Pregnancy and Breast Cancer Treatment

4/17/2020

Receiving the news that you have breast cancer is difficult and life-changing information. But, what happens if you're pregnant and receive this news?

Being diagnosed with breast cancer is the last thing you want to deal with, let alone when you have the happy news that you're pregnant. There is still such a stigma connected to breast cancer that it only happens later in life, and after menopause. But, as we've mentioned in previous blogs, breast cancer doesn't discriminate. It doesn't pay attention to age or sex. Women and men at all stages of life are vulnerable and susceptible to breast cancer, and that includes pregnant mothers. Being pregnant and expecting a child should always be a time of joy and happiness, but a diagnosis of breast cancer changes all of that. What does this mean for you and the baby? How will this change your treatments? What will the next nine months of pregnancy look like? This will be a delicate and complicated journey, one you need to plan very carefully with your obstetrician and your oncologist. You need to be very well informed about your choices and options, and to choose what path is best for you and your baby. These decisions and the treatments need to focus on not just getting rid of or treating your cancer. They also need to be chosen to keep your baby safe and healthy as well. This limits and changes what kind of treatment options are available to you and when exactly you can receive them throughout your three trimesters.

The positive news is that yes, as a pregnant woman, you treat your breast cancer. The tricky part is deciding what route you can safely go to protect your baby and still conquer your cancer. This all depends on a handful of factors. They include how healthy you are overall, how far along you are in your pregnancy if the cancer has started to spread and if it has where it has spread to, the size of your cancerous tumor, and where that tumor is located. For a pregnant woman, two of the safest options are surgery and chemotherapy, while radiation and other hormonal therapy treatments are recommended to be avoided until after you've delivered.

CHEMOTHERAPY
This treatment is safe for babies in the second or third trimester, but not in the first. In the first trimester, some of the most important development and growth occurs, and chemo can seriously interfere in that process. It also runs a higher risk of losing the baby if chemo is used during this time as well. Many of you might be skeptical that chemo is safe at any stage of pregnancy, but studies have shown that when using certain chemo drugs like cyclophosphamide and doxorubicin during the last two trimesters of pregnancy is safe. They don't have the risk of birth defects, health problems, or loss of the baby. The only risk studies have found is the risk of an early delivery. If you do decide or need to have surgery during this time, you will be deciding between a mastectomy or a lumpectomy, with follow up treatments of chemo recommended for the second trimester or later. If your diagnosis comes during your final trimester of pregnancy, chemo is usually recommended after the birth of your child. After week 35 of your pregnancy (out of a total of 40) chemo is no longer recommended. Chemo at this point can bring on early delivery, and it also lowers the mother's blood cell count. This lowered cell count can lead to dangerous issues during birth including infection and serious bleeding. Deciding to delay chemo until after the birth allows the mother's blood cell count to return to a healthy level, so the birth can be as safe as possible.

SURGERY
This is one of the safest routes for a pregnant woman to take while battling a cancer diagnosis. It is the safest to do at any trimester, and you don't have to delay it unless your obstetrician recommends otherwise. Mastectomies are generally the most preferred surgery for a pregnant woman. You can have a lumpectomy, removing just the breast tissue that contains cancer, but it does come with a few risks. A lumpectomy generally requires radiation to follow up that surgery, and radiation is not safe for the baby. But, putting off radiation for the mother, if it is needed, is very dangerous and could increase the risk in cancer returning. The only time a lumpectomy is usually recommended with radiation is if the cancer is found during the third trimester. If the surgery is performed close to the due date of the baby or very shortly after, very small wait time or no wait time at all is placed on the recommended radiation treatments. The removal of a lymph node, or possibly a few, are also needed during surgery. There are two different types of lymph node surgeries, one, in particular, being safer than the other. The removal of lymph nodes under your arm called an auxiliary lymph node dissection, which removes multiple lymph nodes, is the first choice. The second is called a sentinel lymph node biopsy. This uses a small amount of blue dye and radioactive tracers that pick out the nodes that could contain cancer. The blue dye and radioactive tracers come with heavy concerns since radiation is very bad for the baby. This treatment, although it may help with removing fewer lymph nodes, is not recommended during pregnancy. It is recommended to happen after pregnancy or late in your trimesters and without the use of the dye.

TREATMENTS AND THINGS TO AVOID
During your pregnancy, there are some treatments and situations you will need to keep you and your baby safe. Keep these in mind as you move forward. Also listed are a few difficult situations that you might have to face, too.

DO NOT use target therapy, hormone therapy, or radiation therapy during your pregnancy as part of your treatment.
Stop breastfeeding or do not start breastfeeding if you are going through treatments.
Pregnancy can make it harder to treat, diagnose, or even find breast cancer.
If you already have breast cancer while pregnant, the changes in hormones that happen during pregnancy can cause your tumors to grow.
Getting a mammogram during pregnancy isn't commonly used, as the radiation used during the procedure is very dangerous to the baby. Plus, they are usually not effective on women under 40, as the breast tissues is too firm for the radiation to pass through to get any clear results.
A woman's breast thickens during pregnancy making it harder to find any lumps. It is very important to continue regular self-breast exams and to have your doctor continue breast exams throughout your pregnancy. If you have any concerns, they need to be brought to your doctor right away.

THINGS TO REMEMBER
During this time, you already have a lot on your plate and a lot on your mind. We wanted to leave you with some closing thoughts to remember as you begin this process.

There is still hope.
Breast cancer itself does not hurt or harm the baby.
Getting breast cancer while you're pregnant is not very common.
Being pregnant doesn't cause breast cancer.

We know and understand the difficulties you are facing during this time. It is unique, scary, and full of unknowns. We want to help you celebrate the joy of your pregnancy, all while helping you conquer your cancer. If you have any concerns or worries, please don't hesitate to reach out to us. We are here to answer your questions, guide you through this process, and discuss any concerns you might have. Know you are never alone, and there is always hope.

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Healthy Decisions, Strong Immunity

3/30/2020

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Now more than ever, keeping your immune system strong is a necessity. For a breast cancer patient and during your treatments, this can be a very difficult task. How does breast cancer attack your immune system, how do treatments keep it weak, and what can you do to improve its strength and your quality of life?

Having cancer gives your life, and the lives you affect, a very unknown and sometimes scary feeling about what could or couldn't happen almost every day. Cancer treatments are changing every day, how your body responds to your treatments changes every day, and how you feel changes every day. The world today is starting to fill up with daily unknowns, uncertainties, and fear. What can happen, what could happen, and what is already happening is frightening. It is especially very frightening for people with compromised immune systems. Who has some of the most compromised immune systems? You do, my dear friend, as I am sure you have already been told many times before. Your body is already working against you as your cancer sets in, and then your immune system is completely compromised once you begin treatments. How unfair is that? In your daily battle, that is one of the most heartbreaking things we see every day.

But where is the science behind all of it? Cancer cells can sneak past your immune system and the white blood cells used to attack invaders in our bodies because they can look so similar to our normal healthy cells. It's almost like a game of hide and seek inside your body. Some cancer cells can even turn off part of your immune system once they attack, allowing the cancer cells to grow and multiply without being stopped. Cancer can also weaken your immune system if it travels and makes its way inside of your bone marrow. Inside your bone marrow is where your white blood cells are produced and cancer can shut down that production stripping your immune system of its power. But it's not just the disease itself that can lead to your immune system becoming weak, so can your treatments. These life-saving treatments that are needed to destroy the cancer cells can leave your body's immune system weak and not ready to fight. But they are still so important when it comes to saving your life.

Chemotherapy is the leading cause of damage to your immune system, but radiation and surgery can harm it as well. Chemotherapy is designed to kill rapid growth cells, which cancer is. But other rapidly growing cells are found in the most delicate parts of our body like in your bone marrow, blood, hair, and others. This will hurt the production of white blood cells, making your body more vulnerable to infection, sickness, and other issues.

During your cancer treatments and in the state of the world now, keeping your immune system as healthy as possible needs to become one of your top priorities. With that in mind, what can you do to keep yourself healthy and happy, while building up your immune system to whatever dangers are lurking out there? Follow these tips and suggestions to help you in your continued battle day in and day out!

As you begin your battle with breast cancer and throughout your treatments, make sure your doctor takes stock of your white blood cell count. Keeping a healthy level of blood cells is extremely important. When your levels are low, take every precaution to strengthen and protect yourself and your immune system, and let your doctor help with these precations. If you can, make sure there is a decent amount of time between your chemo treatments to allow your system to bounce back. Antibiotics can be given during your treatments to avoid other sicknesses and infections from sneaking in. You can also take medications that will stimulate the growth of your white blood cells and keep up in the fight. It's not impossible to keep your white blood cell count up!
We have said it before, but maintaining a healthy lifestyle is important for every aspect of your life during your treatment, along with keeping your immune system strong. Plenty of sleep relaxation, exercise, drinking plenty of water, and eating a balanced diet all play a huge factor in keeping your immune system strong and keeping you healthy. You may be unable to eat a lot during your treatments and your sleep schedule could be all out of whack. Through these difficulties, try your hardest to keep up with a good diet and to get as much sleep as possible.
Self-care is so important. It is not selfish nor is it a waste of your time. It is a necessity during your cancer battle, and it is also a great way to manage your stress and anxiety. High levels of stress can damage your immune system and wear it out. We know this is already a difficult time for you, especially now more than ever, but managing your stress levels needs to be on the top of your list with self-care. Exercising can help with this, spa days are always recommended, and hobbies can all be a great way to manage the stress and anxiety you could be dealing with every day.
When going out of your home, be prepared and think ahead. Avoid germ heavy environments like schools, nursing homes, large meeting spaces, and even hospitals. The hospital might be your biggest challenge to avoid, but always practice cleanliness to the extreme when you visit the hospital during your treatment and care. Wash your hands as often as possible, disinfect the gadgets you use daily, and even wear a mask. Avoid traveling on planes or public transportation. It is also in your best interest to avoid someone who is already ill and could pass something along to you that could turn into something much worse.

You are fighting a battle inside your body and waging a war on the outside to keep yourself healthy and strong. Now more than ever it is so important to focus on keeping your immune system strong and to be as mindful as possible. It might be hard to not visit or see some of your family or friends to keep yourself healthy, avoiding public gatherings, and avoiding doing things you love doing. But, making these decisions could save your life and keep you healthy. Think smart and stay healthy, it will all be worth the trouble you are going through in the end.

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Screen Time; Pros and Cons

3/16/2020

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It's so easy to get sucked into our cellphones. These handy and incredible objects that can connect us to the world and give us so much information in mere seconds can offer comfort, connection, fun, and a way to express ourselves. But does this stay true during your diagnosis, treatment, and afterward? Is there such a thing as too much screen time?

The unknown during diagnosis, treatment, and after can be one of the most painful parts of your journey. Finding the right kind of support and spending your time as you wish during your journey can be a battle in itself. Panic, fear, and doubt are a part of your everyday life, on top of trying to live your life as normally as you possibly can. Eliminating the negative things and people in your life during this time can be a very difficult decision to make. It can add another layer of worry and doubt to your life while trying to live and heal according to the societal norms around you. But what good are those negative people are things doing for you? Giving you extra stress, worry, hurting you, and possibly even making you angry? Why would you want someone like that in your life? The same thing applies to the cellphone that has casually become a permanent staple in your hand, back pocket, or bag.

We spend hours of our day scrolling mindlessly through our Facebook, Instagram, and Twitter accounts or on news sites, playing games, or surfing the web. We love posting about our families, the exciting things we're doing, looking up recipes, shopping on Amazon, and keeping up to date on the news. When going through treatment and afterward, social media and our connection to it can be a great form of comfort, reassurance, and an extension of learning more about what's happening in your body. There are so many inspiring Facebook pages and groups waiting to welcome you in with open arms, Instagram accounts that will keep you inspired, and brilliant websites to read and podcasts to listen to that will educate and comfort you on this journey. But what about everything else in between? How much time should you be spending on your phone, and when does it become a little too much? Is too much screen time a good thing or a band thing during your road to recovery or through treatment? This is an emerging topic that might cause a dispute or two. As you consider your path and choice of time spent on your phone, here are some things to consider and think about.

IT'S ALL PERFECT

We've talked about the struggles of trying to keep up with the normalcy of your life while going through treatment. That even though you've been diagnosed with something very scary and difficult, you've started invasive treatments that can leave you exhausted and sick, society pressures you to keep on going, caring for your family and your job as if nothing has changed. You can do this all on your own, right? First of all, as we've said many times before, you have to flush the idea of "normal". There is no one way you should be dealing with your diagnosis or treatment, how you care for your family, or live your life through it all. You make those decisions to better your quality of life. But where does that pressure to look and live that perfect life come from? One of its many sources is social media.

You may be following others on social media platforms that are going through a journey similar to yours. But, some of these people make it look easy, that it's not a huge challenge, and their pictures are inspiring or beautiful while doing it. Remember, what you post online is under your control. Filters are there to make everything look exactly how you want it to. You can control every aspect of your pictures and leave the imperfection and ugly behind. The days you get bad news, feel sick, don't look or feel like yourself, the messy house, the distraught or frustrated family members, might be left out of their posts. Even if they don't show these things, it's all still there, just like you. Seeing these cultivated and perfectly inspired posts over and over again can either keep you inspired or weigh heavily on you. Thoughts of doubt, comparison, and low self-esteem can become a daily part of your experience with social media. These posts can make you question why your life and journey doesn't look as easy or as inspiring as others, and make you question why it's not like that for you.

When comparison starts getting in the way, we suggest that it's time to put your phone down. Granted, these posts, these blogs, Facebook groups, and anywhere you can find a connection are there to serve a wonderful purpose. But when that purpose no longer applies to you or when it's making your journey more difficult or upsetting in any way, it might be time to reevaluate why this amount of screen time and what you're doing on your phone is important.

TIME

It's so easy to let the hours disappear while you're scrolling or reading online. How many times have you opened your favorite social media app to check or post something and all of a sudden an hour or two is gone. How did that happen? Hours and time can become precious while on this journey. It is also time that needs to be used to rest and recover. It's so easy to pick up your phone and scroll when you can't sleep. Those hours can slip away and prevent you from getting the rest that you need to keep up your winning battle. Be good to yourself, you deserve the time to rest.

THE CHATTER

Phone calls, text messages, emails, messenger; these are all wonderful ways to stay in contact with your loved ones and to keep them updated on your journey. You can spend hours every day answering or making calls, responding to messages, and sending emails. It can be therapeutic for both you and those receiving them. It's also ok to set time limits on when you're going to be on your phone talking about your diagnosis or treatment. You can set up time slots for when you're going to be answering these calls and messages, and when you're not. There is no need to feel guilty for doing so. You don't need to give any explanation for making that decision. The hours and time you spend on the phone repeating the same information over and over again can be an emotionally draining experience. You are allowed to decide what times during the day is best for you to talk on the phone and when your phone will be put down.

THE SCIENCE

There has been no proven science that being on your phone too long or storing it in your bra will give you breast cancer. Spending large amounts of time on your phone has been linked to headaches, stress, anxiety, depression, short temper, a shortened attention span, and damage to your eyes. None of these things are enjoyable when you're in your best shape, let alone dealing with breast cancer. You already have enough on your plate, why add more to that?

EASE

With all of this being said, there are plenty of benefits to screen time. As I mentioned above, there is a lot of comfort and education you can glean from your time on the web. It's also a way to share your journey, not only with your loved ones but with those you can help educate and inspire with your story. When choosing how much screen time you have in your life, make the choice mindfully. It's not a bad thing for you, but always choose your screen time for the positive reasons all of it was created for.

As in any decision you make while on your journey, make it for you. If you enjoy spending time on your phone, spend time on your phone! These are your decisions to make, so make them proudly. As you live through your diagnosis, treatment, and beyond, give yourself the joy and happiness you deserve in the best ways you can. We are here to give you the support you need, answer the questions you have, and guide you on the journey you want. Say yes to what to want, and allow yourself to say no to the things that are getting in the way of your life.

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Pregnancy and Breast Cancer Treatment

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Screen Time; Pros and Cons

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