Detecting Breast Cancer With Implants

In this news story from 10 News, Dr. Cox gives advice to women considering this procedure and how it could affect the detection and treatment of breast cancer.

Be sure to discuss your options with your plastic surgeon.

Handpick a Winning Medical Team

Finding the right group of physicians to care for you during cancer diagnosis and treatment is very important. Linda Hurtado wrote an article in Tampa Bay Parenting  about how she selected her medical team as she faced breast cancer treatment.

Handpick a Winning Medical Team

Coming Up: The Main Event!

We are rapidly approaching the Hooked on Hope Inshore Fishing Tournament! As always, there are some amazing sponsors and donors. Go to their Facebook page or website to learn more about this year's event. There is a pamper party for survivors, a silent auction, and much more!! Online registration is now open, so join us in getting Hooked on Hope!

Nutritional Guidelines for Chemotherapy Patients

Some people experience virtually no side effects from cancer chemotherapy, but this is rare. Most patients report at least some problems, including nausea, fatigue and diarrhea during the treatment.

Reason: The drugs that are used in chemotherapy are designed to kill fast-growing cancer cells. But they also damage fast-growing healthy cells, particularly in the mouth, digestive tract and hair follicles.

Good nutrition is critical if you’re undergoing chemotherapy. It’s estimated that up to 80% of cancer patients are malnourished. People who eat well before and during chemotherapy tend to have fewer side effects. They also are more likely to complete the full course of therapy than those who are poorly nourished and may feel too sick to continue. What to do...

Load up on Nutrient-rich Foods

In the weeks before chemotherapy, patients should emphasize nutrient-dense foods, such as whole grains, vegetables and legumes. The high nutrient load of a healthy diet helps strengthen healthy cells so that they’re better able to withstand -- and then recover from -- the effects of chemotherapy. Here are some good choices...

Dark leafy greens, such as spinach, kale and swiss chard. They’re high in antioxidants, such as beta-carotene, lutein and other phytonutrients. These compounds help minimize the damaging effects of free radicals, tissue-damaging molecules that are produced in large amounts during chemotherapy. Kale is particularly good because it contains indole-3-carbinol, a compound that has anticancer properties.

Olive oil, like green vegetables, is high in antioxidants. It’s one of the best sources of oleic acid, an omega-9 fatty acid that strengthens cell membranes and improves the ability of the immune system to fight cancer cells. I like extra-virgin olive oil because it has been exposed to the least heat.

Garlic. The National Cancer Institute reports that people who eat garlic regularly seem to have a lower risk for intestinal and other cancers, including breast cancer. The strong-tasting sulfur compounds in garlic, such as allicin, have strong antiviral and antibacterial effects -- important for chemotherapy patients because they’re susceptible to infection. In your recipes, try to use fresh garlic. When using, smash it and let it sit for 10 minutes to allow the antiviral properties to become more accessible -- then chop and cook. (To smash garlic, set the side of a chef’s knife on the clove, place the heel of your hand on the flat side of the knife and apply pressure.)

Increase Protein

It’s the main structural component of muscle and other tissues. People who undergo chemotherapy need large amounts of protein to repair tissue damage that occurs during the treatments.

Recommended: About 80 grams of protein daily. That’s nearly double the amount that healthy adults need. Cancer patients who increase their protein about a week before chemotherapy, and continue to get extra protein afterward, recover more quickly. They also will have more energy and less fatigue.

Try this: Two or more daily smoothies (made in a blender with juice or milk, a variety of fresh fruits and ice, if you like) that are supplemented with a scoop of whey protein powder. The protein in whey is easily absorbed by the intestine. And most people can enjoy a nutrient-rich smoothie even when they have nausea or digestive problems related to chemotherapy.

Drink to Reduce Discomfort

Stay hydrated both before and after chemotherapy sessions to reduce nausea. Drink liquids until your urine runs clear -- if it has more than a hint of yellow, you need to drink more.

Helpful: Soups and broths provide water, as well as protein, minerals and vitamins.

Avoid Your Favorite Foods Two Days before Treatments

It’s common for chemotherapy patients to develop food aversions when they get nauseated from treatments and then to associate the nausea with certain foods. It’s sad when people develop aversions and can never again enjoy their favorite foods.

Eat Lightly and Frequently

People tend to experience more nausea when the stomach is empty. During and after "chemo days," keep something in your stomach all the time -- but not too much. Patients do better when they have a light snack, such as sautéed vegetables or a bowl of broth, than when they go hungry or eat a lot at one sitting.

Treat with Ginger

When your stomach is upset, steep three slices of fresh ginger in a cup of simmering water for 10 minutes, then drink the tea. Or grate fresh ginger with a very fine grater, such as a Microplane, and put the shavings under your tongue. Ginger alleviates nausea almost instantly.

  

Overcome "metal mouth"

The drugs used in chemotherapy can damage the nerves that control the taste buds. Some people complain about a metallic taste in their mouths after treatments. Others notice that foods taste "flat" or that their mouths are extremely sensitive to hot or cold.

These changes, known as transient taste changes, usually disappear a few weeks (or, in some cases, months) after treatments, but they can make it difficult for people to eat in the meantime.

Helpful: The FASS method. It stands for Fat, Acid, Salt and Sweet. Most people will find that it’s easier to enjoy their meals, and therefore ingest enough nutrients, when they combine one or more of these elements in every meal.

For fat, add more olive oil than usual to meals... lemons are a good source of acid... sea salt has less of a chemical aftertaste than regular salt... and maple syrup gives sweetness with more nutrients (including immune-building manganese and zinc) than table sugar.

Try Kudzu Root

Used in a powder form to thicken sauces, puddings and other foods, it soothes the intestine and can help prevent diarrhea. You also can dissolve one teaspoon of kudzu root in one teaspoon of cold liquid and drink that. Drink after meals, as needed. Kudzu root is available in most health-food stores.

Soothe Mouth Sores

You can do this with soft, easy-to-eat foods, such as granitas (similar to "Italian ices") or smoothies. The sores can be intensely painful, which makes it difficult to eat.

Recommended: Watermelon ice cubes. Purée watermelon, and put it in a tray to freeze. Then suck on the cubes. The cold acts like a topical anesthetic -- you can numb the mouth before eating a regular meal. And the juice from the melon is just as hydrating as water but provides extra nutrients, including the antioxidant lycopene.






Go to our website for more guidelines. There you can get a FREE PDF copy of the National Cancer Institute's book "Eating Hints: Before, During, and After Cancer Treatment." Do these pointers help you? Tell us what has worked for you!

Join us for a Party!

Breast Cancer Studies Highlight the 2012 ASCO Conference

At this week's annual conference of the American Society of Clinical Oncology (ASCO), some impressive studies were presented highlighting advancements in breast cancer treatment and detection. Below is an interview with the ASCO president about some of the findings presented at the conference.

Watch Breast Cancer Treatment Averts 'Collateral Damage' to Cells on PBS. See more from PBS NewsHour.

Cryoablation at USF Breast Health

Watch Potential Breakthroughs in Breast Cancer Research on PBS. See more from Need To Know.

About Your Port

What is an implantable port?

Sometimes referred to as a Mediport®, Port-A-Cath® or Infus-A-Port®, an implantable port is a device that is placed completely under the skin and provides direct entry to your blood system. It is used to reduce the need for insertion of an intravenous (IV) line each time treatment is required. The device has two connecting parts: a soft plastic tube called a catheter, and a small round disc called a port.

What can the port be used for?

• Delivering medicines, including chemotherapy

• Drawing or giving blood or blood products

• Receiving intravenous (IV) fluids and nutrition

Insertion of the port:

The port is usually inserted as an outpatient procedure under local anesthesia. Some surgeons may choose to do it in the operating room. Two small incisions are made. One end of the catheter is placed into the vein and the other end is threaded beneath the skin to create a “port pocket”. Fluid is injected into the port to insure it is working properly. The port is placed into the pocket and sewn into place. Both incisions are then closed.

It takes approximately one hour to implant the port. Thin paper strips with gauze and a clear dressing will be placed over the incision sites. You will be able to feel a small bump about an inch in size under the skin where the port is located. This area may be slightly swollen and tender for the first few days. The stitches will usually dissolve after two weeks.

 

How does the port work?

Since all parts of the port system are located under the skin, a special needle, called a Huber needle, is needed to “access” your port. The needle is inserted through the skin and the rubber-like top of the port (septum) and connects with the catheter. After your treatment is complete, the needle can be removed.

Postoperative instructions for your port:

• The area surrounding the port may become sore and/or tender as the local anesthesia wears off. An ice pack may be used for comfort and to lower the chance of swelling. It is helpful to move your arm as usual.

• You may take medication prescribed by your doctor for discomfort. Avoid products that contain aspirin.

• You may shower 24 hours after your procedure. Do not take a bath, use a hot tub, or go swimming until your incisions are well healed. This takes approximately 2-3 weeks.

• Leave the clear plastic dressing on for one week. The thin paper strips on the incision line may stay on an extra week. If the dressing becomes soiled or very wet, you may take the clear plastic dressing off and replace it with sterile gauze. Change this once a day for a week and do not shower.

• You should avoid strenuous activity, heavy lifting and contact sports for at least 3 weeks.

• Reinforce the dressing with gauze and tape as needed. If bleeding should start, apply constant pressure to the area for 20 minutes. If this does not help, call your doctor.

• If you have any questions, please do not hesitate to call.

Call us if you have:

• Bleeding that does not stop

• Shortness of breath or increasing chest pain

• Redness, swelling or pus at the incision sites

• Fever over 100.5 F

How do I take care of my port?

1. Since no part of the port is outside of your body, you can carry on with your normal activities, including showering and swimming, after the site has healed. It is not usually necessary to place a bandage or dressing over the site.

2. To keep the catheter free of any blockage, it must be flushed monthly. This can be done at the same time as your regular check-ups or doctor visits.

3. If an infusion is needed over a number of days, a needle will be kept in place during this time. Avoid excessive movement while the needle is in place in order to prevent it from coming out of the port. During any hospitalization, the needle and the dressing will be changed every week. If you experience any swelling, stinging or pain in the area of the port during an infusion, call your nurse right away.

4. Avoid irritation of the skin over the port by making sure items such as bra straps, seatbelts, or other objects do not put pressure on the port by resting or rubbing on it.

Port removal:

The port can stay in place as long as medically necessary. Once the port is no longer needed, it can be removed. This procedure can be done at our clinic at the LifeHope Medical Offices in our procedure room. The removal of your port will be done as an outpatient procedure under local anesthesia. It will take about 30 minutes and will be done through the same incision where it was placed. As before, you will have a clear dressing, gauze and small paper strips over the incision. The sutures will dissolve. You will follow the same post-operative care as after the initial placement.

During the time that you have your port, you can always call us to answer any questions. 

Exercising After Breast Surgery

Linda Hurtado continues to inspire and educate the public about breast cancer as she struggles with her own recovery. In the video below, Linda's plastic surgeon gives some good advice on getting back to exercising after breast surgery.

 

We All Need Somebody

Check out this story about three sisters that are battling breast cancer at the same time. Even though each of them have had to go through this cancer, they have had each other to draw strength from.

Who do you lean on during times of hardship? It is important to have a support system as you go through the  difficult time of treatment and recovery.


The Breast Care Center, right down the hall from us at the LifeHope Medical Office Building, holds a support group every fourth Tuesday of the Month. There you can meet with others who have either had breast cancer, or are going through breast cancer at the same time you are. Certainly your family and friends are a key support during your trial with cancer, but sometimes it is nice to hear from someone who has been there. Someone who has felt the pain and fear you may have. Someone who is learning just as you are how to navigate through the lengthy process of cancer care. Come and join the group. You will get to ask questions you may have about your care and hear from others who have breast cancer. Who knows, maybe you will be that special support to someone who needs to hear your experience.

Go to our website to see times and dates for upcoming meeting times.

Managing Your Scar

What is a scar?

Scars result when the body repairs skin wounds caused by surgery, accident or disease. They are the natural result of the healing process. The longer it takes a wound to heal and the more damaged the skin, the greater the chance of a noticeable scar. The location on the body or face as well as the patient’s age and skin type will affect the way a scar forms. Older skin tends to scar less visibly whereas younger skin tends to over-heal resulting in larger and thicker scars.

Why are scars visible?

Mature scars become visible if they are raised, indented, or if they exhibit a different color or texture compared to the surrounding skin. Additionally, scars that cross wrinkles or natural expression lines will appear more visible because they neither follow a natural pattern nor look like a naturally occurring line.

Why do scars form?

All skin wounds will result in a scar. When a skin wound occurs from surgery, accident or disease, the body will respond with normal wound healing. Wound healing is characterized by three sequential and overlapping phases.

•  Inflammation: In the first phase the body tries to heal the skin wound by a process of inflammation. During this time the scar will be swollen, tender and red. This phase can last up to two weeks.
• Proliferation: In the second phase the body starts the skin repair process by depositing scar tissue within the wound. In this phase, which may last up to six weeks, the scar will become raised and hard as large amounts of collagen are being laid down within the scar. During the proliferation phase a scar is considered immature and is characterized by the three R’s: red, raised and rigid.
• Remodeling: In this third phase the body works on the scar to soften and flatten it. During this period the scar will become more mature as some of the collagen disappears. This phase can last from twelve to eighteen months.

How can I lessen my scar?

Scar formation and scar maturation are ongoing processes. Scars continue to grow and change throughout the recovery process which may take from twelve to eighteen months. Scar massage is an effective way to decrease scar tissue build up and help make scars less noticeable. Massage will not help soften a scar more than two years old.

What is scar massage?

Scar massage is one method of softening and flattening scars. It serves several important functions:

• Promoting collagen remodeling by applying pressure to scars
• Helping to decrease itching
• Providing moisture and flexibility to the scar

When should I start massaging my scars?

You should start massaging your scars two weeks after surgery. Wait until the sutures have been removed and all scabs have fallen off by themselves. Do not pull your scabs off.

How do I massage my scars?

Use the pads or soft tips of your fingers to massage the scar and tissue around the scar. Massage in all three directions.

 

Circles: Using two fingers make small circles over the length of the scar and the skin surrounding it.

Vertical: Using two fingers massage the scar up-and-down.

Horizontal: Using two fingers massage the scar from side-to-side.

How much pressure should I apply?

You should apply as much pressure as you can tolerate. Begin with light pressure and progress to deeper and firmer pressure. Massage lotion in, applying enough pressure to make the scar area lighten in color or turn white.

How often should I massage my scar?

Massage should be done two to three times daily for ten minutes each time.

How long is massaging necessary?

You should massage your scars as instructed for at least six months following your surgery or injury. Massaging for more than six months will not hurt your scars and may actually prove beneficial.

When should I stop massaging?

Stop massaging and contact your doctor if you experience any of the following:

• Redness
• Bleeding
• Scar feels warmer than the skin around it
• More pain than usual at the site of the scar

What else should I know about scars?

While your scars are healing, you should avoid sun exposure. Sun exposure may cause your scars to hyper pigment, or turn darker than the surrounding skin. You should use sun block with an SPF of 35 or greater and wear protective clothing at all times. Keep your scars away from the sun for at least one year following your surgery.

What lotion should I use?

• Use any moisturizing lotion that will keep your skin soft and supple.
• Do not use heavily perfumed lotions.
• Do not use any lotion containing vitamin E for the first month following your surgery or injury. You may use vitamin E containing lotions after the first month.

The following is a list of some examples:

Arbonne®

Eucerin®

Nivea®

Aveeno®

Mederma®

Copper Scar Cream®