Although they can be lifesaving, breast cancer treatments can lead to various gastrointestinal (GI) issues. These side effects can vary in intensity from mild to severe and can significantly affect a person’s quality of life. Understanding GI issues’ causes, symptoms, and management strategies can help individuals navigate their treatment experience more comfortably. While GI issues can be a challenging side effect of breast cancer treatment, various techniques can help you manage these symptoms and improve your quality of life. It’s essential to communicate with your healthcare team about any GI symptoms you’re experiencing so they can provide appropriate care and support. Continue reading for an in-depth look at the causes, symptoms, and management strategies of GI issues related to breast cancer treatments. Symptoms: The GI issues experienced during cancer treatment can include a range of symptoms, including: Nausea and vomiting Diarrhea Constipation Abdominal pain or cramping Bloating Loss of appetite Changes in bowel habits What Causes GI Issues in Breast Cancer Patients? The primary treatments for breast cancer — chemotherapy, radiation therapy, hormone therapy, and targeted therapy — can all contribute to GI issues. Here’s a closer look at how each treatment can affect the digestive system: Chemotherapy: Chemotherapy targets and kills rapidly dividing cancer cells. Unfortunately, it also targets healthy cells in the body, such as those in the digestive tract, potentially leading to a range of GI issues: Nausea and vomiting: Chemotherapy can trigger signals to the brain that activate the vomiting center, leading to these symptoms. Diarrhea: Damage to the cells lining the intestine can disrupt water absorption and nutrients, resulting in loose or watery stools. Mucositis: An inflammation and ulceration of the digestive tract lining can cause pain and increase the risk of infection. Radiation Therapy: Radiation treatment uses high-energy rays to target and kill cancer cells. The radiation field, including the abdomen or pelvis, can affect the GI tract. Inflammation: Radiation can irritate and inflame the intestinal lining, known as radiation enteritis or colitis. Pain and cramping: The inflammation can cause abdominal pain and cramping. Altered bowel habits: Individuals may experience changes in bowel habits, including diarrhea or, less commonly, constipation. Hormone Therapy: Hormone therapies are used to treat breast cancers that are sensitive to hormones. They can indirectly affect the digestive system by altering hormone levels: Bloating and gas: Changes in hormone levels can affect digestion and increase gas and bloating. Constipation: Hormone fluctuations can slow the digestive process, leading to constipation. Targeted Therapy: These treatments focus on specific molecules and pathways more active in cancer cells. However, they can also affect similar pathways in normal cells: GI symptoms: Depending on the specific targeted therapy, patients might experience various GI symptoms, such as diarrhea, abdominal pain, or liver function changes. Surgical Treatments: Surgical interventions for breast cancer may not directly target the digestive system, but when surgeries involve the abdominal area, they can impact GI function: Direct impact: Surgery can physically alter the structure and function of the GI tract, particularly if parts of the digestive system are removed or altered. Indirect impact: Surgery can affect surrounding tissues, nerves, and blood supply, indirectly influencing GI function and leading to issues like altered bowel habits or digestion. Understanding these potential side effects can help patients and healthcare providers anticipate and manage GI issues during and after breast cancer treatment, improving the quality of life for people undergoing these treatments. Managing GI Issues During Breast Cancer Treatment Dietary Changes Making specific changes to your diet can significantly reduce GI discomfort: Eat small, frequent meals: This approach can lessen the burden on your digestive system, reducing symptoms like nausea and bloating. Stay hydrated. Dehydration can exacerbate symptoms like constipation and fatigue. Aim for clear fluids and consider oral rehydration solutions if you are dealing with diarrhea. Choose bland, easy-to-digest foods: Simple, non-spicy, and low-fat foods can prevent exacerbating GI symptoms. Avoid irritating foods: Foods that are overly spicy, greasy, or high in fiber can aggravate your symptoms. Identifying and avoiding your personal trigger foods can be beneficial. Medications Various medications can help manage specific GI symptoms: Anti-nausea medications: These can be crucial to prevent nausea and vomiting, especially during chemotherapy cycles. Anti-diarrheal medications: Essential for managing diarrhea, these medications can improve your quality of life during treatment. Laxatives and stool softeners: These can provide relief from constipation, a common side effect of specific breast cancer treatments and medications. Lifestyle Changes Lifestyle adjustments can also play a significant role in managing GI symptoms: Rest and relaxation: Stress can exacerbate GI symptoms, so incorporating relaxation techniques like deep breathing or gentle yoga can be beneficial. Gentle exercise: Physical activity can stimulate digestion and alleviate symptoms like constipation and bloating. Professional Support Don’t hesitate to seek professional advice for managing GI issues: Consult a dietitian: A dietitian specializing in oncology can provide tailored dietary advice to manage your specific symptoms. Talk to your oncologist: Your oncologist can adjust your treatment plan or prescribe medications to alleviate severe or persistent GI symptoms. Count On Us for Information, Resources, and Support 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 to offer resources and support every day, every month, and every year. Note: This article is designed to provide general information and not replace professional medical advice. Always discuss your options with your healthcare provider. Learn More: Making Food Choices During Breast Cancer Treatment Metabolic Changes After A Breast Cancer Diagnosis Navigating Cancer Treatment: Top Tips from an Oncology Pharmacist On the Podcast: Breast Cancer Conversations Diet, Exercise, and a Breast Cancer Vaccine, Oh My! SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

By Briana Rickertsen Throughout my breast cancer treatment, I had a friend’s voice in my head encouraging me that said, “Control the controllables.” When you are diagnosed with cancer, it can feel not only overwhelming, but also like you have lost some control. Being able to take back a few bits to help control your day can be powerful. Exercise and movement are one of these tools. There are hundreds of studies to support exercise during treatment and beyond. New studies are being published monthly to support new findings on benefits. Exercise can improve quality of life, treatment outcomes, mental health, side effects (such as energy and nausea), recurrence risk, and mortality. While exercise may seem like another thing on your plate during a hectic and unpredictable time, there is no better time to start or keep active with movement and exercise than when you are diagnosed with cancer. Here are a few ideas to start and keep you moving. The Centers for Disease Control and Prevention (CDC) recommends building up to 150 minutes of moderate cardio and strength each week. Moderate means you should be able to talk during exercise, but you would not be able to sing while moving. I find it helpful to start small and build on gradually. A little exercise is better than none! On days I’m having a hard time exercising, I find other ways to support my mind and body, including doing breathing exercises, stretching, restorative yoga, or meditation. Once I reach 150 minutes of exercise per week, I work to increase the intensity or the amount of time/number of workouts per week. Most of all, I keep it fun! I’m more likely to stick to something that I enjoy. In 2023, I started an Instagram account called The Nifty 150. The goal of the account is to help provide support, education, and empowerment to cancer survivors and increase the number of survivors reaching exercise recommendations. When talking about survivors, I use the National Cancer Institute (NCI) definition of cancer survivors, which begins at the time of diagnosis. Exercise is a powerful tool, movement is an empowering action, and breathing is a gift. In the midst of everything we are experiencing as cancer survivors, I hope this provides encouragement for self-care. I’m here to move with you, support you, and be your number 1 fan. Connect with Bri on Instagram Read More: Moving Through Treatment and Survivorship Exercise and Breast Cancer Check out SBC’s upcoming events for free virtual movement programs! Breathwork SBC Meditation Library On the Podcast: Breast Cancer Conversations The Benefits of Pilates for Breast Cancer Recovery Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

By Kathleen Friel I had the great fortune of attending the Living Beyond Breast Cancer (LBBC) Metastatic Breast Cancer (MBC) Conference from April 19-21, 2024, in Philadelphia. I was able to see several members of our SBC family in person, and my mom joined me on the trip! Seeing people in person is such a treasure. This year, I was a participant in LBBC’s Hear My Voice (HMV) advocacy training program, which dovetailed with the conference. About 30 people were selected to be in the 2024 class. If you applied and didn’t get in, keep trying! It took me a couple of tries. We met as a class for about 10 hours of Zoom-based and offline training in April. We learned how to be stronger advocates for ourselves and our friends with MBC in many ways. We learned about ways to advocate to legislators, encouraging them to increase research funding for MBC and pass laws that will bring people with MBC more medical benefits. We learned about research advocacy – serving as grant reviewers or patient advocates in research studies. We spent time brainstorming fundraisers and social media education content. We laughed a lot, we shared our stories, and we grew close. At the LBBC conference, we sat together, with our caregivers. It was amazing to meet people in person. Cancer is a strong bond. Similar to in our SBC family, we can meet someone and quickly dive into the intimacies of living with cancer. Everyone in HMV has MBC, which I think gives us even stronger connection. We’re eager to work hard to advocate for the MBC community, while also living with the side effects and uncertainty of MBC. We don’t know how much energy, time, or even life we’ve got in our future. I found it very uplifting to know these lovely friends who are committed to making a difference for others in the MBC community amid their own MBC struggles. We also had a class Spotify playlist! I’m not sure if I correctly submitted mine, though here it is. The writer and singer, Nightbirde, died of MBC in 2022, after shining on America’s Got Talent. I honor the bravery of our class, and all living with MBC. Nightbirde’s definition of bravery is to live authentically. I just love her music! The LBBC conference was short but full of information and connection! All presentations are online for viewing! We heard presentations from panels of people with MBC, sharing their tips for navigating this wild ride. One panelist brought me to tears – diagnosed with MBC at 18 years of age. Unreal. She just got married and seems to be doing quite well. Every year, there’s a presentation about the newest medications and clinical trials for people with MBC. It’s always a session that brings me mixed emotions. It’s great that new drugs are being developed. I have several dear friends on a drug that was only approved last year, and the drug is working for most! Still, the timelines give me chills. Drugs still don’t work for very long, as MBC is like an evil shapeshifter that mutates to become drug-resistant. At one point in the conference, a speaker asked people to stand up based on how many years they’ve lived with MBC. Lots are at 1-2 years. Once the speaker got up to 7-10 years, not many stood up. But some did! And then the super responders got a standing ovation, those living 15, 20, or more years with MBC. It was a mix of hopeful and sobering to me, as I near my 6 th anniversary of diagnosis. Getting to see my friends in person is the best part of the conference! There was social time, which included time to visit exhibitor booths. The SBC booth rocked!! Even @ImLoganTheGolden Laura, and William’s dog, made an appearance. There were many exhibitors from organizations that provided support to people with MBC. Since I’m writing this on Mother’s Day weekend, I also want to celebrate my mom! She’s come to LBBC with me for two years now, and her support every day means so much to me. I spent a lot of time in doctor's offices and hospitals as a kid, and my entire family has been there for me throughout. The love, advocacy, and resilience of my mom are huge sources of strength and example for me. Thank you, Mom!!

By Marissa Haislip They look at you, in the eye, holding your gaze, Trying to show comfort and understanding, While saying the dreaded words, “I’m sorry, it is cancer.” But those words don’t bring any comfort. Instead, they plunge you into darkness. Others look at you with a slight smile on their lips Attempting to mask the pity behind their eyes, Trying to be a friend the best way they know how. “I’m sorry,” they say. “But you got this. You are a warrior.” But these words feel hollow. Am I? Some don’t even look at you; They stay away, not knowing what to say. Not realizing that not reaching out hurts too. The words that are absent are just as memorable As the wrong words from some. But those battling the same fight, stand beside you. They know exactly what to say. No hollow words from them-- Only words filled with meaning and understanding. They look at you and see you. Dedicated to my IG “Breasties” who have made this journey a bit more bearable. Connect with Marissa on Instagram Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

A collaborative poem by the SBC Poetry Society This journey of life is for the brave of heart Cancer transformed love into a test, a bar to hit, a threshold to prove depth of feeling I fight with all my might I have discovered a sleeping knight I hold my spirits bright I have entered a tunnel… now searching the light Where will this new path take us? Make a pact to lift me when I’m down Trust yourself, you have an inner light that will illuminate your path forward. When sadness and desperation arise Have the courage to open your eyes. Look for the hands reaching out to support, Let kindness and love guide you Change guides us, fearless and bold embracing a new beginning. We have the strength to forge on We have the strength to face each new dawn. Our perception shapes focus, Which in turn influences decisions and ultimately our happiness. Nurture what you focus on; it blooms. Endurance blooms resilient, a delicate flower thriving amidst the storm, its petals unwavering in the chilling winds of challenge. The real beauty lies in friendship, in support and in the sisterhood of SBC. Tell cancer to take a hike! Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

By Olivia Smith Content warning: death and dying Grief comes in waves, and the waves can get bigger around important dates. I am still in my first year of “firsts” after the loss of my mother, and a lot of important dates in my life were overshadowed by her cancer diagnosis and death. Two days before my wedding ceremony in Italy, my mom’s husband pulled me aside and told me that they thought she had cancer again. He said there was a rash on her breast and it was swollen, and she was having back pain. I was angry because I was supposed to be excited about getting married and now I was focused on this heavy news, something in me knowing we were facing heavy news soon. About two weeks after the wedding/honeymoon trip, I was preparing for our casual post-wedding celebration back home when my mom asked my sister and I to join her on a three-way call and told us that she had breast cancer again. She didn’t have all of the information yet besides it was inflammatory breast cancer, which starts minimally at stage 3 because it’s already in the skin. She told us it wasn’t a death sentence, that she would fight it, and would tell us once she got results back from further testing and had more information. A few days later, just as my in-laws were walking in my front door, I received a text from her with the full news; it was stage 4 – metastatic – and had already spread to some spots in her bones. This was not the news we were hoping for, yet I had to put a smile on my face and host my guests who came to celebrate me at a party I really didn’t even want to have. My mom tried her hardest over the next ten months to keep the cancer at bay and continue living her life, but unfortunately, she died on August 20, 2023, after the cancer spread to her liver and caused it to shut down. On August 20 of the prior year, my husband and I got legally married in our home state of South Carolina before our wedding abroad. My mom wanted to be cremated after her death, and we honored that wish. Her ashes were ready to be picked up and brought home on September 5, 2023 – my husband’s and my first wedding anniversary. My mom always loved to be the center of attention, so although it was fitting (and a little humorous) for her to continue the trend of overshadowing any event surrounding my wedding and first year of marriage, it made things difficult. The first year of marriage is supposed to be a giddy, lustful year full of love and happiness. That was not my experience. While I am so thankful for my husband’s continued support and understanding, I was not a happy, fun wife for our first year of marriage. I was stressed, sad, worried, and grieving the inevitable loss of my mom along a roller coaster of emotions that went with her cancer diagnosis and treatment. Our first anniversary was supposed to be spent in Hawaii enjoying some rest and fun together, but we canceled it as it was just under two weeks after her death. I am so incredibly thankful my mom was able to attend our wedding and will cherish those memories forever. However, our anniversary will now forever be overshadowed by watching my mother die, not simply our dreamy Italian wedding ceremony and honeymoon. I hope to be able to honor both events each year. Death and grief are difficult, but as difficult as they can be, finding ways to honor them can be so fulfilling and healing, too. Honoring a loved one can look different for everyone, but I truly believe it’s important to be present in your grief, even though it comes with pain. Some people honor their loved ones by visiting their grave site on holidays and bringing flowers or other items that their loved ones loved. I don’t believe there is a “wrong” way to do it, but I will let you know some of the ways I have found that have worked for me. My sister, Stephanie, and I enjoy coping through dark humor. It’s common to talk about the best parts of a person when they’re gone or glamorize them in a sense. But sometimes we laugh about, “What would mom really think about this?” or “What would she actually say?” We created a TikTok that made us laugh so hard, “touring” our mom around my sister’s new house and commenting on what we think she would’ve thought about it. For example, we included things like “She loved the front door – orange was her favorite color” and “She loved the dining room, tons of natural lighting.” But we also included comments like, “Here is the mantel she will stay on to judge my sister’s life choices, starting with wondering why she is sitting next to the sage and other spirit-cleansing agents,” and “Here is where she would rather stay (on the top of the stairs in the foyer) so everyone could see her when they walked in; she always loved being the center of attention.” We were cracking up and had such a great time “spending time” with our mom again. I have created a few other funny and more serious TikToks remembering my mom, some with my sister and some without. It has been a fun outlet to connect with others who have experienced loss in a more light-hearted way while keeping my mom’s personality alive. I have also done a few small things to honor her on different dates, like unique nails with different designs of some of her favorite things (leopard print, mascara, her motorcycle club saying, boobs, etc. for her celebration of life and her birthday. It brought me joy to look down at my hands (which look just like hers did – strong genetics) during tough dates and seeing some of her favorite things. The nails were also useful as a talking point with people who were uncomfortable broaching the subject. I spent her birthday in Washington D.C., prior to a work trip. I decided to go shopping at T.J. Maxx in her honor because we loved shopping there together, and I miss those trips so much. I found a cute sundress in her favorite color I had to buy. After that, I spent some time walking by the waterfront and trying to be present and remember my mom on her birthday, even though it hurt a little bit. I sat and enjoyed the sunshine and breeze and sound of the water and let myself feel what came up. That evening I enjoyed a delicious dinner and glass of rosé with a colleague turned friend, and we cheered to my mom. With Mother’s Day coming up, I haven’t been sure how I want to spend it. The emails start coming early with gift ideas for your mom. (Some of them will have an email beforehand offering an opt-out option for those who have a difficult time with the holiday. This is a newer option that seems to be becoming more prevalent for certain holidays, which I appreciate.) One email caught my eye from the spa where I get massages: a two-hour Mother’s Day massage special including extra treatments. I joked about getting it as a treat to myself for my first “I don’t have a Mom’s Day.” Then, I joked to my friends, asking if I should get it for said holiday. They all said different versions of YES, so I did it. I will be spending time near Mother’s Day relaxing and treating myself to a massage. We all deserve self-care, plus the body stores emotions such as grief that can cause physical pain, which a massage can alleviate. I think it will be a great way to pour back into myself while remembering my mom, and I know she would approve of it. For some of the bigger holidays like Thanksgiving and Christmas, I was able to prepare myself further in advance for what could come up, which I think helped me on the day of. I was prepared for the feelings that could come up so I wasn’t caught off guard. They were still difficult, but the mental preparation and grace I gave myself helped me get through it. The hardest day so far was such an unexpected one. It was about two and a half months after my mom passed, and I was a bridesmaid in my sister-in-law’s wedding party. I didn’t expect any emotions to come up, which I think contributed to how difficult it was for me. The day started out fine with typical wedding party things, getting ready with the bride and bridal party and helping ensure things were going smoothly. Weddings are such a beautiful time with so many special moments between the bride and others. The last wedding I attended prior to this one was my own, which of course, was tied to so many moments of my mom’s diagnosis and death, which likely increased my emotions. Watching my sister-in-law and mother-in-law have so many special moments together on that day made me so happy. I wish I could go back to my wedding day and do things differently with my mom, and make more memories like they were making. I love seeing moms and daughters bonding and enjoying time together even more now that I’m unable to do so. However, witnessing all those beautiful moments between mother and daughter on such a special day reminded me that I would never have special moments like that with my mom anymore, and really amplified my loss and grief. I sat with my husband at the dinner table, unable to hold back my pain and tears of grief anymore, and against my will, tears came. I tried my best to stop it and put a smile on my face. It was such a beautiful day and wedding, and not about me, but I hadn’t prepared myself for the feelings that could come up at a time like this, so it took me by surprise. I am no expert in how to handle holidays without a mom after loss; I am still fairly new to this. I miss going to visit her on holidays or picking out just the right gift for her. I loved getting her sentimental gifts that I knew she would treasure, or getting her something she not-so-subtly told me she wished she could have. Gift-giving is my most prominent love language, so it’s something I have missed. However, I think sometimes it is all about mindset. Being sad, angry, and grief-filled is completely okay and expected. But just because you can’t still spend time with your loved one physically or send them gifts doesn’t mean you can’t accomplish that in other ways. Here are a few ways to consider honoring your loved one after loss: Bring them flowers/gifts to a cemetery plot Pour out a drink for them (or enjoy their favorite – doesn’t have to be alcohol) Treat yourself to something that reminds you of them Visit a place you enjoyed together (or their favorite place) Cook a meal they liked (or one you have fond memories of making together) Create a funny video about how you wish you could spend the day with them Do their favorite activity Sit at home and think of them Create a craft that reminds you of them Talk about them with someone you love Go for a walk in nature and appreciate the sounds, sights, and scents Look at photos/videos of them Engage in a self-care activity All this to say, I don’t believe there is a right or wrong way to spend those difficult dates or holidays, but the most healing way is to remember them, think about them, and let yourself feel the emotions that come up. Many say that grief is all your love with nowhere to go. Give yourself some grace for how heavy this feeling may be, and be proud of yourself for getting through another hard day after loss. Different holidays or dates have hit me in different ways, and there are many more to come. If you are searching for someone who understands or have questions, feel free to reach out to me at @gingers_breasties on Instagram or at gingers.breasties@gmail.com. Read More: Navigating Grief: Understanding the Stages of Loss and Healing Metastatic Breast Cancer: Understanding the Significance of Stage IV The Last Thing I Told My Mom Was a Lie Breaking the Silence on End-of-Life: What is a Death Doula? On the Podcast: Breast Cancer Conversations A 23-Year Look at Inflammatory Breast Cancer with Ginny Mason Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

By Dani Romano I took a picture of my healing body today. I had my medi-port (IV port) taken out three mornings ago. (I thanked my port in pre-op before it was removed.) The picture I took just now shows a multitude of colors as the bruising spreads from where the port used to be. Much of it is hidden under the suture cover, which is also covered with medical glue. It is an interesting array of colors. It would probably gross some people out. To me it is beautiful. It is my time to heal. Cancer “recovery” (for lack of a better word) is a difficult time and most would probably say, “You healed from a list of things over the last two years, Dani; why do you say NOW is your time to heal?” Sure. It has been a long two years, with many, many things to heal from. And obvious physical things: IV chemotherapy, immunotherapy, procedures, hospitalizations, surgery, radiation, oral chemo. But I did not and still do not consider that I was healing after any of those things. Let me explain. While I was undergoing a long course of radiation, it got to the point where my skin was falling off, like in small chunks in the shower. Sure the skin started to grow back and the colors lightened and lightened, but at no time while crying over what was left on the shower floor did I feel like, “Wow, look at that, I am healing!” IV chemo, immunotherapy, and oral chemo (well, what I was able to tolerate before my liver caused a quick stop) destroyed many things in my body, and I am now in the process of seeing a myriad of doctors to try to fix as much of that as I can, so did I see myself healing from that? Nope. But now, as I pass my two-year mark of my diagnosis date and have had my port removed, I see this beautiful bruising changing each day and say, “It is now finally, FINALLY, my time to HEAL.” Read More: Cancer Sucks, and That’s Okay Moving forward but not moving on… Once a Patient, Always a Patient On the Podcast: Breast Cancer Conversations 11 Years of Survivorship: A Breast Cancer Survivor’s Story Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

By Brookshire McDonald I thought I didn’t have words for a poem But found out I was wrong. That would have been true If I were writing a song. The “Write a Poem Month” Is now upon us; So with pen in hand I’ll begin Without a fuss. SBC has grown rapidly As the years passed by. Now it’s time to reveal Just exactly why. William and Laura had a dream They wanted to come true, So they embraced many avenues For me and for you. Their plan expanded Along the way Until it overflowed As recently as today. Thousands have a brighter future As they wasted not a second to spare. Through education, support groups, and advocating They did share. Everyone has gained much hope To which to cling As additional support They did bring. So to “April is Write a Poem Month” I would like to add Words of happiness That have made us glad. A “Celebration Day” to include A “Thank You” too For the works you’ve done To make your dreams come true. “Thank you” for your time, your talents, And your vision for all The dream you had for sure Was very tall. William and Laura I’d like to call this A “Day of Honor” for each of you As we’ve been witness To your dreams coming true. For those whose lives Have benefited from it, We send continued wishes And love that will never quit. Brookshire McDonald, Patron Saint For April 26, 2024 SBC “Write a Poem Month” Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

By Mandy Richardson My diagnosis came as a shock, as I think it does for many people. I was still young. I was actively breastfeeding. And I was relatively healthy. I remember, a couple of times, being told by someone that they wished they could take the cancer for me. As moving as that sentiment was, I didn’t wish that. 1. I wouldn’t wish a cancer diagnosis or treatment on my worst enemy. 2. I knew I was in what you could probably call the best position to fight and beat it. I had my “youth” and “health” going for me. And I think you could see that in how my body handled the chemo. I was tired. Very tired. But I didn’t get physically sick, or have the joint pain that so often goes along with Adriamycin/Cytoxan (AC) chemo. But I also knew a little bit about fighting, and advocating for myself. My self-advocacy started before my cancer diagnosis, when I was facing fertility challenges. When I couldn’t sustain a pregnancy, after two years, I asked to see a fertility specialist. At first, I was denied by my current OBGYN. While I was told the rule of thumb was to see a specialist if I couldn’t get pregnant within a year, I was simultaneously told that didn’t apply to me because I COULD get pregnant, I just couldn’t sustain it. I called the office and told the receptionist to never schedule me with that doctor again, then requested an appointment with the office’s physician that usually handled infertility cases. He agreed to see me. Not long after that, after yet another miscarriage, I was with yet another doctor and asked about any connection between thyroid disorders and miscarriages. I was told that’s not likely. I hadn’t had my thyroid checked since before getting pregnant with my oldest, but I knew I had a family history of thyroid problems. I told him I had good insurance, and I wanted my bloodwork done. Sure enough, my thyroid-stimulating hormone (TSH) levels came back incredibly high. I started seeing a specialist at an actual infertility clinic, and my reproductive endocrinologist started me on medications for the first time ever to treat hypothyroidism. That story had a happy ending, and we welcomed our little rainbow baby in October 2020. Advocating for yourself is a lot like giving yourself grace. So often, we’re asked, would you talk to a friend going through something similar the same way you talked to yourself? It may, at times, be easy to see that a friend or relative needs to push for a second opinion, yet when it comes to ourselves, there are at least a dozen reasons we might tell ourselves not to. We’re too busy; we don’t have time for that. We trust our original doctors at their word. So-and-so had the “same thing” and was just fine. Sometimes we really just don’t want to know. Deep down, we know there’s a journey ahead and we’d rather stay off that road. But if a second opinion is only an “opinion,” that means that’s all the first was as well. Don’t accept an opinion. Make them give you the facts. And if they can’t, then they need to get them. This experience came into play later on during my breast cancer diagnosis and treatment. For more on this part of my story, check out my previous blog post: Breast Cancer at 33: A Young Mom’s Story of Self-Advocacy. I wouldn’t, in a million years, wish that someone else would go through my experience for me. It was a hard road, and certainly not one I ever want to travel again. But I fought, and I won, and I learned so much about my own strength and resilience in the process. While I would often joke that “my body hates me” or “my body tried to kill me,” it’s also gotten me through all of that stuff. I’d still rather be me. Check out Mandy’s other blog posts: Breast Cancer at 33: A Young Mom’s Story of Self-Advocacy Once a Patient, Always a Patient Read More: Breast Cancer in Young Women: Common Questions Answered The Role of Hormones in Breast Cancer Why A Second Opinion Matters for Breast Cancer On the Podcast: Breast Cancer Conversations Young and Diagnosed: A Journey to Motherhood & Parenting with Triple Positive Breast Cancer Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

By Jacqueline Edwards You came in uninvited You never took the time to introduce yourself Even when another stranger announced you You took it upon yourself to be silent As I moved forward as instructed I was not sure you were still there But I trusted the strangers who guided me on how to extract you from my fears My life became chaos while you made my health unclear You came in uninvited So I knew you couldn’t stay here So I prayed for your departure while I took the meds that dared To rid you from my presence despite the dramatic wear and tear it would take to distract you so you’d no longer reside here You came in uninvited That was very clear, but what I never understood was how you got here Which means you weren’t invited so get out of here. Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

Receiving a breast cancer diagnosis can evoke a complex array of emotions. Initially, you may feel shock and disbelief. Those feelings can quickly give way to fear and anxiety, sadness or grief, anger and frustration. It can seem unfair and have you questioning, “Why me?” In addition to the mix of emotions, you’re also trying to absorb mind-boggling mountains of information. The combination of emotions, urgency, and the perceived authority of medical professionals cause many people to feel locked into the first opinion they receive, making them reluctant to seek a second opinion, either due to emotional distress, financial concerns, or the fear of offending their doctor. Some people may hesitate to seek a second opinion or discuss their diagnosis with another doctor, fearing it might upset or offend their current physician. It’s important to understand that feeling uncertain and wanting reassurance through additional consultations is completely normal and essential to managing your healthcare. For example, you might express your concern by asking your doctor, “Is it alright if I consult another specialist to get a second opinion on my treatment options?” Most doctors will respond positively to such questions, affirming that seeking a second opinion is prudent and can help ensure the best treatment plan. They might say, “Absolutely, getting a second opinion can provide additional perspectives that might be beneficial, and I can recommend specialists who have experience in this area.” Medical professionals generally encourage seeking a second opinion and view them as a standard part of medical care, especially for significant diagnoses like cancer. You should feel empowered to pursue all avenues to help you feel more confident and informed about your treatment decisions. Breast cancer is a complex disease with various treatment options, each with risks and benefits. Different specialists might have varying experiences and expertise, which can lead to alternative insights or treatment approaches. The process can provide reassurance, confirm a diagnosis, and help you understand the full range of treatment options available. A second perspective can offer reassurance about your diagnosis and treatment plan or reveal alternative options previously unknown. Continue reading to learn about the importance of obtaining a second opinion regarding a breast cancer diagnosis, illustrating how it’s not just beneficial but essential for comprehensive care. You will also learn about how to get started seeking a second opinion. Remember, it’s your health and your decision; seeking clarity and comfort through additional expert advice is a proactive step toward your well-being. The Initial Diagnosis An initial diagnosis of breast cancer typically involves a combination of clinical examinations and diagnostic tests. The process usually begins when an individual or a healthcare provider identifies symptoms, such as a lump in the breast or a change in breast shape or texture. A healthcare professional performs a clinical breast exam to check for lumps or other physical changes. If there is a lump or significant concern based on the initial examination, your healthcare team may recommend imaging tests like mammography, ultrasound, or magnetic resonance imaging (MRI). These imaging techniques help visualize the breast’s internal structure and identify abnormalities. If these tests indicate the presence of potential cancer, a biopsy is usually the next step. During a biopsy, a small tissue sample from the suspicious area is removed and examined under a microscope to check for cancer cells. The biopsy is a critical component of the diagnosis, as it confirms whether the abnormality is cancerous and, if so, determines the specific type and characteristics of the breast cancer. The information is crucial for planning appropriate treatment. The diagnosis process may also include additional tests to assess your overall health and check for signs of cancer spread. Why a Second Opinion Matters According to BreastCancer.org, up to 40% of breast cancer patients had a change in their diagnosis when they sought a second opinion. Reasons why a second opinion is so valuable include: Confirming your diagnosis and treatment plan: A second perspective can provide reassurance that you’re on the best possible path. Discovering alternative treatment options: Doctors at different facilities may be aware of emerging therapies you and others don’t know about. They may also have different experiences and perspectives on treatment options, offering a broader range of choices. Improving your chance for clinical trials: Consulting another specialist can improve your odds of learning about potentially beneficial clinical trials. Gaining peace of mind: Another opinion can give you confidence in your diagnosis and treatment plan, relieving stress. How To Seek A Second Opinion Seeking a second opinion for breast cancer is an essential step that can provide additional insights into your diagnosis and treatment options, empowering you to make more informed decisions about your care. Consult your primary doctor: Your doctor can refer you to another specialist. Look for specialists: Consider experts with extensive experience treating breast cancer, particularly those involved in research and teaching. When you meet the new specialist, ask questions about their treatment approach, the potential benefits and risks, and any alternative treatments they might suggest. Prepare your medical records: Ensure you have all your medical reports, scans, and test results to help avoid unnecessary repeat tests and provide a comprehensive view of your condition. Count On Us for Information, Resources, and Support When facing something as serious as breast cancer, it pays to gather as much expert knowledge as possible to make the most informed decisions about your health. Don’t hesitate to consult another doctor for a second (or third or fourth) opinion until all your questions are fully answered. 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 to offer resources and support every day, every month, and every year. Note: This article is designed to provide general information and not replace professional medical advice. Always discuss your options with your healthcare provider. Learn More: Understanding Your Pathology Report: A Comprehensive Step-By-Step Guide Different Types of Breast Cancer Breast Cancer in Young Women: Common Questions Answered The Role of Hormones in Breast Cancer On the Podcast: Breast Cancer Conversations Understanding and Coping with Medical PTSD in Cancer Care SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

By Jerilyn Young My body is a vessel Navigating ocean waves Pushing Pulling Flowing sensations of unknown Preparing for rough seas ahead No land in sight No anchor to drop I must become the waves ~ Living in their movement Their swells Their surges I pray to rest in the breeze of their ripples Washing away the internal sludge Only to be morphed back into the surf Rising Falling Embracing the current I become a wavelet ~ Gently tossed to shore I feel my hands grasp tightly What wasn’t there Solid ground My existence About Jerilyn: I was diagnosed with triple negative breast cancer (TNBC) in April 2022. I wrote this poem in the throes of my chemo treatment in the summer of 2022. I took this photo the year before I was diagnosed. Little did I know how symbolic that picture became. Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

By Joanna Kreisel I thought I couldn’t bear any more Then I expand Time slips away, slowly Awake with grief I dig deeper, heart heavy Mine, scars His, wounds Lean on me, I will take you through I tighten my grip, but it continues to take A strength stronger than before I wish I didn’t need to be Moments of deep despair We share tears You are home, where I need to be I am yours I long for before or after But there is only now About Joanna: I am a breast cancer survivor and caregiver to my partner who is undergoing treatment for a rare kidney cancer. Connect with Joanna on Instagram Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

By Dania Francis Read Dania’s breast cancer story: Thoughts on October: Breast Cancer “All Too Aware” Month Every morning for 5 weeks. I park my car, walk down the long path, check in while patients much older than me can’t help but stare, and I smile as I stick out my right wrist to get my ID band placed by the nice front desk staff. I walk down the hall. The first day I was a bit lost with each turn, but now I know exactly where to go. I find my locker, lucky number 23, and I grab my XXL gown and get changed. I take the same seat every morning and look around the waiting room. Some women are reading, some are there for the first time, and some are almost done. I smile at whoever is looking, and make a connection. A 41-year-old woman just like me with the same diagnosis of triple negative breast cancer (TNBC), she’s from Italy originally and has a beautiful accent. We talk about our Italian culture and how hard this has all been. We exchange numbers and offer each other comfort and good wishes for the day. We are on the same schedule and will end our radiation within two days of one another. She is struggling with knee pain from immunotherapy and I offer her some advice to talk to her doctor about. A 35-year-old woman is holding a big tub of chocolate biscotti to give to the radiation team, because she heard that’s what you should do. I tell her I’m a nurse and that we always appreciate that. We smile at each other and I learn that she is halfway through her treatment for triple positive breast cancer. I wish her luck as the tech calls my name. An 85-year-old woman is here for her first day of treatment for HR+ breast cancer. She is nervous and unsteady on her feet. Her daughter comes back with her to help her get into her gown. She sits down next to me. I smile at her and tell her everything will be okay. She smiles at me and I can tell she feels sorry I am so young. She reaches her hand to my arm and squeezes gently. The tech calls her name and I wish her luck. I look forward to seeing her tomorrow. I only have five more mornings in this waiting room after today... and I will remember the connections I made forever. Maybe it’s the nurse in me, or the desire to connect with others on this path. The waiting room is a special place for me. About the author: Dania is 41 and lives in NY with her husband and two small children. She is a Family Nurse Practitioner, Yoga teacher, and certified Reiki healer. She is a stage 2 Triple Negative Breast Cancer Thriver. Read More: Thoughts on October: Breast Cancer “All Too Aware” Month Different Types of Breast Cancer Breast Cancer in Young Women: Common Questions Answered On the Podcast: Breast Cancer Conversations Radiation Therapy: What Every Breast Cancer Thriver Needs To Know Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

By Olivia Smith Content warning: death and dying Read part 1 of Olivia’s story: The Last Thing I Told My Mom Was a Lie (Part 1) My sister met me in South Carolina and we drove with my 2-month-old puppy down to Florida, stopping for the night along the way. The time is still such a fog; it seemed so quick, and it felt like I was moving through a vat of honey all at once, almost as if life was happening to me and I wasn’t in my body. I was terrified to get there and see how she looked. Before this round of cancer, she was always very fit and healthy, enjoying the gym. For much of her life, she was ripped. Over the past 11 months, she had shrunk over 3 inches from the tumors along her spine and compression fractures from the cancer. She was a bit hunched over and had lost a lot of weight. She refused to look at herself in the mirror, which broke my heart. She was beautiful, but had spent her 56 years on this Earth having a bad relationship with her body, including eating disorders. The changes the cancer made to her body exacerbated her low body image and this was a big struggle for her. On my previous trip down, two weeks prior, her weight loss and new height were pretty evident. But it was still a shock to see her only two weeks later, so very frail and her complexion looking a grayish yellow. She came outside to see us, so excited we were there, and my stomach dropped seeing the changes, making it feel real. I tried to mask the shock from my face so she wouldn’t notice. As our mom, she was already more afraid of the effect her death would have on her daughters than her fear of death itself. The next few days passed in a blur; the hospice care team finally came to do an intake on Friday. By then, my mom’s speech was a bit slurred. She also left with her husband Friday to complete her will. In her 11 months with this cancer, she had yet to do that until the last possible minute. I spent the days with her and my sister while she was awake, playing with my puppy while trying to keep his high energy from bothering my mom. We tried our best to make her laugh, keep her comfortable, and be there for her, but we had no clue how much longer she had left. I spent the nights sobbing on the floor in their bathroom by myself before I took a shower. I was so afraid of what was to come and how I could survive it. I tried to keep my pain and fear to myself, even though we were all experiencing it. That Saturday, my sister and I were lying by my mom’s pool while she rested, and I decided to read the hospice pamphlet. The back of it had signs of coming death to look for, grouping it by how soon death was to be anticipated. One sign that meant death was coming very quickly was swelling and discoloration of the feet and ankles. Later that day, I noticed that her feet and ankles were swollen and discolored. I looked at my sister and asked if she’d read that pamphlet. “Yup,” she said. “Did you see Mom’s feet?” I asked. “Yup,” she said. And we just nodded and sighed, knowing it was coming soon. This was all happening in August, but we were thinking ahead to Thanksgiving, as it was my mom’s favorite holiday. We had planned to go down that Thanksgiving to spend it with her in case it was her last, and to celebrate my sister’s master’s degree graduation, but we didn’t make it. At the suggestion of one of my best friends, we decided we would do Thanksgiving for my mom that Sunday and invited a few close people to celebrate with her. By the time Sunday came, my mom was barely leaving the hospice bed, except to try to use the restroom. That morning, my mom’s husband told us that she told him she didn’t know how much time she had left, and we took it as a sign of goodbye. Later, my mom asked for my sister and me. She told us she loved us very much and was proud of us. We then knew she was definitely saying goodbye. I asked her if she was scared, hoping she would tell me no and that she was at peace and ready to go to set my mind at ease. But she wasn’t. She barely got the words out, “Yes, I’m scared,” and it broke my heart. I hugged her and tried to keep myself together. Just as my step sister and family friends were arriving, I left her room and cried while mashing potatoes for Thanksgiving dinner. I wasn’t ready for this. My mom wasn’t well enough to sit and eat with us. Right before dinner, she had her first hospice nurse visit. The nurse told us she was at the five-day or less timeline, gave us some emergency medicine, and gave my mom an anxiety and pain pill. We sat down and tried to enjoy Thanksgiving dinner with the door from my mom's room open right next to us. She started groaning while we ate, and one of us at a time would go in and sit with her. Just before dessert, my sister called for me to come in. “It’s time,” she said. I stood by my mom, brushing her hair with my hand and telling her I loved her. I kissed her forehead while she groaned and cried when I felt her cool skin, knowing it really was coming. I had to get a chair to sit on because I was shaking. My step brother was supposed to be leaving for the airport but couldn’t because my mom was actively dying. We all sat around her for what felt like hours as she groaned and moaned, and her breathing slowed. We all lied to her, telling her it’s okay, she could let go, and we would be okay. My sister and I told her she raised us well and we would be okay without her, but even I didn’t believe myself. I didn’t want to say those lies; she taught me not to lie. “Honesty is the best policy,” she had said, but I had to lie to let her go, to get out of pain. I had watched my mom suffer for 11 months, and I couldn’t ask her to suffer for one more moment. It wasn’t okay, though. I didn’t believe I would be okay. At one point, she groaned, “Help me.” I lost it and started sobbing; my big sister motioned to my step brother and pointed to me as if to say, “Take care of her.” He immediately stepped over and hugged me, and I spent the rest of the time she was dying sobbing into his stomach. What do you do when your dying mother says “Help me” and you can’t? That was the most painful part of all for me. I had never watched anyone die before; I wasn’t prepared. My only expectation was seeing “so-and-so died peacefully surrounded by family” in obituaries. But this was far from peaceful; she cried for help! Would she be okay? Would she find peace? As someone who doesn’t handle not having all of the answers well, this tore me apart. After a painful 11 months with cancer, I just needed to know she was at peace and out of pain at the end, and I didn’t know how to trust that after watching her painful death. Her breathing continued to slow, and eventually her groaning became quieter and quieter. Her husband noticed she had wet herself and asked us to change her. We moved her body from the hospice bed to her bed. My sister and I helped take off her nightgown while my step sister cleaned the hospice bed and got new sheets. We moved her back, covering her dying, naked body with a blanket. Soon after that, her breathing stopped altogether. She was gone. We said goodbye, and we all left the room, calling our partners and trying to process the news. I spent the majority of that evening crying. My sister and step sister went back into the room after calling the funeral home to come pick up her body. They let her dogs sniff her dead body so they would know what happened. Together, they picked out an outfit and shoes to dress my mom in so she could look beautiful and have dignity as her body was cremated. My sister even applied my mom’s favorite beauty item, mascara, to her eyelashes. I am forever grateful my sister could do this for my mom. I wasn’t strong enough to see her again. I stayed outside when they came to remove her body, too. I couldn’t take seeing her lifeless body another time. That evening, after she was gone, all of us kids spent time in her pool, laughing and crying over memories of her. She was gone. I still didn’t know how I would move on, how I would forget the feeling of her cool skin, forget the lies I told her, forget her last words begging for help. It’s been six months now, and although I get flashbacks and nightmares about her death less frequently, they still come. I don’t know if they’ll ever go away. The pain it brings me is hard to explain. I wish I could take away her pain, take away her death. Sometimes, I forget she’s not still alive and well in Florida, riding on a motorcycle and enjoying the warm weather. I still don’t know how to get over a lot of it. Sometimes my brain can’t comprehend that it happened, even though I watched the life leave her pale cold body that was once a strong, warm place to seek safety. Sometimes I have a thought cross my brain of a question I need to ask her, or something funny to tell her before I realize that’s not possible, and the pain comes flooding back again. I have to constantly re-remember that she’s dead, that this is real life and not some terrible nightmare I will wake from, which oftentimes means reliving her suffering and death. Sometimes my sister and I are forced to relive her death through nightmares and spend the next day in a fog. But I’m in therapy to process it, and the waves of grief come less and less frequently. And sometimes I can remember fond moments with her now, and make fun of her annoying tendencies with my sister. Sometimes we also make other people uncomfortable with dark humor, and sometimes we eat what we call “dead mom cheesecake” and mope. Dead mom cheesecake got its name from my sister. One day at work, shortly after our mom died, one of her coworkers brought in a cheesecake that their wife had made for my sister. My sister was tired of people being awkward about our mom’s death and not knowing how to act around her. So, when she took the cheesecake out to eat it, she asked everyone if they would like to eat some “dead mom cheesecake” with her. Her dark humor worked and broke the ice with her coworkers, putting them at ease. They felt more comfortable around her and enjoyed “dead mom cheesecake” with her. Using dark humor may not be for everyone, but it has been a coping mechanism my sister and I appreciate. Sometimes it makes others uncomfortable, but sometimes it can help break the ice to put people at ease. When it’s just her and I, it can help make things more bearable and allow us to laugh alongside the pain. Nothing could’ve prepared me for my mom dying. But it wasn’t until I read a memoir about a woman who lost her mom to cancer, who said her mom’s last word was “pain” that I felt seen and like I wasn’t alone in experiencing such a painful death. It felt comforting to know that my mom wasn’t alone, that maybe it was more common than I thought. That maybe she is okay now somewhere, playing with my childhood dog and looking after me in another way. People don’t talk about death often; it’s not a fun thing. I often feel isolated by it, wishing people would talk about her more, even if it brings up some sad feelings. It feels good to talk about her, to remember her, that she mattered. Death is inevitable for all of us. Through her death, I have found a passion for advocating and fundraising for breast cancer organization funding and research. I dream of a world where nobody will have to experience what my mom did. Where no loved ones will have to experience what my sister and I did. I have been hesitant to talk much about her death, for many reasons. It isn’t easy to talk about. I wrote most of this in tears, having to relive a really traumatizing experience. Talking about death makes most people uncomfortable, and who likes to make people uncomfortable? Also, since being more involved in the breast cancer community, I see so many stories of hope and beating the odds. So many women working so incredibly hard to rid their bodies of cancer, like the one that killed my mom. Those stories bring me and so many others such a heart-warming sense of hope and happiness. I am afraid to share my experience with her death because I don’t want to bring fear to anyone experiencing breast cancer. Everyone’s cancer experience is unique, and thankfully many don’t end in death. There have been so many advancements in the last decade, improving statistics. However, death is the one thing that is guaranteed in life, we will all experience it at some point, hopefully in a more peaceful way than my mom did. Sharing my experience isn’t easy. I’d prefer to keep it to myself and shield people from the harsh death we witnessed. However, the more people I’ve shared my experience with, the more I’ve felt not alone. I’ve heard others suffering quietly in their own bubble, afraid to talk about what they saw. Writing it down and sharing it has helped me, and if this brings at least one person some comfort and to feel a little less alone, then it was worth the pain that came with writing this. My sister and I did what we could to bring our mom comfort when her time came, even though it caused us pain, including telling her one last lie. I can only hope that the lie brought her some peace in her last moments and that she’s proud of us and who we are becoming in her absence. If you are searching for someone who understands or have questions, feel free to reach out to me at @gingers_breasties on Instagram or at gingers.breasties@gmail.com. Read More: Navigating Grief: Understanding the Stages of Loss and Healing Breaking the Silence on End-of-Life: What is a Death Doula? Newly Diagnosed with Metastatic Breast Cancer Living with MBC Metastatic Breast Cancer: Understanding the Significance of Stage IV Supporting Loved Ones with Breast Cancer: How to Offer Meaningful Help Thursday Night Support Groups On the Podcast: Breast Cancer Conversations Breaking the Silence on End-of-Life Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

By Lourdes D. Heras These six-letter dreadful words I hear In solitude’s embrace, in the shadow of darkness, I battle unseen, unheard. Cancer you said? This cruel touch, a relentless and silent one, has come into my temple. Starting today after hearing the word, my nights and days are devoid of light, my heart, my heart, my mind. I wage a war, obscured from sight. No hand to hold, no comforting embrace, no I love you, No WE will beat this fight or be OK. All I hear... is just whispered prayers in this empty space. In the depths of isolation, many fears in silence cross my mind. I dare not say, I dare not think of what it would be if … I pick myself up and fight. I love ME, I love YOU body. In solitude, I become a soldier in the darkest of nights, keeping watch. You will be okay, I promise that! Albeit, the endless nights, I walk this path alone. My voice still echoes, a quiet drone. You will be okay, I promise that! For in my struggle, I raise a plea, a cry for awareness, for all to see. Again, can you see, can you please comfort me? In this solitude, I scream and cry inside my mind. All I need is a listening ear, a shoulder to cry on. Nothing more, nothing less. Someone to tell me: You will be okay! In the absence of you, my voice echoes, a quiet drone. You will be okay, I promise that! Cancer knows no boundaries, one in eight; it strikes without warning, fulfilling its cruel greed. So let us stand united, hand in hand, to fight this foe, to make a stand. No one deserves to be in solitude. Finally, I am not alone. SBC brings forth the light. That gentle touch, that love you yearn for, an ear that listens and gives bear hugs. For in solidarity, we find our strength and together, we will go to any length. You will be okay, I promise that! As for you Yes, YOU If these cruel six-letter words strike your beloved, be the love, the warm and light in the darkness. Whisper these words: You will be okay, WE will be okay – I got your back! Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

By Brookshire McDonald After the death of my husband in 1996, I waited the suggested year and moved from Mandeville, Louisiana to my birth city of Raleigh, N.C. Two of my five children had asked if they could get married, and I replied, “If I’m not moving the week of your weddings!” Back in Raleigh, I fell from a ladder while hanging wreaths outside on my windows. Who would have thought my rescuer would be an exterminator who kills bugs and fleas! I had emergency surgery on my shattered knee, followed by a second and third surgery, a blood clot, and a month in a nursing home followed by six months of live-in care at home. I was due for a mammogram, but was told it could not be performed in a wheelchair (which was false). When I finally could stand, I had my mammogram and was called to their office during their lunch hour. The nurse, seeing me on crutches, blurted, “Oh, you have that, too!” The doctor verified I had breast cancer. I was denied a double mastectomy, and instead had a single mastectomy. My surgeon informed me if my lymph nodes were clear, I would not need chemo. My oncologist did order chemo after seeing the pathology report. The pathology report showed that my cancer was estrogen negative, progesterone positive, and HER2/neu positive. I always thought he prescribed chemo because of that, but I never really knew. Two years to the day later, I was diagnosed with breast cancer in the remaining breast. I changed surgeons and had my second mastectomy, followed by treatment with an aromatase inhibitor for five years. As a widow, I hated to part with my 36 DD, which I thought was my only asset! I later found many new assets! Experiencing humor along my journey was MOST helpful! Examples: My grandson yelling to his older brother after seeing my wig in my hand, “Come quick, GeeGee has just take-ed her hair right off the top of her head!” Poking a hole in my post-surgery drain while pinning it to my gown and having to call my doctor at 10:30 p.m., receiving instructions to DUCT TAPE it! Another survivor saying she didn’t want implants because she would rather put her prosthesis on the shelf at night and opt for a different size every morning! I had two mastectomies, reconstruction, areola tattoos, a hysterectomy, hip replacement, and three surgeries on my knee: 10 surgeries in nine years. Keep moving forward and explore new interests. Mine were performing hearing tests on newborns, signing (not singing!) the national anthem at the Miracle League baseball games for special needs children, and involvement with adult day care. Find humor on your journey, be your own advocate and follow your heart. On August 8, 2024 I will celebrate 20 years of Thrivership! P.S. AFTER being diagnosed, I discovered I had five aunts who had breast cancer, but the “C” word was never said back then. My cancers were two primaries, and my middle daughter was diagnosed during the Covid-19 pandemic with lobular breast cancer. Each of us was negative for the BRCA gene mutation. I love my sisters I’ve gained (even though my mother said I would never have a sister), and wish each of you well. Love and hugs, Your Patron Saint Read More: Different Types of Breast Cancer Understanding Your Pathology Report: A Comprehensive Step-By-Step Guide Understanding Genetic Testing for BRCA1 and BRCA2 Mutations On the Podcast: Breast Cancer Conversations Granting Wishes Brings Joy with Elesha Snyder & Jan Hillman Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

(my tiny love story) By Sara Kandler Unpacking the shopping bag from Marshalls, my husband sits a chrome cruet on our kitchen countertop. He has a thing for olive oil. Its bold ticket — marked “Oil Can” — tickles me. “Let’s see how much American culture you’ve assimilated over the years!” I tease, and grab the oil can, stiffen my body, grit my teeth and screech, “Oil can, oil can…” “Wizard of Oz!” he shouts, proudly. I also know a thing or two about his homeland, like how first cold press is an absolute must, and the age-old olive trees shimmer like silvery fish on the breezy hills above Fez. Connect with Sara: https://medium.com/@sarakandler Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

By Olivia Smith Content warning: death and dying “I have some news to share with you girls. I went to the doctor because I have been having concerns with my breast. I found out that I have inflammatory breast cancer. I don’t have all of the details yet, but I know it’s a very aggressive cancer, but I’m going to fight it. This isn’t a death sentence.” – Michelle “Ginger” Griswold, 11 months before she passed. My mom and I didn’t have a perfect relationship. She did a lot of things that stressed me out, made me upset, annoyed me, and, frankly, hurt me. But I loved her; she was my one and only mom, and although we didn’t get along perfectly, she was a good person with a lot of love to give. I spent the last 11 months of her life taking time from work and visiting her when I could. I tried to push past the moments she upset me or stressed me out, and instead spend time working to understand her more and accept her for who she was. We’re all flawed individuals trying to enjoy this thing called life while we have the privilege to. I knew time was fleeting with her now more than ever, and we truly made some memories that year that I will cherish forever. One of my favorites was when I extended a work trip to Orlando and surprised her with a stay at the Princess Castle Hotel. When she heard I was going to Orlando for work, she mentioned how she hadn’t been yet and had always wanted to—my mom’s way of telling me it would really be cool if we explored Orlando together. We walked around Disney Springs while she had the energy, her with a margarita in hand, enjoying the scenery. We just spent the weekend exploring and hanging out together, just the two of us, and it became some of my favorite moments of that year, being able to provide her with love, support, laughter, and new experiences. Ever since the day my mom told us she had cancer on the phone, my sister Stephanie and I both get anxious when anyone asks us to jump on a three-way call. We had to take many more three-way calls together in the following 11 months, none of them with good news. The purpose of this piece isn’t to document those 11 months but to talk about the last month. This wasn’t our mom’s first experience with cancer. She had stage 1 invasive ductal carcinoma about seven years prior and had been in remission, doing well. This wasn’t our first cancer rodeo. Of course I understood it was a much more aggressive and severe cancer, but why should the outcome be any different? We would fight it, and she would be okay, just like last time. For my mom, that diagnosis did end up being a death sentence. One that came much sooner than any of us had prepared or hoped for, with a lot of highs and extreme lows throughout. The last three-way call we were on with our mom, she told us from the oncology hospital that she wasn’t responding to the third round of treatment that they had hoped would be a miracle drug for her, after she quickly stopped responding to the first two treatment plans. I remember sitting at a red light while receiving this call, feeling like the wind was knocked out of me while feeling numb in the same instant. After an agonizing 11 months with metastatic breast cancer, she had told me a few weeks prior that if this treatment didn’t work, she didn’t think she wanted to put her body or mind through any more. As tough as it was to hear, my sister and I assured her we supported whatever she chose for her body and her quality of life. As much as I selfishly wanted her to try everything and stay with us as long as she could, I respected her decision and could never ask her to suffer longer for us. The following day, I decided to stay home from a work trip I had been planning and looking forward to all year, as we still didn’t have a full picture of what my mom’s newest health update meant. We knew it didn’t look good, but we still had no timeline. I felt dramatic for canceling because my mom was in the hospital and not doing well. It wasn’t like she was going to die that day, so why did I cancel this work trip that was important to me? Thankfully, I had a wonderful boss who allowed me to have a flexible schedule while my mom was sick and spend as much time with her as I could when I wanted. However, I still carried that guilt for not showing up every day with 100% of myself that year. A few hours later, I was sitting on the couch in my living room when my mom attempted another three-way call with my sister and I. This time, my sister wasn’t able to answer immediately. When I answered, my mom was on the other end of the line crying and apologizing because there was nothing left they could do. “The cancer has almost completely destroyed my liver and other organs. I’m in 83% liver failure. I have days to weeks to months left. I’m going to go home with hospice; I’m so sorry,” my mom tearfully told me. “Don’t apologize, I will be there soon,” I said. I sat on the couch in shock, fear, anger, and disbelief. I knew this outcome was possible, I had googled all the statistics. I knew this day would come eventually, breast cancer or not, but I thought we had so much more time together. The 5-year life expectancy of her cancer was 19%. My mind believed that she was so strong, always had been so strong, she would be one of those 19%, she had to be. And if she wasn’t part of that 19%, well then surely we would at least have close to another five years after diagnosis, right? I live near Charlotte, NC and my sister was living in Roanoke, VA from the time my mom was diagnosed until her death. I called my sister and we made arrangements to visit our mom. I sobbed into my husband’s arms when he came home from work. I cuddled my dog. I booked hotels for my sister and me to stay in on our way down and back up, splitting up the long drive, hoping she wouldn’t die on that trip. Partially because I still hoped she’d defy the odds, that they were wrong, she had more time, the medicine just needed a few more days to kick in. And partly, selfishly, because I didn’t want to watch her die. How could I possibly handle watching the woman who brought me onto this earth leave it? How could I ever manage that and be okay afterward? How could I watch my mom take her last breath? We hadn’t even really discussed her death yet, and what she wanted. She told my sister what she wanted for a funeral, but that was it. She hadn’t signed a will yet, hadn’t told me what she wanted from me. We hadn’t had those conversations I wanted to have, knowing I forgive her for the things she carried guilt for throughout her time as my mother. I wasn’t ready for those conversations yet, and I didn’t feel like bringing them up. I told myself I was giving her the space to talk to me about it when she was ready. But in reality, I was afraid to have those conversations with her because that meant the end was inevitable. Continue Reading: The Last Thing I Told My Mom Was a Lie (Part 2) Read More: Newly Diagnosed with Metastatic Breast Cancer Living with MBC Metastatic Breast Cancer: Understanding the Significance of Stage IV Breaking the Silence on End-of-Life: What is a Death Doula? Supporting Loved Ones with Breast Cancer: How to Offer Meaningful Help Thursday Night Support Groups On the Podcast: Breast Cancer Conversations A Caregivers Guide to Cancer Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

By Brookshire McDonald, “Patron Saint” SurvivingBreastCancer.org has enabled us To become friends really fast. My hope is that all our friendships Will last and last. Our boobs have brought us together As our stories we do share Over states and even countries We come from almost everywhere. Boobs of ours Measured A, B, C, or D; And one of you even claimed To have been a G! Plastic surgeons try to match them up The best they can do. Mine don’t match at all; I don’t know about you. With a breast cancer diagnosis Many options come your way — Lumpectomy, mastectomy, reconstruction, tattoos Or flat to stay. Having fallen from a ladder My journey did endure Three leg surgeries, a blood clot, then two primary breast cancers And many prayers for sure. I admire each of you As through breast cancer you go. Your struggles, courage, and strengths Really do show. On top of that road You are traveling today COVID-19 has thrown A wrench into play. Dealing with just one issue Was a master feat. Each of you now Has additional obstacles to beat. I can laugh with you, And I can cry with you But I can’t really imagine All you’re going through. As you travel this journey — Not a choice you did choose, You are reaffirming my faith That I didn’t lose. You awakened my awareness Of how blessed I have been; And to have you as my cancer sisters Has introduced a special kin. You may not realize it As your journey you do fight, But each positive gesture of yours Brings to someone a promising light. Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

By Trudy Trybulski In 2016, I was 63 and not long retired. I noticed a change in the shape of my left breast and went to see my doctor, who quickly referred me to the hospital where I had a mammogram and biopsy. Three weeks later, it was confirmed that I had breast cancer. Tissue samples showed I had stage 3, grade 3 invasive ductal carcinoma (breast cancer). I received the treatment that goes along with this sort of diagnosis: lumpectomy, three cycles of FEC (fluorouracil, epirubicin hydrochloride, and cyclophosphamide) chemotherapy, three cycles of docetaxel chemotherapy,  three weeks of radiotherapy, Herceptin targeted therapy, and letrozole hormone therapy. I began to walk about the hospitals like a professional cancer patient. Five years later, in 2021, I was diagnosed with a recurrence of the same cancer in the same breast which was also stage 3, grade 3. My oncologist recommended a left breast mastectomy, but I made a case to have a double mastectomy as I knew I would not cope very well with one large breast. I turned down chemotherapy and Herceptin, but agreed to zoledronic acid infusions and letrozole following the double mastectomy. I have no regrets at all about the double mastectomy. I knew that mentally I would not cope well with one breast, implants, or any reconstruction. Three years post-mastectomy, I have an amazing tattoo covering my missing breasts and scars. I’d never had a tattoo before. At age 70 I am now converted and love my new upper body. It has given me confidence and joy. I designed the tattoo myself working alongside an amazing tattooist. He created something inspiring that tells a unique story about the threads of my life. My experience with cancer has actually enhanced my life. I’ve made changes to who I live with, developing my own home into a safe peaceful sanctuary. I have surrounded myself with amazing friends and neighbors. My family supported me, but also we have developed our already strong and caring relationship, I would say with a deeper love and understanding of our importance to each other. I have left people on the wayside too, people who wanted to drain my positivity or offered me more stress. I am currently struggling with the side effects of the drugs, particularly letrozole. It is having an effect on my joints and muscles. Constant pain is hard to live with, so it’s time to up my resistance. My plan is to get back into the gym and do more weight-bearing exercises. I want to get that feel-good factor back in my body. I’ve decided to let my hair grow, show off my tattoos, and let myself flourish—well that’s the plan, anyway! Luckily I love sports and swimming, but also chocolate and wine! Breast cancer or any cancer doesn’t have to mean the end of a fulfilling life. Yes, it can cause difficulties and tough endings for some. I suppose it’s about making the most of what you have and who you are, and celebrating the good things in your life. I know this sounds like a cliché, but as a person affected by cancer, I feel I have the right to say it. I’ve had many say to me things like, “You could get run over by a bus,” or, “We all have to die sometime.” These statements are really not helpful, because the bus is right in front of my face. I’ve learnt to understand the fear that others have around cancer, allowing them to voice that fear to me. As I watch the rain, typing this with my wrists aching from carpal tunnel syndrome, I wonder at the beauty of it. I’m looking forward to the spring and what delights that will bring. Read More: Exploring Breast Reconstruction Surgery: Pros and Cons Navigating Relationships After a Breast Cancer Diagnosis The Choice to Go Flat On the Podcast: Breast Cancer Conversations Building a Strong Relationship Between Patients and Their Medical Team Share your story, poetry, or art: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

By Jayita Chatterjee I learnt to live, I learnt to stay A voice inside me told me to pray To give thanks and stay the way, And not to think of what’s beyond today. When I was weak… each day was hard I could tell no days apart. My body was battered... it wept, it cried It wanted to break away and die. But my spirit held strong and wouldn't let me give up. The ravaged spirit wouldn’t give up. I despised how I wasn’t strong I felt I didn’t belong I needed help with little things I had to learn it wasn’t wrong. It wasn’t wrong, and I wasn’t weak It was a sign of respecting my new limits And loving myself enough to accept the treat. The treat that is the love of others… Who wanted to help and truly felt my needs. The body bore the trauma, but the spirit grew stronger. I hope to live... to live much longer. Those dark days when my mind would spiral On lonely nights and rage a storm Deep breaths and visions of happier days Would lift me up and bring me home. And so I gave thanks, and so I prayed. And I lived and I stayed. Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

How can we optimize anti-cancer therapies to ensure we are receiving the full potential of the drug without significantly compromising quality of life?  In the realm of cancer treatment, finding the right dose is paramount. It's a delicate balance between delivering enough medication to combat the disease effectively while minimizing adverse effects on the patient's overall health. Let's delve into the nuances of dosing in cancer therapy and explore how patients can be their best advocates when asking about dosage and how oncologists navigate this crucial aspect of treatment. Understanding Dose Selection In 2021, Stefanie Groenland and team published “The Right Dose: From Phase I to Clinical Practice” where they explored ways for optimizing the right dose. While drug labels will typically state what the maximum dose is, it may not be optimal for the specific patient, noting that the majority of patients may be receiving excessive doses of therapies which result in increased toxicity.  More recently, in the 2024 article, The Right Dose: Results of a Patient Advocate–Led Survey of Individuals With Metastatic Breast Cancer Regarding Treatment-Related Side Effects and Views About Dosage Assessment to Optimize Quality of Life researchers suggest that patient-physician discussions may facilitate the identification of the most favorable dose for each patient, and that the majority of patients would be receptive to this conversation. The process of determining the right dose for cancer treatment involves several key considerations and conversations between the patient and the medical physicians. Factors to consider include the type and stage of cancer, the one’s overall health and tolerance to medications, the specific drugs being used, and any previous treatments or therapies the patient has undergone. Oncologists rely on a combination of clinical guidelines, research data, and personalized assessments to tailor the dose to each individual's needs. Factors Influencing Dosing: Body Weight and Surface Area: In many cases, medications are dosed based on a patient's body weight or surface area to ensure optimal efficacy and safety. This approach helps account for variations in drug metabolism and distribution among different individuals. Kidney and Liver Function: The functioning of vital organs like the kidneys and liver plays a crucial role in drug clearance and metabolism. Oncologists may adjust doses accordingly for patients with impaired organ function to prevent toxicity or suboptimal treatment. Genetic Factors: Advances in pharmacogenomics have highlighted the impact of genetic variations on drug response. Genetic testing may inform dose adjustments or help identify patients who are more likely to benefit from certain medications. Adverse Effects: Monitoring and managing treatment-related side effects are essential in dose optimization. Adjustments may be necessary if patients experience significant toxicity or if initial doses are not well-tolerated. Treatment Goals: The intended goals of cancer treatment also influence dose selection. For curative intent, higher doses or combination therapies may be appropriate, whereas palliative care focuses on symptom management and quality of life with potentially lower doses. Side Effect History: Understanding how one has tolerated other drugs and if we can learn about a patient’s experience on a former line of treatment, it may help us to understand the possible side effects on the new drug. Tailoring Doses for Individual Patients Personalized medicine has revolutionized cancer care by allowing oncologists to tailor treatments to each patient's unique characteristics. This includes adjusting doses based on genetic markers, biomarkers indicating treatment response, and ongoing monitoring of patient outcomes. The goal is to work with the person to achieve the best possible therapeutic outcome while minimizing the risk of adverse effects. The Patient-Centered Dosing Initiative calls into question the practice of treating people living with metastatic breast cancer with the highest possible dose. Once a patient experiences significant side effects from breast cancer treatment, patients and their medical care team should have conversations around dosage. Perhaps there is an opportunity to lower the dose, or change the frequency of the treatment. After all, medicine is just as much of a science as it is an art. As research and technology continue to advance, the landscape of cancer dosing is expected to evolve further. Precision medicine, targeted therapies, and innovative drug delivery methods hold promise for refining dose selection and enhancing treatment outcomes. Collaboration among oncologists, researchers, and pharmaceutical companies remains crucial in driving these advancements and improving cancer care globally. Finding the right dose in cancer treatment requires a multidimensional approach that considers patient factors, treatment goals, and emerging scientific insights. By optimizing dosing strategies, oncologists strive to maximize the effectiveness of therapies while ensuring patient safety and quality of life. The ongoing pursuit of precision medicine heralds a future where customized cancer treatments based on individual needs become increasingly attainable.

By Mary Montefinese It came into my life; abrupt it was No, I didn’t invite it; it must leave It thinks it will interrupt; I’ll fight its flaws My strength, my resolve, I believe It will be cut off at its claws My design will be changed My look, my health; oh abrupt it will be It may take long but I’ll have VICTORY. Connect with Mary: Instagram https://themodernlifewithcancer.wordpress.com/ https://meagermodernpoetry.wordpress.com/ Share your poetry: https://www.survivingbreastcancer.org/submit-breast-cancer-story SurvivingBreastCancer.org Resources & Support: Podcast Weekly Meetups Free Events

By Laura Carfang What is Lymphedema? Lymphedema is a chronic condition characterized by the accumulation of lymph fluid in the tissues, leading to swelling, discomfort, and sometimes pain. It typically occurs when the lymphatic system is damaged or impaired, hindering the proper drainage of lymph fluid from the affected area. Understanding Lymph Fluid: Lymph fluid is a vital component of the lymphatic system, which plays a crucial role in the body's immune function. This fluid contains white blood cells called lymphocytes, which help fight infection and remove waste products from tissues. Lymph fluid circulates through a network of lymphatic vessels, filtering through lymph nodes, before returning to the bloodstream. Breast Cancer and Lymphedema: For individuals undergoing breast cancer treatment, such as surgery or radiation therapy, damage to the lymphatic system may occur. Lymph nodes may be removed or damaged during surgery, disrupting the natural flow of lymph fluid. Additionally, radiation therapy can cause scarring and inflammation in the lymphatic vessels, further impeding lymphatic drainage. Preventing Lymphedema: Those diagnosed with breast cancer can take proactive steps to reduce their risk of developing lymphedema. Some preventive measures include: Gentle Exercise: Engaging in low-impact exercises, such as walking or swimming, can promote lymphatic circulation without putting excessive strain on the affected area. Graduated Compression Garments: Wearing compression sleeves or garments can help support the lymphatic system and prevent fluid buildup. Skin Care: Practicing good skin hygiene and avoiding cuts, burns, or other injuries can reduce the risk of infection, which may exacerbate lymphedema. Avoiding Tight Clothing: Tight clothing or accessories, such as bras with underwire or tight jewelry, can restrict lymphatic flow and should be avoided. Managing Lymphedema: Despite preventive measures, some people may still develop lymphedema. If you experience symptoms such as swelling, heaviness, or tightness in the affected limb, it's essential to seek medical attention promptly. Treatment options for lymphedema may include: Manual Lymphatic Drainage (MLD): MLD is a specialized massage technique performed by trained therapists. It involves gentle, rhythmic movements that stimulate the lymphatic vessels, encouraging the drainage of excess fluid from the affected area. MLD can help alleviate swelling, improve circulation, and enhance the functioning of the lymphatic system. Compression Therapy: Compression therapy is a cornerstone of lymphedema management. It involves applying pressure to the affected limb through the use of compression garments, bandages, or wraps. Compression helps reduce swelling, prevents fluid buildup, and provides support to the tissues.. Compression garments come in various styles, sizes, and compression levels, ranging from light compression to high compression. It's essential to work with a qualified therapist or certified fitter to ensure that you get the right fit and compression level for your needs. Exercise Therapy: Exercise plays a crucial role in managing lymphedema by promoting lymphatic circulation and muscle movement. However, it's essential to engage in exercises that are safe and appropriate for your condition. A qualified physical therapist can develop a personalized exercise program that includes activities such as gentle stretching, strength training, and aerobic exercises. Skin Care: Proper skin care is essential for individuals with lymphedema to prevent infections and complications. This includes keeping the skin clean and moisturized, avoiding cuts and injuries, protecting the skin from sun exposure, and practicing good hygiene habits. Finding the Right Qualified Therapist: When seeking treatment for lymphedema, it's crucial to find a qualified therapist who specializes in lymphatic disorders. Here are some tips for finding the right therapist: Ask for Referrals: Seek recommendations from your healthcare provider, oncologist, or support groups for breast cancer survivors. They may be able to recommend experienced therapists in your area. Check Credentials: Look for therapists who have received specialized training and certification in lymphedema management. The National Lymphedema Network (NLN) and the Lymphology Association of North America (LANA) offer certification programs for lymphedema therapists. Research Experience: Inquire about the therapist's experience in treating lymphedema, particularly in breast cancer survivors. A therapist with extensive experience in this area will be better equipped to understand your unique needs and provide effective treatment. Schedule a Consultation: Before committing to treatment, schedule a consultation with the therapist to discuss your condition, treatment goals, and any concerns you may have. This will allow you to assess their expertise and determine if they are the right fit for you. (click to listen) Is Swimming Good for Managing Lymphedema? On a personal note, I have noticed that swimming laps has helped me to manage my lymphedema. Swimming can be beneficial for individuals with lymphedema, but it's essential to approach these activities with caution and to consult with a healthcare professional before starting any new exercise regimen. Swimming is particularly beneficial for me  for  several reasons: 1. Low-Impact Exercise: Swimming is a low-impact exercise, meaning it puts minimal stress on the joints and muscles compared to high-impact activities like running or weightlifting. For individuals with lymphedema, especially in the limbs, avoiding activities that involve heavy impact or repetitive motion is crucial to prevent exacerbating swelling and discomfort. Swimming allows for a full-body workout without subjecting the limbs to excessive strain. 2. Hydrostatic Pressure: The water's hydrostatic pressure during swimming provides natural compression to the body. This pressure helps improve blood circulation and lymphatic flow, assisting in the movement of excess fluid out of the affected limb. Hydrostatic pressure also aids in reducing swelling and promoting tissue healing. It effectively supports the body, making movements easier and less strenuous, which can be particularly beneficial for individuals with compromised lymphatic function. 3. Lymphatic Circulation: The rhythmic movements involved in swimming, such as kicking and stroking, promote lymphatic circulation. As lymph fluid relies on muscle movement and external pressure to flow through the lymphatic vessels, the repetitive motions of swimming help facilitate this process. By encouraging lymphatic circulation, swimming aids in reducing fluid buildup, alleviating swelling, and improving the overall functioning of the lymphatic system. Precautions: While swimming offers numerous benefits for individuals with lymphedema, it's essential to exercise caution and follow safety guidelines: Gradually increase the duration and intensity of swimming sessions to avoid overexertion. Protect the affected limb from injury or strain by using flotation devices or wearing compression garments if necessary. Monitor for any signs of discomfort or worsening symptoms during or after swimming, and adjust your routine accordingly. Consult with a healthcare provider or lymphedema specialist before starting a swimming program, especially if you have any underlying medical conditions or concerns.