Early detection is key for effectively fighting breast cancer! The most important screening test in early breast cancer detection is a mammogram. In addition to an improved outcome, some patients diagnosed with early-stage disease are candidates to have less aggressive surgery, can skip chemotherapy or radiation, or will receive a shorter course of treatment for breast cancer.
Breast cancer does not represent “one disease” but, rather, many different and similar diseases all characterized by normal breast cells becoming cancerous breast cells. Although we do not know why most patients develop breast cancer, abnormal genes appear to play a key role in some patients and genetic testing has assumed a greater role in evaluating many newly diagnosed patients.
Breast Cancer Treatment
We can now identify several different subtypes of breast cancer which we recognize as key in formulating an effective breast cancer treatment plan. The vast majority of breast cancers are estrogen-dependent, meaning estrogen promotes the growth of malignant cells. The use of anti-estrogen drugs (hormonal therapy) represents one of the earliest and most successful forms of so-called “targeted therapy” and remains an important part of treatment for patients with estrogen-positive breast cancer. The goal of hormonal therapy is to reduce estrogen production and/or block estrogen, eliminating the “fuel supply” that causes cancer cells to divide and multiply. These drugs, many of them given orally, often with very few side effects, can be used to reduce the risk of recurrence after surgery.
This is called adjuvant therapy, meaning treatment that is given in addition to surgery with the goal of eliminating microscopic cells as well as in patients whose disease has recurred where, in select situations, hormonal therapy can be even more effective than chemotherapy! Several new drugs (the CDK4/6 inhibitors) have been developed in the past few years which, when given with estrogen-blocking drugs, have nearly doubled the duration of remission in patients with advanced disease.
Beyond estrogen-positive breast cancer, we have now identified two other important types of breast cancer – cancers that are driven by the HER-2 gene, and triple negative breast cancer (TNBC) where tumor cells lack hormone receptors (both estrogen and progesterone receptors) and the HER-2 gene (i.e. all three markers are negative).
For patients with HER-2 positive breast cancer, drugs that target HER-2 are often given in combination with chemotherapy after surgery to reduce the risk of recurrence as well as in patients whose cancers have spread. The development of HER-2 targeting drugs represents a major advancement in the treatment of HER-2 positive breast cancer and has significantly improved outcomes for women with this particular type of breast cancer. Currently available treatments greatly reduce the risk of recurrence after initial surgery as well as significantly extend life in patients whose cancers have spread. Many patients now survive with an excellent quality of life for many years after their cancer has metastasized with the use of anti-HER-2 drugs.
TNBC is recognized as a potentially aggressive form of breast cancer. That said, many women with TNBC do very well. For patients who present with large breast masses or lymph node involvement (locally advanced disease), chemotherapy is frequently given prior to surgery (called neoadjuvant therapy) to reduce tumor size and provide early treatment of any microscopic cells that might have spread beyond the breast. Shrinking a tumor prior to surgery may allow a patient the option of breast-conserving surgery (a big lump becomes a small lump allowing a lumpectomy operation which might not have been possible prior to treatment) and is also a test of sorts to determine the responsiveness of an individual’s cancer cells to chemotherapy. It is now known that patients who have a complete disappearance of their cancer at the time of surgery with pre-surgical chemotherapy have a much better long-term prognosis than patients whose cancers shrink but do not disappear completely. In the latter case, additional chemotherapy can be given with the goal of improving the likelihood of cure.
Early detection of breast cancer is associated with earlier stage disease, improved outcome, and less aggressive treatment.
Increasingly, the treatment of breast cancer has become highly individualized as we have come to learn that while sharing commonalities, each cancer is unique. The precise identification of breast cancer subtype and a better understanding of the drivers of cancer cell growth (cancer genomics) will, undoubtedly, lead to new cancer therapies with even better outcomes in the years ahead.
For patients with significant lymph node involvement, further therapy in the form of additional surgery, radiation and/or chemotherapy may be indicated.
Surgery
Standard surgical options for breast cancer include mastectomy versus breast-conserving surgery. Mastectomy was the traditional surgical approach used for most of the 20th century. This involved removing the entire breast and a number of regional lymph nodes. In the 1980s, there was a slow transition from mastectomy to breast-conserving surgery. Most patients diagnosed with early-stage breast cancer now have the option to save their breast by choosing partial mastectomy or lumpectomy. This involves excising only the cancerous tissue with a rim of normal tissue and sampling lymph nodes. Lymph node surgery has become less aggressive for patients with minimal or no lymph node involvement. Sentinel lymph node dissection, which involves dissecting only a few nodes most likely to contain cancer, is now standard of care. Surgery and radiation go together for optimal local and regional control of the cancer.
Radiation Therapy
Radiation is used after breast-conserving surgery to improve local control. Traditionally this is a 6-week course of daily radiation treatment, Monday through Friday, to the entire breast and sometimes adjacent lymph nodes. External radiation is delivered by a linear accelerator (or linac) which directs radiation toward the cancer. Whole breast radiation is well-tolerated with no nausea or vomiting. Common side effects include fatigue, redness or tanning of the breast and breast firmness. Cosmetic outcome is good to excellent in 90% of patients.
New breast cancer treatment approaches have increased the choices available to patients with early breast cancer, in some cases eliminating the need for 6 weeks of external beam radiation and improving quality of life.
Hypofractionated Radiation
For node-negative patients, a short course of whole breast treatment, delivered over a 3-4 week period, is equally effective and well-tolerated. To be a candidate for the shorter (or hypofractionated) course of whole breast treatment, patients have to meet certain pathologic and dosimetric criteria, and the heart should be blocked (for left-sided breast cancers).
Reduced or Partial Breast Radiation
There is a trend toward reducing not only the length of treatments but also the amount of breast tissue that is exposed to radiation therapy. A recent publication in Lancet showed that reduced breast radiation or partial breast radiation was not inferior to standard whole breast treatment and may be associated with improved cosmetic outcome.
Brachytherapy
Another form of partial breast radiation for node-negative patients over age 40 is internal radiation or brachytherapy. Brachytherapy is an innovative form of internal radiation that uses a radioactive source that is placed inside the body. High dose rate (HDR) brachytherapy is a technically advanced form of brachytherapy. A high-intensity radiation source is delivered with millimeter precision under computer guidance directly into the lumpectomy cavity (the space left when a tumor is removed). The radiation is targeted to the area where the cancer is most likely to recur. Advantages of HDR brachytherapy are a short 1-5 day course of outpatient treatment, fewer side effects, excellent coverage of possible microscopic tumor extension and improved accuracy and precision of radiation delivery. Typical side effects are minor and include redness, bruising and breast pain. Sometimes there is breast swelling and dry desquamation (shedding or peeling of skin) or a local wound infection may occur. Overall cosmetic results are good to excellent in most patients.
No Radiation
Some patients with early-stage disease may be candidates to skip radiation. Patients with non-invasive (stage 0), low-risk cancers may not require radiation. This recommendation is made on a case by case basis and influenced by patient age and pathologic factors such as tumor size, the width of surgical margin, tumor grade and biology. Patients age 70 and older, with early stage (<2 cm and node negative) invasive cancers that are estrogen-receptor positive, may be able to skip radiation if they agree to receive adjuvant hormonal therapy. This decision is made after careful review of pathology and discussion of risks and benefits of treatment with the patient.
Arizona Oncology has a team of breast cancer oncologists and radiation oncologists who are breast cancer specialists and offer a full range of services at multiple locations. Remember, early detection of breast cancer is associated with earlier stage disease, improved outcome and, in some cases, less aggressive cancer treatments.
It’s normal to feel anxious during cancer treatment with your number one concern whether the treatment will work. Add to that the stresses of managing appointments, family responsibilities, job responsibilities and you have the makings for a lot of anxiety. It can be enough to cause physical problems including irritability, shortness of breath, a tightness in your chest, and sleeplessness to name a few.
It’s very important to give yourself a break during cancer treatment. Take a step back from all that you normally do to give yourself time to process all that is going on, and then find ways to help you feel better.
Here are some of the best options for relieving anxiety during cancer treatment. Not all of them will work for you, but be open to trying a few things to see what’s best:
Today, you don’t need to leave home to join a support group. Virtual meetings have become the new normal. There are both local and national support groups for various types of cancer that you can join.
And, with social distancing in place, it’s easier to find a virtual group than it has ever been.
Support groups can:
Provide a safe place to voice your anxiety and receive support from people with similar problems.
Allow you to learn and incorporate things that other cancer patients have tried to help them feel better both physically and mentally.
Offer professional advice from experts who know how to minimize anxiety levels for cancer patients and their families.
Increase the quality of life by reducing anxiety, fatigue, pain, and emotional distress.
Provide emotional support to families and caregivers.
Relaxation techniques aid both your body and your mind. It’s worth noting that they tend to have a cumulative effect; the more you do them the better you feel.
Meditation – can balance emotions, relieve anxiety, and even reduce blood pressure. Many meditation guides exist online. However, taking a couple of lessons from an expert can help you achieve better results.
Visualization – the process of using your imagination to relax your mind and build positive emotions by visualizing something relaxing or positive. It improves your ability to relax by focusing the mind on calming imagery.
Deep breathing – studying different breathing techniques can help your body and mind cope with stress.
Progressive muscle relaxation – this technique involves tensing muscles as you breathe in and relaxing them as you breathe out.
Massage therapy – a professional massage may ease pain, headaches, stress, and anxiety in cancer patients.
3. Exercise Regularly
Everyone knows that exercise is good for their bodies. As a cancer patient, you may not feel up to it. But getting in even a little bit of physical exercise can actually increase your energy levels and boost your mood. This makes it easier to deal with all of the demands that cancer treatment puts upon you. Exercise can keep your mind off unsettling issues while stimulating the immune system.
Talk to your oncologist about the best exercise options for you. Yoga is an excellent exercise for both body and mind that reduces anxiety and helps you keep better balance and muscle strength. Right now you may not be able to take classes at a facility, but there are yoga classes online that could be useful for at-home practice.
4. Maintain a Healthy Lifestyle
Maintaining a healthy lifestyle can ease the pressure on your mind and body. Now may not be the time to try to lose a lot of weight, if that’s one of your personal goals. But focusing on a healthy diet and making healthy lifestyle choices may result in reaching a healthy weight.
Adjust your diet – personalized nutritional strategies can help relieve stress and anxiety. Talk with the Arizona Oncology dietitian for more information on what to eat during cancer treatment.
Get enough sleep – Fatigue is such a common side effect for cancer patients that you may need more sleep than you’re used to. Try to get between 7 and 9 hours of sleep each night and take naps when you need to. Everyone feels better when they’re not overly tired!
Avoid negativity – if people around you make you experience stress, try to minimize contact with them. Lately, with all that’s going on in the world, this might include spending less time on social media. If you find yourself experiencing negative emotions while on social media, put it down and give it a break for a few hours, or even a few days.
Kick bad habits – smoking and drinking alcohol can contribute to your anxiety instead of easing it.
5. Keep the Lines of Communication Open
Especially after months of quarantine, we know just how much better we feel when we’re connected to other people. Without regular communication with those we love, you may start to feel anxious. Use Facetime or Zoom for live conversations, text and call others on the phone. If you find yourself avoiding social situations and shying away from relationships, you may be showing signs that anxiety is becoming a serious issue.
6. Find a Source of Religious or Spiritual Support
Spirituality and religion can help cancer patients and their families find a sense of peace and experience personal growth.
If you’ve never explored religion or spirituality, it may be a good opportunity to try. They can open up new ways to deal with anxiety and depression during cancer treatment and beyond. Meanwhile, spirituality exploration can keep your mind off cancer-related issues and even turn into a new hobby.
7. Seek Professional Counseling
Cancer patients may face severe depression and anxiety symptoms, if you’re constantly feeling anxious or depressed, or if none of the above options work for you even some of the time, you may want to consider professional assistance. Talk with the oncology social workers at Arizona Oncology who can help you find a counselor that is experienced in the anxiety that cancer patients experience.
These specialists with a master’s degree (or PhD) focus on the effects cancer has on patients and their families, including depression and anxiety. They can also refer you to local resources and help navigate the healthcare system.
8. Take Anti-Anxiety Medications
Your counselor or your medical doctor can talk with you about the possibility of using medications to help control your anxiety, especially if you simply cannot start to feel better at least some of the time. This might indicate that medication can help you to feel better, even if you only use it occasionally.
Talk to your doctor if you’re experiencing anxiety symptoms such as:
Excessive fear and worry
Abnormally high distress
Restlessness
Muscle tension
Fatigue
Insomnia
Concentration problems
To get the right prescription, you need to be straightforward about your medical history and the current cancer treatment. Your oncologist can prescribe this for you.
Gaining Control Over Your Anxiety During Cancer Treatment
Even if you know that anxiety is normal, it doesn’t make it easy to deal with. And you don’t need to just hope it will go away. By trying some of the above tactics, you may be able to ease the excessive worry and improve the quality of your life tremendously. Some cancer patients are able to do this without medication. But don’t feel like taking anti-anxiety medication is unusual. If you’ll feel better and be closer to your normal self, it will be worth it.
Preparing for your first breast cancer screening can be an intimidating experience. However, it’s important to follow your doctor’s recommendations for all health screenings. Learning more about the process and what to expect can help ease any fears you have and help you feel more confident when your appointment arrives. Here are 5 common questions to ask your doctor about breast cancer screening.
Do I need a breast cancer screening at my age?
Are mammograms safe?
How accurate are breast cancer screening tests?
Do I need a 3D mammogram?
If I’m at increased risk for breast cancer, do I need additional screening?
Questions to Ask Your Doctor About Breast Cancer Screening
Learning all the facts is the best tool for good health. Your primary care physician or OB/GYN can help you learn more about the breast cancer screening tests that you need. Asking these questions will help you learn more about the different screenings for breast cancer.
that have non-dense breasts should get a yearly screening mammogram starting at age 40
that have increased breast density should get a yearly mammogram at age 40 and consider supplemental imaging
Women with higher-than-average risk:
that have genetic markers associated with higher cancer risk should start an annual MRI at age 25, then an annual mammogram starting at age 30
that have had prior chest wall radiation from age 10-30 should start an annual MRI at age 25, then an annual mammogram starting at age 30
with a risk of greater than 20% by any model, or a strong family history of breast cancer should start an annual mammogram and supplemental imaging starting at age 35 when recommended by your physician
Women with a prior history of breast cancer age 50 or more should get an annual mammogram
Women with prior history of breast cancer under age 50, or with dense breasts should get an annual mammogram and supplemental imaging when recommended by your physician
Additionally, it’s recommended that all women should be provided with the known benefits and risks of breast cancer screenings and be familiar with the way their breasts normally look and feel so changes can be reported immediately.
2. Are Mammograms Safe?
Yes. A mammogram is a type of X-ray which means you will be exposed to a tiny bit of radiation. In fact, the amount of radiation from a mammogram is even less than that of a chest X-ray. The procedure lasts only about 20 minutes and discomfort is minimal for most women.
In the past, there have been suggestions that mammograms lead to the overdiagnosis of breast cancer since the screenings can find very small cancers that may never cause symptoms or problems. However, it’s impossible to tell which breast cancers would never cause problems, and early diagnosis is vital in providing life-saving treatment for all women with breast cancer.
3. How Accurate Are Breast Cancer Screening Tests?
Breast cancer screening tests are the most accurate way to detect breast cancer. A mammogram is the most common type of breast cancer screening and is 87% accurate in correctly detecting breast cancer. Sometimes, mammography results in a false positive result which requires additional testing. About 13% of the time, a mammography results in a false negative result. This is why it is vital to follow up if your radiologist suggests additional tests.
Additional screenings include breast ultrasound and MRI. While follow-up testing is stressful, it’s important to remember that a recommendation for these additional tests isn’t necessarily a suggestion of a positive result. Sometimes dense breast tissue requires a closer look with additional screening.
4. Do I Need a 3D Mammogram?
It’s not necessary to have a 3D mammogram, but it might be something recommended by your doctor under certain conditions. A 3D mammogram can provide dozens of images instead of approximately only a few that are usually produced with a typical mammogram. It may not be necessary to have 3D mammography if you are at average risk and your health insurance won’t provide coverage. However, a 3D mammogram might be a good choice for women with dense breasts or those who have a personal history of breast cancer. Your doctor will help you understand your personal risks and recommend what type of mammogram you should get.
5. If I’m at Increased Risk for Breast Cancer, Do I Need Additional Screening?
It’s important to talk to your doctor about whether you are at a higher risk of developing breast cancer. Your risk factors may be increased due to genetic factors or other reasons related to your lifestyle. Risk factors for breast cancer include:
Genetic Risk Factors
Gender – Women are 100 times more likely to develop breast cancer.
Age – Women over 55 are at a higher risk.
Family history of breast cancer – Women with immediate family members who have been diagnosed with breast cancer may be at higher risk.
Personal history of breast cancer – If you’ve previously had breast cancer, you may be more likely to develop it again.
Dense breasts – Dense breasts make it more difficult to detect cancer on a mammogram.
Lifestyle Risk Factors
Drinking alcohol
Being overweight
Certain types of birth control
Even in women with increased risks, a mammogram is the most common initial screening for breast cancer. However, your doctor may recommend that you begin screenings earlier and have them more often than women at average risk. Be sure to discuss any concerns you have about your risk for breast cancer with your regular doctor.
Breast Cancer Detection and Diagnosis
If your doctor recommends you begin breast cancer screening, you will most likely be sent to a center that specializes in Mammography and other methods of breast cancer detection and diagnosis. The most common screening for breast cancer is a mammogram. If the mammogram indicates abnormal or unclear results, other tests like a breast ultrasound or MRI will likely be recommended.
If breast cancer is detected, you will be referred to a cancer specialist (often called an oncologist) to begin treatment. Early detection leads to early treatment which is the best tool for a positive outcome. Breast cancer screenings play a vital role in the improved survival rate observed in breast cancer patients.
Many patients have to go through chemotherapy as part of their cancer treatment program, which is extremely challenging. If your oncologist has included intravenous chemotherapy as part of your treatment plan, then you can take actions before and during your course of chemotherapy. This will make the overall experience easier on you.
Things You Can Do Before Chemotherapy
1. Ask someone to drive you to and from your treatments.
Sometimes, chemotherapy treatments can take several hours to complete. You will likely be exhausted and you might not feel that great. It’d be ideal if you had someone who could drop you off and pick you up after your chemotherapy sessions.
It doesn’t have to be the same person each time. You don’t want to feel like you’re burdening anyone. However, most people will volunteer to help you out in this situation.
2. Set expectations with your employer.
Make sure that you communicate with your employer about chemotherapy. If you’re able to work while also undergoing chemotherapy, make sure that you let your employer know what you’re going through. They should understand how long it will take, and they might be able to make adjustments in order to suit your specific needs. Plan for a couple of days off right after chemotherapy in case you need them.
The Family Medical Leave Act offers time off, sometimes without pay, for medical care. You might have access to short-term disability insurance, which would provide you with some income during this challenging time. Make sure that you find out every detail of this law before undergoing chemotherapy.
3. Go to the dentist.
Unfortunately, mouth sores and other dental issues are common side effects of chemotherapy, depending on which kind you receive. It’s a good idea to get dental cleanings before going to your sessions. You should also ask about the best dental hygiene practices to adhere to. It’s very important to use alcohol-free mouthwash and a soft toothbrush because this is a gentle way of brushing your teeth if you suffer from mouth sores.
4. Consider purchasing a wig.
Unfortunately, depending on the type of chemotherapy you receive, you might lose your hair. Consider wearing a hat or a scarf sometimes and a wig at other times. It might help to go wig shopping prior to your sessions so that the wig stylist can see your hair as you normally style it before you undergo chemotherapy. If you’re looking to change things up, this could be a good time to try something new.
5. Request help with your pets.
Your furry friends are loyal companions, but they’re also quite a handful. You deserve to give yourself time to rest during this process and hire somebody else to take care of them. You’ll be so glad that you did. Requesting help with your pets is also very important because chemotherapy raises your risk of contracting infections. You don’t want to be picking up dog feces, or cleaning litter boxes, bird cages, and fish tanks.
6. Consider cutting your hair before undergoing chemotherapy.
Consider cutting your hair short before undergoing chemotherapy. It’s a good time to explore a different style. It will also be slightly less of a shock if you end up losing your hair as a result of your treatments.
Things to Do During Chemotherapy
1. Clear your schedule so that you can just go home after chemotherapy.
Don’t plan any rigorous activities for a few days after chemotherapy. You’ll want to relax for a while, especially after your first treatment. You deserve to.
2. Request and secure help with meals.
Chemotherapy is very intense and your body will need to time recover. This means that you should ask for assistance in other areas of your life while you’re going through it. You might want to hire a housekeeper or ask a family member to help you with the dishes and the laundry so that you don’t have to worry about doing household chores while you’re recuperating from your sessions.
You might have to deal with fatigue or nausea. Ask your loved ones to prepare meals for you and help you around the house. It’ll be nice to have other people keep everything in order so that you don’t have to deal with housework and the side effects of your treatments, which can be quite intense.
You might feel weird asking for this sort of help. You don’t want to burden anyone. However, it’s important to take care of yourself by directly asking for what you need so that your friends and family members can support you during this challenging time.
3. Stock up on healthy groceries.
Make sure that you eat well and stay hydrated. Plan ahead and choose foods that have nutritional value. Doing so will help you feel better.
Staying hydrated can ease the side effects of chemotherapy. Make sure that you have plenty of low-calorie drinks on hand. You might also want to subscribe to a meal-delivery service or purchase quite a few frozen meals.
You’ll be able to heat up frozen meals quickly if you don’t feel like cooking. Keep high-protein snacks on hand as well. There are many excellent options to enjoy including smoothies with your favorite fruits, hummus with soft pita bread, and cottage cheese with fruit. Make sure that you avoid foods that are rough and sharp because they can cause mouth sores.
4. Use protection during sex.
If you’re still in your childbearing years, you might be concerned about long-term damage to your reproductive system. You can talk to your oncologist about freezing your eggs or sperm. This would not be a good time to get pregnant, due to the risks for the child, and, if you’re female, for yourself.
Chemotherapy drugs can cause birth defects and damage sperm. They can stay in semen and vaginal fluids, so you should make sure that you use protection no matter what. Talk to your doctor about how long you should take this precaution for.
Don’t Be Too Hard on Yourself During Chemotherapy
We hope that these strategies assist you in taking care of yourself in any way that you can. You deserve to take this time to focus on your health and any measures that you take for self-care are very important. Don’t be afraid to ask for help.
Your loved ones are there to support you and will probably take care of your pets. They’ll likely drive you to and from your sessions quite willingly and you’ll be able to take time to relax. You’ll be happy that you did. Chemotherapy will likely prolong your life if not lead to a full recovery.
Your nurse navigator at Arizona Oncology will also help guide you through your cancer treatment journey. They can help answer your questions about what to expect during chemotherapy treatment and follow-up care.
We hope that you recover swiftly and thoroughly. Chemotherapy is intense. We hope that you remain perseverant and stay strong.
Even though summer is halfway over, August is Summer Sun Safety Month. This means there is still time to be conscious about practicing sun safety. One major way you can do this is by slathering on some sunscreen and repeat it often anytime you’re outside.
Choosing a sunscreen can be a daunting task. With so many combinations of numbers and specializations, it’s no wonder a lot of people skip wearing sunscreen altogether. To clear up some confusion, let’s talk more about what SPF is as well as its importance when using the right sunscreen for your skin.
What is SPF?
SPF stands for sunburn protection factor.
That number you see behind it on the bottle? That’s a relative measure of how long the UV rays of the sun would take to redden (burn) your skin with sunscreen versus how long it would take without. So, for example, if you wore an SPF 30 sunscreen (as directed), it would take you 30 times longer to burn than if you weren’t wearing any sunscreen at all.
There are other factors that go into how quickly you burn. Someone with blonde hair, blue eyes, and porcelain skin is going to burn long before their friend with dark hair, brown eyes, and olive skin. However, both should use a sunscreen with higher numbers to protect their skin.
Is SPF Enough?
It depends. An important thing to understand is that the sun produces two types of ultraviolet rays that affect the skin: UVA and UVB. These rays can cause premature aging and increase your risk of developing melanoma or non-melanoma skin cancers. Most skin cancers are caused by exposure to UVB rays, while UVA rays are known to play a major part in skin aging and wrinkling.
You may be wondering what this has to do with SPF. The thing about SPF is that it only measures UVB protection, which is great if your main concern is reducing your risk of skin cancer. However, if you’re also concerned about premature aging, it’s important that you look for a sunscreen that states “broad spectrum” on the label. A broad-spectrum sunscreen provides both UVA and UVB ray protection.
SPF Numbers: Is Higher Better?
The American Academy of Dermatology recommends using a sunscreen that is SPF 30 or higher. Keep in mind, however, that although higher SPFs do mean more protection, the difference in that protection becomes smaller.
No sunscreen can filter out 100% of the sun’s UVB rays. This is why it’s a good idea to include other sun safety practices, such as seeking shade, wearing protective clothing, and staying indoors from 10 am to 4 pm when UV rays in Arizona are the strongest.
Slather and Repeat
Apply your sunscreen 20 minutes before going outside. To ensure continued protection reapply every 90 minutes. If you will be actively sweating or in the water, be sure to find a sunscreen that is also water-resistant and reapply each time you get out of the water.
Pay attention to all areas of bare skin, including your neck, face, ears, legs, and tops of your feet. For your lips, choose a lip balm that’s at least SPF 15 and reapply it frequently throughout the day. For more information on protecting your skin from both sunburns and skin cancer, visit our blog on sun safety.
In many cases, people who get sunburned don’t use enough sunscreen, don’t reapply it, or use a product that is past its expiration date. Remember, your skin is exposed to UV rays every time you go outside – even on cloudy days, on the snow, and in the water – so practice sun safety by slathering on some broad-spectrum, SPF sunscreen.
Other Products That Offer SPF
As the importance of SPF for skin care has become more common and a larger topic of discussion, many companies have begun offering SPF in their products. Today, you find SPF in your makeup and moisturizers.
These products make SPF a part of your daily care routine. However, you don’t want to rely solely on these products. First, you need to make sure the product has at least an SPF 30.
Second, you’re only using these products on your face and neck, so you need to be sure to protect the rest of your exposed skin.
Third, if you’re spending time outdoors, you need to reapply the SPF every 90 minutes to ensure coverage.
When Summer Fades
You know the summer season has arrived when you visit the pharmacy or grocery store to find a prominent shelf filled with sunscreen. The rest of the year, sunscreen is tucked away on a couple of shelves hidden at the back of the store.
This does all of us a great disservice. It leads you to believe that sunscreen isn’t as important during other times of the year.
This isn’t the case!
Each and every time you leave your home you should be wearing sunscreen with an SPF 30 or greater on any portion of exposed skin. This includes driving to work each day. You can get color on your exposed arms while driving back and forth to work.
As we celebrate Summer Sun Safety Month in August, it’s important to learn the basics of protecting our skin from the sun’s harmful rays.
Understanding the difference between UVA and UVB rays helps you make better choices with sunscreens that contain broad-spectrum coverage. It’s also essential that we care for our skin and use a sunscreen with a minimum of SPF 30 throughout the year.
Learning you have cancer is shocking news. After you accept your cancer diagnosis, your main focus is probably, “How can I beat this?” Your oncologist will begin treating you using established, proven treatment protocols based on the specific type of cancer that was diagnosed. In some cases the most commonly effective treatments aren’t working as hoped, and sometimes the cancer returns in other parts of the body. In these cases your oncologist may recommend enrolling in a cancer clinical trial. Should you do this? Find out more about cancer research being done at Arizona Oncology through The US Oncology Network.
Clinical Trials Involve Fine-Tuning FDA-Approved Cancer Treatments
Medical breakthroughs are making new cancer treatments available more often than ever before. Plus, cancer specialists are finding ways to use or combine the already-approved treatments for new uses in cancer treatment. Before these treatments can be made available to everyone they undergo a careful and extensive testing process through clinical trials. There are four primary clinical trial phases.
Phase 1 Clinical Trials: Is the treatment safe?
Research, which leads to human testing, often starts at the test tube level. For cancer, this may include treating cancer cells with the drug(s) of interest.
If a therapeutic response is observed, then the drugs are given to animals. Animal testing provides some insight into possible side effects and generates the starting dose that will be used in the first level of human testing called a Phase I clinical trial. Patients, considered for this cancer treatment, have typically exhausted standard of care options, have an advanced stage of cancer, but have few symptoms from their cancer.
Enrollment in a Phase 1 trial is typically open to patients with various cancers. The first patients are administered the lowest planned dose and observed for side effects over a period of time. If the low dose is tolerated, another group of patients are enrolled at a higher dose level and observed for side effects. Escalating doses of the drug are given to more patients until the maximum tolerated dose is determined. An analysis of the effectiveness against specific cancers is undertaken once the maximum dose is achieved. It is important to understand that not all cancers will respond to any given agent. Only five to ten percent of Phase I agents are effective enough to proceed to the next level.
Phase 2 Clinical Trials: Does the treatment work?
Phase 2 trials have more selective enrollment requirements. The inclusion criteria are based on tumor types that appeared to respond to the Phase 1 trial and often places a restriction on the number of different treatment regimens a patient previously received for their cancer. These patients usually have advanced-stage cancer and are relatively asymptomatic. Many patients are enrolled in a Phase II trial because one of the primary end-points is to prove effectiveness with acceptable side effects. If a reasonable response rate is seen at the Phase II level, the experimental drug or combination can proceed to a Phase 3 trial.
Phase 3: Is the treatment better than what’s available?
Usually, promising drugs undergo FDA approval during phase 3 trials. A Phase III trial usually represents the final destination for a new drug or combination. At this level, the experimental study can be designed for patients with early-stage disease, where a cure is being sought, or more advanced stage cancers where prolongation of life is the goal. Participants are randomly assigned to standard of care chemotherapy or the experimental drug(s). The patients and physicians are blinded to the regimen the patient is receiving. A larger number of patients are enrolled, and the study could take years to complete. The experimental drug(s) can become a new standard of care if they are more effective than the current standard of care, or equivalent but less toxic.
Phase 4: What else can researchers learn about FDA-approved treatments?
In Phase 4 cancer clinical trials, the cancer therapy is tested after it has been approved for a specific use. They are used to collect information about a therapy’s long-term effect on the patient’s quality of life, length of life and any unexpected long-term side effects.
Phase 4 trials may also be used to try new combinations of approved therapies to determine if there are better outcomes.
Most cancer patients who participate in clinical trials in the community setting will join during phases 2 or 3 when researchers are evaluating the effectiveness of new dosages, new combinations of drugs or new uses for existing drugs. Because of this the studies are considered very safe for patients and offer options when other treatments haven’t been effective.
How Do You Participate in a Cancer Research Trial?
You and your oncologist can discuss the potential option of a clinical trial when discussing treatment options. Trials may not be right for all patients. If there is a clinical trial that your doctor and you feel would be right for you, and you agree to participate (you’ll never be added to a trial without your knowledge), you will be carefully monitored throughout the entire process of treatment. This may require more visits than a typical patient would have.
The research team will also contact you regularly after treatment is complete to see how effective it is in the long run.
Who Pays for the Clinical Trial?
Typically there’s no extra cost to the patient for this additional care. The clinical research team will carefully go over this with you.
Many patients who are asked to participate in a clinical trial believe all their care will be paid for through the study. The reality is that only part of their care might be covered. The trial sponsor would provide additional medications as well as funding to cover additional costs considered outside the standard of care practices. Insurance companies are still required to pay for the components of a patient’s care that are considered the standard of care i.e. routine provider visits, laboratory tests, radiographic imaging and prescription medication.
Questions and Concerns About Participating in a Clinical Trial
Because participating in a clinical trial is a different process, there are questions you may have. One concern may be side effects of treatment. Every patient reacts differently, and with new drug combinations or doses there may be new side effects for your oncologist to address. If you participate in a clinical trial but have a poor response, your treatment plan will be changed based on the other options that are available.
If you’re considering participating in a clinical cancer trial, discuss your questions, concerns and expectations with your doctor. Some questions to ask include:
How will my side effects be managed?
What happens if I have a poor response while on the clinical trial?
What’s the purpose of the study?
Is the trial testing new dosages or combinations of a drug that is already FDA-approved, or is it testing a new therapy?
How will I know if I’m qualified to participate?
What will I have to do as a participant? Is there a large time commitment on my part?
How long will the study last?
What type of side effects do you expect?
Will it cost me anything to participate?
Will the researchers tell me the results of the study?
If the treatment is effective for my cancer, can I still get it after the study?
What are the Benefits of Participating in a Clinical Trial for Cancer?
Commonly prescribed medications such as analgesics, antibiotics, and inhalers have gone through the rigorous process of clinical trial investigations. Participation in clinical trials has become an international phenomenon that improves the health of communities. Choosing to enter a clinical trial may provide the benefit of having another opportunity to treat your disease with a non-standard of care option. It is the participation of our friends, neighbors, colleagues, family and strangers that provide us with access to medications and diagnostic tests that have improved the quality of life for all.
If you’re interested in learning about clinical trials appropriate for your specific diagnosis, we encourage you to contact us at Arizona Oncology. We provide Arizona cancer patients access to cutting-edge, innovative cancer clinical trials in a comfortable, convenient setting. Arizona Oncology has locations in and around Northern and Southern Arizona.
