulating your sleep-wake cycle and is also believed to possess antioxidant properties  that protect cells from DNA damage. Some studies suggest melatonin may also inhibit estrogen production —a relevant factor for hormone receptor-positive breast cancers. Sleep Apnea and Cancer Risk Obstructive sleep apnea (OSA) has been associated with an increased risk of cancer mortality. During OSA episodes, your airway becomes blocked during sleep, reducing oxygen levels and leading to frequent awakenings (and often loud snoring). Over time, these frequent oxygen drops and sleep fragmentation can create systemic stress and inflammation. If you're a snorer or experience daytime fatigue, it's worth talking to your doctor about a sleep study. A diagnosis and treatment (like a CPAP machine) could not only improve sleep but also reduce long-term health risks. The Emotional Side: Why Sleep Feels So Hard During Cancer If you’re undergoing treatment, in survivorship, or living with metastatic disease, insomnia can be a frustrating, persistent companion. Fear, stress, medication side effects, hormonal changes, and chronic pain can all contribute to restless nights. Sleep disturbances among cancer patients are common, with studies estimating that 30–50%  of people in active treatment experience insomnia—and those numbers don’t always improve after treatment ends. Rather than blaming yourself or forcing sleep to happen, we encourage you to approach sleep like healing: with curiosity, compassion, and gentle experimentation. 20 Sleep Strategies for Cancer Survivors and Thrivers Whether you’re in active treatment or learning to thrive post-diagnosis, here are 20 evidence-based hacks and holistic tips  to help improve your sleep over time: Keep a Consistent Sleep Schedule: Go to bed and wake up at the same time daily—even on weekends. Apps like Sleep Cycle or Calm can help track your sleep patterns. Wake Up During Optimal REM Cycles: Sleep apps can analyze your REM cycles and wake you gently within a window that prevents grogginess. Cut Back on Fluids and Stimulants: Limit caffeine after lunch, reduce alcohol, and stop drinking large amounts of fluids in the evening to avoid nighttime trips to the bathroom. Warm Bath + Cool Room + Warm Feet: A warm shower followed by a cooler bedroom (60–67°F) and cozy socks can help signal the body to wind down. Use an Eye Mask if Your Room Isn’t Dark Enough: Even small light sources can disrupt melatonin production. Ditch Screens Before Bed: Blue light from phones and tablets suppresses melatonin. Power down at least 60 minutes before bed or use "night mode" features. Exercise (But Not Too Late): Daily movement—preferably in daylight—can help regulate your sleep cycle. Avoid high-intensity workouts within 2 hours of bedtime. Create a Calm Sleep Environment: Soothing colors, blackout curtains, and a clean, peaceful room can improve rest. Say No to Pets in the Bed: Your furry friend may be adorable, but even small movements can disrupt your sleep cycle. Take a Power Nap: If you nap during the day, keep it to 20–30 minutes. Long naps can throw off your nighttime rhythm. Journal Before Bed: If racing thoughts keep you awake, jot them down. A bedside notebook can also capture middle-of-the-night worries. Practice Deep Breathing or Meditation: Try guided meditations, breathwork, or yoga nidra to ease into sleep. Use Calming Scents Like Lavender: Aromatherapy (with oils, diffusers, or sprays) may help you relax faster. Try Progressive Muscle Relaxation: Starting at your toes, slowly tense and release each muscle group, moving up to your head. Visualize Something Peaceful: Like artist Patti Smith’s approach to insomnia, imagine comforting scenes or people you love. It helps shift your focus from stress to serenity. Get Morning Sunlight: Expose your eyes to natural light for 15–30 minutes shortly after waking to help regulate your circadian rhythm. Check Your Pillow: The wrong pillow can cause neck strain and discomfort. Replace pillows every 12–18 months, and choose one suited to your sleep position. Review Your Magnesium Levels: Magnesium supports relaxation. Some people benefit from supplements (including magnesium glycinate or calcium-magnesium blends)—check with your provider first. Try a Weighted Blanket: These provide gentle pressure that may reduce anxiety and promote calm. Use a White Noise Machine: Sound machines with settings like ocean waves, rain, or soft static can help mask background noise and lull you to sleep. Sleep is not a luxury—it’s a vital part of your recovery and long-term health. Whether you’re newly diagnosed, living with MBC, or navigating survivorship, prioritizing sleep is a form of self-care that’s often overlooked. Start small. Try one or two strategies at a time. Listen to your body, be patient with yourself, and remember: sleep doesn’t have to be perfect—it just needs to be healing.

The power of positive thinking is so pervasive today that many doctors and nurses strongly recommend developing a positive mental attitude to prevent sickness, help overcome medical setbacks, and assist in recovery from cancer surgery. Indeed, there is healing power in positive thinking, but can you heal yourself just by being positive, optimistic, and focused? Many believe that positive thoughts can prompt physiological changes that strengthen your immune system, decrease pain, and provide stress relief. The “Power of Positive Thinking”, a self-help book by Norman Vincent Peale, published in the last century, first proposed the method of "Positive Thinking". It aimed to ensure that one could achieve a permanent, fruitful, and optimistic attitude through the constant positive influence of their conscious thought. This was to be accomplished through affirmations/visualizations, thus allowing one to attain higher satisfaction and quality of life. Similarly, in the book “The Secret” by Rhonda Byrne, the Law of Attraction is explored and suggests that whatever energy, thoughts, or visualizations you put out into the universe, you will receive. Therefore, if you send out negative vibes or think something negative will happen, it probably will. If you send out positive vibes, positive things will be returned. How to Develop Positive Beliefs and Drive Expectations to Activate Self-Healing Start by applying the right kind of positive thinking to direct your subconscious mind to help heal your body and improve your life, including: Direct your conscious and subconscious mind to help you heal Apply positive thinking. Don’t worry, be happy. "Worry only takes the joy out of your day." Find a way to focus on the positive. What are you grateful for? Start a mental list of the things and people in your life that you are thankful for. Be optimistic Imagine you can see your cancer, take a deep breath, and now, as you exhale, visualize the cancer floating away and leaving your body. If you are experiencing pain after surgery, say “hello” to your pain, acknowledge that you can feel it, perhaps your pain has a particular color, or name. Experience the sensation, and then, tell your pain that it is time for it to leave and say “goodbye”. Develop a positive attitude. By enabling your conscious and subconscious mind to be more optimistic, you tend to attract greater positivity into your life. Migrate Towards Positive Thoughts and Positive Beliefs The changes begin when one’s subconscious mind begins to adopt the new belief system. It then starts to guide you to those opportunities that help you improve your health. Once you begin to calm your mind, the subconscious begins to calm the body, leading to better health. When your mind begins to focus on what you want and stops being negative, you will begin to see dramatic changes. Try the following: Create a belief system that allows you to heal Develop a new positive, optimistic attitude and outlook. Eliminate negativity. Surround yourself with people who make you smile, laugh, and are encouraging. Remove limitations Remain focused on what you want. This isn’t to say never be upset or that you cannot have a bad day, we all go through our ups and downs; Everyone has their good days and bad days. However, the Power of Positive Thinking is a mindset, a way of life. You have to believe in yourself and get your subconscious mind and inner self working for you. You have to give them the right instructions, and they’ll bring you what you want and more. You can help to heal yourself and improve your life when you’re positive, optimistic, and focused on improvement. References: The Science of Positive Healing Thoughts - https://articles.mercola.com/sites/articles/archive/2016/02/04/healing-thoughts.aspx Can Positive Thinking Help You Heal? | Psychology Today https://www.psychologytoday.com/blog/owning.../can-positive-thinking-help-you-hea... Can positive thinking make you well? - CNN - CNN.com https://www.cnn.com/2011/12/05/health/positive-thinking-deepak.../index.html Healing With Positive Thinking - Affirmations For Positive Thinking www.affirmationsforpositivethinking.com/Healing-with-Positive-Thinking.htm The Science of Healing Thoughts - Scientific American https://www.scientificamerican.com/article/the-science-of-healing-thoughts/ Positive Thinking Improves Physical Health | Psych Central https://psychcentral.com/lib/the-power-of-positive-thinking/ Positive Thinking, Faster Recovery - ABC News abcnews.go.com/Health/story?id=117317 Can Positive Thoughts Help Heal Another Person?: NPR https://www.npr.org/templates/story/story.php?storyId=104351710

By Jasmine Shukla & Laura Carfang The results of the Oncotype Dx are a recurrence score, a number which ranges from 1 through 100. The higher number is associated with a greater probability of the cancer returning, and that the patient will receive greater benefits from undergoing chemotherapy. If the number is lower, studies have found that there is little added benefit of adding chemotherapy as part of the patient's treatment plan. These scores suggest the risks and chances of breast cancer’s return even after therapy and surgery. The result or outcome serves as a point of reference for a dialogue between the patient and the oncology team to determine the best course of action. What is the Oncotype Dx Test? The Oncotype DX is a genomic test that analyzes the behavior of 21 genes and, through an algorithm, predicts the likelihood of how effective chemotherapy would be for a particular individual. We know there are several benefits of undergoing chemotherapy, but the choice to put our bodies through such a potent and toxic treatment does not come easily. Those diagnosed with breast cancer and their medical oncologists need to discuss the pros and cons of a chemotherapy regimen, the timing of chemotherapy (neoadjuvant, i.e., before surgery, or adjuvant, meaning after surgery), and understand that it may not be for everyone. A research study called "Trial Assigning Individualized Options for Treatment” (TAILORx) set out to determine whether chemotherapy is beneficial for women who have mid-range Oncotype DX tumor recurrence scores. This trial—the largest breast cancer treatment trial ever conducted—showed that endocrine therapy alone was as effective as endocrine therapy plus chemotherapy in women with certain types of early-stage breast cancer. The results of this trial have been implemented immediately into practice after its announcement at the American Society of Clinical Oncology . When is the Oncotype Dx Test Used? The Oncotype Dx test is used in two main scenarios. If the breast cancer has not spread beyond the milk ducts, (ductal carcinoma in situ), it will help doctors understand the woman's risk of the cancer coming back, or returning, as well as provide insight into the benefits the woman would receive from radiation therapy after DCIS surgery. If the early-stage cancer is estrogen-receptor positive, the Oncotype DX test can help frame the conversation for how likely the woman would benefit from chemotherapy after surgery. Who is Eligible For the Oncotype Dx Test? This test isn't for everyone. The thought of not needing to have chemotherapy sounds like a dream to many breast cancer patients. However, many find that they are not candidates for the Oncotype Dx test because the cancer has already spread to their lymph nodes. The following conditions may mark a potential candidate for the Oncotype Dx Test: You have recently been diagnosed with stage I or II invasive breast cancer The cancer is estrogen-receptor-positive There is no cancer in your lymph nodes (lymph-node-negative breast cancer) You and your doctor are making decisions about chemotherapy The results of the Oncotype Dx test must be given enormous significance and is to be conducted without any glitches, as the resulting consequence leads to an essential decision about the effectiveness and recurrence. Each test is unique, as it will never be the same for any two people, and predictions for each individual will vary. Proper consultations with medical specialists are always necessary to ensure the safety of the patient and avoid complications. ASCO has provided the latest guidelines and recommendations here . Oncotype Dx Test Cost The American Society for Clinical Oncology and National Comprehensive Cancer Network Guidelines now include the ODRS in their treatment guidelines for early breast cancer. However, the test is expensive and costs approximately $4000 per patient in the United States. Oncotype Dx Recurrence Score Chart Oncotype DX test recurrence scores (ODRS) are a way for oncologists and patients to discuss the next steps of a treatment plan. While it is easy to find information on how the Oncotype DX is scored, it is important to read the fine print that determines the charts. The following is a general guideline for various ODRS ranges: Score 0 to 17: considered a low recurrence score, and the chance that your cancer will return is low. This score also suggests that the benefits of chemotherapy may not be worth the risks for you. However, please remember a low recurrence score does not mean that your cancer will definitely not come back. Score 18 to 30 : considered a medium recurrence score, and the benefits of chemotherapy for you are uncertain. Your doctor will discuss with you what this means and take in all of the factors that are specific to your diagnosis and cancer characteristics. Score 31 to 100: considered a high recurrence score. If you have a high recurrence score, the chance that your cancer will return is somewhat high, and adding chemotherapy to your cancer treatment may help keep the cancer from coming back. It’s important to note that a high recurrence score does not mean that your cancer will definitely come back. Oncotype Dx Test Reliability The Oncotype DX has a significant impact on decision-making in adjuvant therapy recommendations, but the scoring system is not as definitive as it may seem. Age and stage play a significant role in interpreting these results. According to the TAILORx study, women 50 and younger with an Oncotype Dx score of 16-25 may benefit from both hormone therapy and chemotherapy in the treatment plan. Similarly, a result of 39 for women who are in stage 0 with DCIS is considered low risk for local recurrence, and the benefits of radiation do not outweigh the risks. It’s important to know that you may qualify for an Oncotype DX test and that the results are a starting point for a deeper conversation with your oncologist. Significant advancements are being made in the breast cancer community, including opportunities for patients to limit the toxicity they're exposed to. However, treatment plans are individual-specific, and every patient must choose the treatment path that works for their unique physiology and preferences. Listen to our latest podcast with Dr. Jordana Phillips . Watch our latest video References Dialani V, Gaur S, Mehta TS, Venkataraman S, Fein-Zachary V, Phillips J, et al. Prediction of low versus high recurrence scores in estrogen receptor-positive, lymph node-negative invasive breast cancer on the basis of radiologic-pathologic features: comparison with Oncotype DX test recurrence scores. Radiology . 2016;280:370–378. Siow, Z. R., De Boer, R. H., Lindeman, G. J., & Mann, G. B. (2018). Spotlight on the utility of the Oncotype DX® breast cancer assay. International journal of women's health , 10 , 89–100. doi:10.2147/IJWH.S124520 Sparano JA, Gray RJ, Makower DF, et al. Adjuvant chemotherapy guided by a 21-gene expression assay in breast cancer. N Engl J Med. 379(2):111-121, 2018.