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Poetry Friday

welcome

The Guest House

This being human is a guesthouse.

Every morning a new arrival

A joy, a depression, a meanness,
some momentary awareness comes
as an unexpected visitor.

Welcome and entertain them all!
Even if they’re a crowd of sorrows,
who violently sweep your house
empty of its furniture,
still, treat each guest honorably.
He may be clearing you out
for some new delight.

The dark thought, the shame, the malice,
meet them at the door laughing,
and invite them in.

Be grateful for whoever comes,
because each has been sent
as a guide from beyond.

 ~ Rumi ~
 

researchNearly 40% of breast cancer tumours change form when they spread, a UK study shows.  The researchers say this could mean that patients require changes to their treatment regime. They analysed 211 tumours which had spread to the lymph nodes in the armpit – the place where breast cancer tends to migrate first. The study, by Breakthrough Breast Cancer scientists in Edinburgh, appears in Annals of Oncology.

Breast cancer is a complex disease with many different types which can be treated in different ways. Breast cancer spreads to the lymph nodes in about 40% of the 46,000 women diagnosed with breast cancer in the UK each year. Cancer cells which spread in this way are often more difficult to treat than those in the breast – so it is vital that women receive the most appropriate treatment.

Researchers were surprised to find the disease changed in such a high proportion of patients, and in so many ways, when it had spread. For example, 20 tumours changed from oestrogen receptor (ER) negative to ER positive. This change would mean hormone therapies such as tamoxifen, which would not have worked for the original tumour, could help treat the disease if it has spread.

Other tumours changed from ER positive to ER negative, which suggests those patients may be given treatments which will not benefit them – experiencing side-effects unnecessarily.

Lead researcher Dr Dana Faratian said: “We were surprised that such a high proportion of tumours change form when they spread beyond the breast. “This suggests there is a need to test which type of disease a woman has in the lymph nodes, because it could radically alter the course of treatment she receives. “We now need a clinical trial to see how these results could benefit patients.”

Professor David Harrison, director of the Breakthrough Breast Cancer Research Unit, said: “This research may show why some women whose cancer has spread to the lymph nodes do not respond to treatment. “With an additional test we may be able to treat women more effectively and also make more efficient use of NHS resources.”

The researchers stress that a clinical trial needs to be carried out to fully evaluate the benefits of testing cancer cells in the lymph nodes before it can be approved for use on the NHS. .

Source:  BBC NEWS

Support Movember

movemberMovember, the month formerly known as November, has been set aside to raise money for Action Prostate Cancer, an initiative of the Irish Cancer Society.

Talented photographer, Chari Olmedo has created an album of photographs for sale to raise money for Movember. It’s simple – just visit http://www.myartprofile.com/irlanda/artwork/73633, choose your picture and send her a message with the name of the photograph and your address (postage included in price).

Payments can be made here: http://ie.movember.com/mospace/253010

Meat Free Monday

beetrootWhile I don’t usually make any claims for cancer fighting food, it is claimed that specific anti-carcinogens are bound to the red colouring matter in beetroot which supposedly helps fight against cancer. Additional studies are taking place to add support to these claims. However, cancer fighting or not, what is proven is that beetroot is of great nutritional value in our diets. The green leafy part of the beetroot contains beta-carotene and other carotenoids,which function as antioxidants. This part of the beet also contains lots of folate, iron, potassium and some vitamin C. Try eating the leaves and stalk boiled or steam and accompany with other more flavoursome vegies like onions and garlic. Or chop finely and add to quiches, salads or stir fries.

Beetroot is in season right now, so buy a bunch and savour the rich earthy smell and sweet taste of this versatile root vegetable. If you are looking for a new way to serve it, try this recipe:

Beetroot Couscous

Ingredients (serves 4)

  • 1 cup (250ml) vegetable stock
  • 1 cup (200g) couscous
  • 2 tbs olive oil
  • 1 red onion, thinly sliced
  • 2 tbs each balsamic vinegar & lemon juice
  • 2 peeled, cooked beetroot cut into 2cm cubes
  • 1/2 cup chopped flat-leaf parsley, plus extra whole leaves to garnish

Method

  1. Bring stock to the boil in a pan. Remove from heat, then slowly stir in couscous. Cover with a tea towel, stand for 5 minutes, then fluff grains with a fork.
  2. Meanwhile, heat the oil in a frypan over medium-low heat. Cook onion for 10 minutes, stirring, until softened and just starting to caramelise. Stir in vinegar, juice, beets and parsley. Season, then stir through couscous. Transfer to a portable serving dish. Serve with extra parsley.

Recipe Source: Taste.com

CSI Breast Cancer

csiI am a huge fan of the CSI series on TV – I am fascinated by the techniques, so I was intrigued to read today that breast cancer therapy that’s customized for each patient’s personal genetic makeup is one step closer to reality, thanks to a new use for crime-lab technology pioneered at Roswell Park Cancer Institute (RPCI).

A team led by Petr Starostik, MD, chief of RPCI’s Clinical Molecular Diagnostics lab, is using CSI-type methods to multiply the reliability of testing that predicts whether a given patient will benefit from a first-line chemotherapy drug, or should avoid it and its harsh side effects.

According to Dr. Starostik, better testing is one of the keys to “personalized medicine,” the long-sought solution to the problem that many drugs turn out to be ineffective for up to 50 percent of those who take them. “So far, we know that personal genetic variations in tumors affect each patient’s response,” he says.

The Starostik team’s innovation is a reliable, automated test for abnormal activity in the tumor-cell gene HER2, which marks patients who are unlikely to respond to the tumor-inhibiting compound Trastuzumab. While Trastuzumab is frequently prescribed, its side effects are harsh. Today’s HER2 tests often yield ambiguous results, he says, partly because they rely on manual lab work and subjective visual analysis.

The new approach employs multiplex polymerase chain reaction (PCR) technology, which is widely used in applications ranging from the diagnosis of hereditary diseases to the forensic identification of “genetic fingerprints”. Multiplex PCR is faster, more sensitive, easier to perform, and less costly than manual HER2 testing.

“Is personalized medicine achievable? I’m sure it is,” Dr. Starostik notes. “We just have to keep in mind that manual testing in this arena is impractical, no matter how skilled the lab personnel may be. But by taking advantage of powerful, new, automated tools, we can make more and more therapies specific to the genetic makeup of the individual and his or her tumor.”

Source
Roswell Park Cancer Institute

Hope in Bloom

I came across an uplifting story recently about an organization with the wonderful name, Hope in Bloom, a nonprofit that plants gardens for breast-cancer patients.

Source: The Enterprise

Source: The Enterprise

Linda (Bosse) Charron is getting a reminder of how she won her fight against breast cancer right outside her home. In 2007, the lifelong Easton resident was enjoying her young daughter Jillian, now 21/2 years old, along with her husband, Joseph, and their son, Jared, now 7.

But a routine annual exam four months after her daughter was born showed she had malignant invasive ductal carcinoma, a form of breast cancer. Charron, who graduated from Oliver Ames High School in 1987, faced surgery, five months of chemotherapy and more reconstructive surgery.

While she was going through treatment, Charron’s friend submitted her name to Hope in Bloom, a nonprofit organization that plants gardens for breast-cancer patients. “I am constantly reminded of (the cancer),” Charron said. “Now I’m going to look outside my window and think how beautiful the garden is and how good it makes me feel. I’ll be reminded I triumphed over cancer.”

Hope in Bloom founder Roberta Hershon said the gardens reduce stress and anxiety, lower blood pressure, and increase serotonin levels in the body. “The combination makes people more receptive to medical intervention,” Hershon said.

A landscape architect consulted with Charron and designed the garden consisting of arborvitae, butterfly bushes, and perennial and annual flowers. It is being built free of charge.

Gardens typically cost $1,500 to design and build and are all privately funded, according to Hershon. Cherron’s garden was built with the help of Baker’s Landscaping Inc. of Norton. Workers will remove the grass and dig the larger holes for some of the trees.

“We’re going to go in and do the gorilla work for them,” said Aaron Donnelly of the landscape company. “It speeds their day up.”

Donnelly said owner Chris Baker is a cancer survivor, so the prospect of doing the work for another survivor appealed to him.

The remaining digging, planting, and fertilizing will be done with a crew of volunteers from many different towns.

While Charron enjoys gardening and working in her yard, her garden from Hope in Bloom took two years to be built because the organization does not have the funds to build gardens for all requests that come in.

Hershon said those deemed most sick get gardens first and then the organization works down the list of requests even if someone has finished treatment since they first applied like Charron. While 60 gardens have been built since Hope in Bloom formed in 2007, there are still 100 names on a waiting list.

Because she has completed most of her treatment Charron said she almost felt not worthy to receive the donated garden.

“My husband said, ‘you did go through it,’” Charron said. “My friend knew this was something that would make me happy. This is a really neat thing.”

Source: Enterprise News

Poetry Friday

Earlier in the week, I reviewed Caryn Mirriam-Goldberg’s cancer memoir, The Sky Begins At Your Feet. Caryn’s latest blog post features a poem which is very beautiful and the last two lines of which I have been repeating to myself for the past few days.

It is written by N. Scott Momaday, a Native American writer from Oklahoma, and a Pulitzer-prize winner whose novel House Made of Dawn led to the breakthrough of Native American literature into mainstream literature.

The Delight Song of Tsoai-Talee 

I am a feather on the bright sky

I am the blue horse that runs in the plain

I am the fish that rolls, shining, in the water 

I am the shadow that follows a child

 I am the evening light, the lustre of meadows 

I am an eagle playing with the wind 

I am a cluster of bright beads 

I am the farthest star 

I am the cold of the dawn 

I am the roaring of the rain 

I am the glitter on the crust of the snow

I am the long track of the moon in a lake 

I am a flame of four colors 

I am a deer standing away in the dusk 

I am a field of sumac and pomme blanche 

I am an angle of geese in the winter sky

 I am the hunger of a young wolf 

I am the whole dream of these things 

You see, I am alive, I am alive 

I stand in good relation to the Gods

 I stand in good relation to the earth

 I stand in good relation to everything that is beautiful… 

You see, I am alive, I am alive

 

cd

A computer-based decision-making aid may make it possible for more women to have breast reconstruction after surgical treatment for cancer.

The tool has helped women play a larger role in decision-making, according to results from a new study reported at the 2009 Clinical Congress of the American College of Surgeons. Women who used the computer-based learning module were more involved in choosing reconstruction than those who did not, and they believed they were offered a greater number of options for breast reconstruction. The study was conducted at Beth Israel Deaconess Medical Center and Harvard Medical School, both in Boston, MA.

Nearly three-quarters of 168 women who had access to the decision-making aid reported they were solely or mostly responsible for choosing breast reconstruction compared with a little over half of 87 women who did not use the tool. The women also retained more information and were more satisfied with the amount of information they received. Four times more women reported they had learned about four types of reconstruction if they had seen the computer-based learning module (24 percent) than those who had not (six percent). Eighty-four percent of women who used the tool were very satisfied compared with 75 percent of those who did not, according to Bernard T. Lee, MD, FACS, an instructor in plastic surgery, Beth Israel Deaconess Medical Center and Harvard Medical School.

The computer-based decision aid explains each of five breast reconstruction options, presents data on outcomes from the clinical literature, and includes pictures and diagrams. “It talks about what the surgery is like, the postoperative recovery, and the different stages of the operation. It is very comprehensive, almost encyclopedic, but in a very user-friendly sort of format,” Dr. Lee said.

The decision-making tool was given to patients in the form of a compact disc (CD) so they could view the information at home in privacy and at their leisure. “When patients are sitting in your office and you’re going through a consultation with them, they may absorb only 10 percent or 20 percent of what you’re talking about. However, if you offer patients one of these computer aids, they can sit at home in front of a computer, pop in the CD, and go back and forth to look at all the available pictures and information. There is no major rush,” Dr. Lee said.

Use of the CD was not tested in physicians’ offices. However, it could be a valuable adjunct to the education of patients following an operation for breast cancer. Patients that did not view the CD at home were also shown the presentation in the office prior to the standard consultation. These patients found it to be a valuable educational tool in presenting the different choices in breast reconstruction. “Nowadays, it becomes difficult to spend a lot of time with patients explaining things to them during surgical consultations. We haven’t looked at this [scenario] yet, but if you have a good framework for discussing the questions with patients, you could potentially reduce the time that you need to spend with patients but still increase their understanding of the problem,” Dr. Lee said.

The underlying hope is to increase the number of women who have breast reconstruct-tion. Even though improvements in body image and self-esteem have been well documented following breast reconstruction, only about 20 percent of women undergo the procedure. A major reason is the lack of referrals for consultation about breast reconstruction.

In another new separate study reported at the ACS Clinical Congress, 92 percent of 313 patients who were referred for consultation underwent breast reconstruction. None of the 158 patients who were not referred had reconstructive surgery. “Patients who are being referred are much more likely to be reconstructed. If they aren’t referred, the patients are not taking it upon themselves to find out about breast reconstruction. Patients should be given that option,” said Beth Aviva Preminger, MD, MPH, an instructor in plastic surgery at Columbia University who conducted the study under the direction of Christine Rhode, MD, from New York Presbyterian Hospital, New York City.

The study emphasized the role of the breast surgeon as the gatekeeper for breast recon-struction procedures, Dr. Preminger said. “The breast surgeon is there for the treatment of cancer. The focus is obviously on getting the cancer out and treating the patients until they get well. Appropriately so. The question is whether breast surgeons are spending enough time discussing reconstruction with the patient, and if they’re not, are they sending every patient to a plastic surgeon to be evaluated? Because breast surgeons do not necessarily always know who is or who isn’t a good candidate for reconstruction,” she added.

An emerging standard of care is to perform breast reconstruction immediately after cancer treatment so the patient can be spared another operation. “Patients can wake up from the operation thinking they have started on the way to recovery. But there are some instances when the patient is not a candidate for immediate reconstruction. These are issues that a plastic surgeon should have the opportunity to discuss with the patient. Our study underlines to general surgeons–breast surgeons in particular–the importance of sending patients to a plastic surgeon so patients can have that conversation and understand what their options are,” Dr. Preminger explained.

The study also has a message for patients. “Patients need to be advocates for their own care. They need to ask for a referral if they are not getting one, so they make an informed decision about their care,” she concluded.

Source: American College of Surgeons (ACS)

The Sky Begins at Your Feet

carynbookcoverThe Sky Begins At Your Feet: A Memoir on Cancer, Community and Coming Home to the Body, is the title of a recently published book by Caryn Mirriam-Goldberg, poet laureate of Kansas.

Caryn, as many of us decide to do during treatment, kept a journal of her experiences (out of which this memoir was born), but unlike many of us I suspect, she would hand her oncologist pages of the journal to put in with her chart.  It was she says “how he came to know me”.  I love this idea that Caryn connected with her doctor in this way and that he could see her as a whole person, not just another patient.

I have read many cancer memoirs since the day I was diagnosed, and the majority of these are, well let’s be honest, quite prosaic.  At this stage of my journey with cancer, I am looking for something a bit deeper in my reading, something that speaks to my soul. In Caryn’s writings, I have found this.

The subtitle of this book, A Memoir on Cancer, Community and Coming Home to the Body, promises that this book is more than a mere recounting of surgical and chemotherapeutic interventions. Caryn also writes of how her community, friends, family and the beauty of the earth and sky helped her negotiate her journey with cancer.

As befits her calling as a poet, Caryn paints scenes with her words, which evoke sense memories of my own experiences. Her transcendent retelling of these scenes make me almost want to go back to those experiences and live them more deeply. I identify strongly with Caryn’s connection to nature as a source of healing,  but Caryn takes this connection to an even deeper level of meaning. In one memorable scene in the book. Caryn returns home with shorn hair clippings, having decided to shave her head following her first round of chemotherapy. She tells her young son that they are going to give it to the birds so they can make nests out of it. Taking “soft, weightless handfuls” of her hair in their open palms, mother and child scatter the hair in the yard, “both of us imagining baby birds sleeping in my hair, high up in trees.” The book is filled with many such poignantly beautiful rituals, making a sacred art of her experiences.

Caryn is quite clear on her belief that reaching out, not just to family and friends, but to the wider community is a vital step on the healing journey. She is an advocate of the “it takes a village” notion that the care and healing of a person is a community effort, benefitting not just the individual, but the community as a whole.

Finally, and perhaps most fittingly for me at this stage of my journey with cancer, the author’s belief that our bodies are  “the most local earth we inhabit”, was a call to compassion for my own body. While I sometimes struggle with an altered body image, Caryn teaches me to see my body as a part of the earth, “to forgive my imperfections and learn to love being in this flawed but still amazing body (as all our bodies are flawed and still amazing)”.  She reminds me to love my body for what it is right now, to return again to this body as my home, something which ties in seemlessly with my practise of mindful meditation. Just as I can see beauty in nature ravaged by winds and rains, I can surely learn to see that same beauty in the myriad scars of my own body, which bear testimony to my battle with cancer.

I read this delightful book in one sitting, and after finishing the last page, I took a long, slow, mindful breath, and inspired and strengthened by its message, I examined the road-map of scars which criss-cross my body, my home, my earth.  I worked my way up from those faintly visible scars from childhood falls and scrapes, the tomboy climbing gates and trees, running headlong and heedlessly at life; the child learning to ride a bicycle on her first bid for independence and freedom; the raised appendix scar on my tummy; the scar on my arm, gained from a brush with childhood cancer, until I finish at my most recent scar from breast surgery. I looked at that scar and marveled at the skill of the surgeon who performed his life-saving work, cutting away the cancer from my body. Writer, Dana Jennings describes scars as “primal tattoos, marks of distinction that showed you had been tried and had survived the test.”

Each of my scars tells its own story. I haven’t always loved my scars, and society certainly doesn’t encourage us to celebrate them, but Caryn Mirriam-Goldberg in her memoir has taught me to love them as the signs that show the world that like the author, I have indeed been tested and survived the test, stronger, wiser, and more compassionate than before.

Note:

I was asked by Women on Writing to read The Sky Begins At Your Feet for the author’s blog tour. I am delighted to have had this opportunity to encounter Caryn’s work, an opportunity I may not have had otherwise.  

Visit Caryn’s website and her blog to learn more about the author and her transformational work. You can also purchase a copy of The Sky Begins from her website.

dublin 

I am giving one lucky reader a ticket to the Dublin Web Summit. 

As readers know, I am a regular evangelist when it comes to my belief in the power of social media to reach out, build online communities and help get your message out there. The Lance Armstrong Foundation is probably the best example around of how to utilize and maximise the force of social media for good. 

The Dublin Web Summit which takes place this Friday, 30th October, at Bewley’s Hotel, Ballsbridge, Dublin 4, is an international conference primarily aimed at the Irish businesses market, but it will also include sessions aimed at non-profits, which is why I will be attending.  I have one ticket (worth 195 euro) to give away to someone who would like the opportunity to learn more about using social media in this way . Perhaps you are just starting off in the social media world and would like to learn more about how to use tools such as blogging, Facebook, Twitter, etc. to get your message out there. Or perhaps you have already taken that step and would like to learn more about how to maximise your online presence.  If you are interested in this opportunity, leave a comment below, outlining why you would like to attend and how you plan to use the knowledge and expertise to further your social media for good cause. You can also leave a comment on the JBBC Facebook page.

 I look forward to hearing from you and meeting with the winner on the day.

Note: This beautiful image of Dublin is supplied by Maria Olmedo. Visit http://www.myartprofile.com/irlanda to see more of Maria’s work.

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