Birthday parties – 14 million of them

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Any excuse to celebrate, and millions of birthday parties around the world tell the story – cancer, though still a big public health concern, is not a death sentence. Since reaching a peak in the early 1990’s, cancer death rates have been steadily falling – at around 20% for women and over 25% for men. This is according to Cancer Research UK and the American Cancer Society. Probable reasons for this improvement are: – fewer people smoking – improved screening and early diagnosis for common cancers – more treatment options – targeted drug and/or radiotherapy treatment – new surgical techniques – more effective treatment and prevention of co-occurring conditions such as diabetes, obstructive airways disease, stomach ulcers, chronic infection and so on “We needed to give patients more options and better news about their future. I was impatient for more advances sooner and I still am. But clearly we’re moving in the right direction” – Prof Peter Johnson, Cancer Research UK There are still challenges. Pancreatic cancer appears to be on the rise, and amongst women, lung cancer has increasing by around 8% (whilst falling amongst men). This is thought to be the tragic harvest of 1960’s cigarette marketing, which successfully targeted millions of women by promoting tobacco smoking as an aid to slimming. Whilst older women tend to take better care of their health, younger women sometimes fail to notice or to report symptoms that could serve as early warnings of cancer. These include: – unexplained weight loss – bloating – breast changes: lumps, thickening, persisting rash, discharge, nipple changes – unusual bleeding – skin changes (moles, pigmentation, scaling) – difficulty swallowing – blood in urine or stool – gnawing abdominal pain especially associated with depression (may indicate pancreatic cancer) – indigestion for no apparent reason – white patches or spots in the mouth (especially if you are or were a smoker) – unexplained pain: not likely to be cancer but get it checked out – a swelling under the armpit, in the neck, or anywhere else – unexplained fever (sometimes associated with early blood cancers) – persistent fatigue, even if you think you have reasons to be so tired – persistent coughing There are a few ‘wild cards’ in our future whose effect on rates of cancer diagnosis and death are still unknown. The most worrying of these is the so-called “obesity epidemic”, especially insofar as it affects younger people. Recent research has connected excessive sugar consumption with a variety of conditions including auto-immune and inflammatory conditions which may predispose to some forms of cancer. We really need to start dealing with this!  ...

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Calling nursing professionals!

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Port Elizabeth’s nursing professionals – community nurses, midwives, nurse trainers and hospital nurses – have a fantastic opportunity to develop clinical skills in breast care and the nursing management of breast problems. And thanks to sponsors Netcare, Carecross and Pathcare, the Breast Course for Nurses (BCN) is absolutely FREE. Cape breast-cancer surgeon Dr Jenny Edge has run this training course for some years in Cape Town, and is now bringing it to Port Elizabeth. The BCN has been adopted in University settings (UCT, US and UJ) as well as by Baragwanath Hospital and Netcare nursing. It is not formally accredited (in order to keep it affordable and accessible to all nurses) but has been well received over the past few years – see the BCN website for more information and feedback from colleagues.  The course begins with an Introductory day (19th May, 2014)  in which two modules are presented. To take home, each participant receives a course manual specially written by Dr Edge and Prof Dave Woods. This book uses the popular Perinatal Education Programme (PEP) format of affordable,enjoyable, practical education at a pace suited to busy nurses, to update knowledge of the most common and important breast conditions. Over the next six months, regular Multiple-choice Questionnaires keep participants motivated and up to speed with the main learning content. The course rounds off in November with two days of practical workshops (details to be advised). Places are limited to a maximum of 50 participants and booking for the PE course is already going well, so don’t snooze or lose – call Lieske to book your place or ask your questions. Date and Time: Monday, 19th May, 9am-3pm Place: Netcare Training Academy, 1st Floor, Pamela Arcade, 2nd Ave, Newton Park            ...

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Crowning glory – from PE with love

Posted by in Blog, Looking Good, Well being | 0 comments

“People always ask me how long it takes to do my hair. I don’t know, I’m never there.” ― Dolly Parton When we think of wigs, the picture coming to mind might be something that screams “Diva”. As Dolly herself often says “it takes a lot of money to look this cheap!” Patients undergoing chemotherapy face a dilemma: whether to “go bald” and brave it out with caps and scarves, or cover up with a wig. Tracey Gervais (Wigs@Hair@Tracey’s, Amble In Centre, Main Road, Walmer) understands that helping a woman find the perfect wig is a ministry to her soul. Patients at Bay Breast Care had recommended Tracey, so we got together with her recently.  Here’s what we learned. After running a successful hair salon in Port Elizabeth for 33 years, Tracey was given a golden opportunity last year, to take over a long standing wig-fitting business. She’d always loved wigs, but sharing premises with expert wig fitter Norbert for a year in 2012 really inspired Tracey as she saw the clients come in looking ordinary, and go out with their new wigs “looking fantastic”. Tracey even asked Norbert if she could work alongside to learn from him – but he turned her down, explaining that his approach was always very personal, sensitive and extra-respectful of clients’ privacy so he wouldn’t be comfortable with that – an attitude that made Tracey respect him even more. But when the time came a year later for Norbert to retire, he offered Tracey the business, and she couldn’t have been more honoured that he was putting his trust in her. (We aren’t surprised. Tracey’s caring approach and love for people is obvious). Women undergoing treatment for cancer form the majority of clients, then and now. Tracey says that her clients often fear losing their hair more than breast surgery: “So many women tell me, ‘Maybe my hair won’t fall out’. I ask them, ‘What does your doctor say? That hair loss is a side effect? Then it is going to fall out, so let’s make a plan before it happens”. With chemotherapy, hair usually takes at least a year to return fully – and it may not look the same as before. It could grow out grey if hormone replacements have been stopped, or have a different texture. Keeping it under the wig until you’re ready buys time to decide on a style that works for you in the longer term. “My word is ‘enhance’, because the right wig makes a woman look and feel so much better than she did before, yet it’s still her own look”, says Tracey.  “When a client is so happy and excited to go out with her new wig, well,...

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Vitamin D – are you getting enough?

Posted by in Blog, Prevention, Uncategorized, Well being | 0 comments

For some time it’s been known that maintaining adequate levels of Vitamin D helps prevent cancer, especially colo-rectal cancer but also of the breast, pancreas and bladder. Now there’s evidence that women who already have breast cancer can benefit from increased Vitamin D. A major review study reported in the journal Anticancer Research has found that women with high levels of Vitamin D in their blood when diagnosed with breast cancer showed improved survival rates (at average 9 years), compared to women with low Vitamin D levels. The study involved 4443 patients with breast cancer and according to the statistics there is almost no probability that this difference occurred by chance – though further research is needed to see whether more severe illness can lower Vitamin D levels. Improved levels of Vitamin D prevent cancer by helping cells to stick together. When cells are loosely packed they start reproducing at a faster rate and may evolve into cancer cells. The presence of Vitamin D can keep a developing cancer in check by limiting its ability to develop its own blood supply, and/or to invade nearby structures like blood vessels. Dr Cedric Garland of the University of California, San Diego, told Medscape Medical News that up until a fairly late stage of development, cancer cells have intact Vitamin D receptors. He recommends that women undergoing treatment for breast cancer should check their blood levels of Vitamin D, to keep it in the optimal range. And most women could use more Vitamin D. The average American would be in the “low” group whereas the “high” group had nearly twice as much Vitamin D. Moreover, current recommendations for daily consumption are conservative: you would have to take a large amount of Vitamin D on a daily basis before signs of toxicity (such as thirst, nausea, stomach upset or muscle weakness) occur. This would be unlikely unless supplements are added to natural sources. Vitamin D deficiencies by contrast are fairly common, especially in climates where winters are long and cold. Some of the study data came from Canada, but studies in Southern Australia have also found Vitamin D deficiency, so South Africans shouldn’t be complacent about our sunny skies. Here are some ways to keep Vitamin D in good supply: – Sunlight. Make the most of the sun, especially in winter – it’s 100% free! You don’t need to risk getting burned – 20 minutes will do. After that, avoid the hottest part of the day or use sunblock, keeping the sun off your face if you want to protect your youthful good looks. – Oily fish, which comes with a bonus of cholesterol-free protein and heart-healthy fatty acids. A generous serving of...

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Psychological Resources for people living with cancer

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For anyone living with cancer and looking for accessible, trustworthy resources, Ken Pope’s psychology resource pages are a goldmine. He provides this valuable service at no charge and always shares freely with other interested groups. Thank you, Ken – you’re a scholar and a gentleman! Your site represents the Web at its very best – well researched, helpful, relevant, and also free. The cancer support page offers full citations of 153 recent articles, chapters, and books. These include academic studies, discussions of therapy, peer counselling, self help – and more. There are also links to similar pages of related resources: 1) 12 Useful Steps if You’re Diagnosed With Cancer 2) Cancer Exercise: Prevention Recovery 3) New Resources for Breast Cancer 4) New Resources for Prostate Cancer 5) New Resources for Lung Cancer 6) New Resources for Colon Cancer 7) Resources for Caregiving 8) New Resources for End-of-Life Challenges This last page gives information about Hospice care, and creating an “At-Home Hospice” (very relevant in PE where our Hospice does not have an in-patient unit). It also discusses Living Wills and Advance Directives. Knowledge is power. The more we know, the more we can change our own lives and the world around us to offer better service and support to people diagnosed with cancer and those who care for...

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You wish you had breast cancer?

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This is Kerry Harvey, aged 24 and living with metastatic Pancreatic Cancer. In the UK this week, Pancreatic Cancer Action grabbed attention with a series of terrifying ads featuring her and others with the same diagnosis. Spokespersons from breast cancer organisations were horrified that anyone would wish for breast cancer, or compare different forms of cancer this way. Breakthrough Breast Cancer chief Chris Askew fumed, “I’ve yet to meet a man or woman with breast cancer who would consider themselves in any way fortunate to have received a diagnosis!” Reuben Turner, whose grandfather died from pancreatic cancer, comments, “…wishing you had one form of cancer over another, or cancer instead of another disease, seems to me like the last resort of the desperate. But maybe that’s the point. Maybe these people are desperate. Desperate for attention. Desperate for funds. Desperate for a cure”. Jenni Murray expressed similar anger as someone with a history of breast cancer, but also shared the process by which she came to understand and support PCA: “When I first saw the advert showing a picture of a ravaged, bald patient suffering from cancer of the pancreas, with the tagline ‘I wish I had breast cancer’, I felt an overwhelming sense of fury. ‘How could they make such a comparison?’ I thought, fuming at the Pancreatic Cancer Action charity that produced the image. ‘Does it really think breast cancer is a breeze? Just a bit of fun, swathed in pink ribbons?'” Kerry Harvey denies that it can be a breeze to have breast cancer; but still affirms that if she had to have cancer at all, she would prefer that to what she has which is “almost no hope”. This controversial statement draws attention to a crucial aspect – the illness narrative or script that follows a particular disease, shaping the way we think about it – and to some extent the way we experience it and the treatments available. The very meaning of life is represented in scripts like this, which are not made up from nothing. Instead, the stories of our lives – including stories of being diagnosed, experiencing treatment, and remission or recovery or failure – are put together like sandcastles. Variations are infinite; but all are limited by the nature of the building material we have at hand. Like any other story, illness narratives draw the listener into the world of the central characters, setting the scene. How does Breast Cancer enter the action? Often, after a routine examination followed by more specific tests…But, go back a couple of decades or somewhere with limited health services, and the setting, the main characters and the action would look very different. This critical difference...

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