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| Health Alert: Inflammatory Breast Cancer |
Sandra Mahncke thought she was coming down with the flu in late April, but instead of a quick recovery, she has spent the last five months in a race for her life.
She started feeling bad at work. "I had body aches and felt like I had a fever," says Sandra, "by the time I got home and changed my clothes I noticed that my left breast was very inflamed and bright red."
Those are classic symptoms of inflammatory breast cancer or IBC. According to the National Cancer Institute, IBC is "a rare but very aggressive type of breast cancer." It accounts for 1 to 5 percent of all breast cancer cases in the United States.
As with many other cases of IBC, Sandra's wasn't diagnosed right away. Her gynecologist thought she might have mastitis, a fairly common breast infection. When the redness and swelling didn't clear up after one course of antibiotics, the doctor ordered a mammogram. That's when Sandra first knew something was wrong.
"Obviously, I was kind of shell-shocked and in disbelief," recalls Sandra. A breast surgeon broke the news that Sandra's biopsy tested positive for cancer. Sandra says, "It's very frightening and because it's an uncommon disease and we haven't heard a lot of stories from other people."
In spite of its name, Inflammatory breast cancer isn't caused by an inflammation or infection. Experts say IBC occurs when cancer cells block the lymph vessels in the skin of the breast. Surgical Oncologist Sheryl Gabram of the Winship Cancer Institute at Emory University in Atlanta, Georgia, says IBC "presents itself like an infection with redness and swelling, but unlike traditional breast cancer, there usually isn't a mass."
There can also be ridging on the breast and an inverted nipple. A mammogram might reveal thickening skin.
Dr. Gabram says the best way to make the diagnosis is by looking at a woman's breast and obtaining a biopsy. While there are no specific risk factors, experts believe it is more common among African American women and those with a higher body mass index. Typically, IBC is diagnosed in younger women. Sandra is a 48-year-old mother of three teenage boys.
"Twenty years ago, women did not live beyond two years with this disease," says Dr. Gabram. Now, the National Cancer Institute puts the five-year survival rate between 25 and 50 percent. Part of the reason is early diagnosis, the other is aggressive treatment.
"Starting with chemotherapy first, to get control of the disease in the breast as well as throughout the body, followed by surgery and then radiation therapy can definitely decrease the local recurrence as well as increase survival," states Dr. Gabram.
Sandra is halfway through her chemotherapy sessions. She'll have a mastectomy in a couple of weeks. Her husband, Peter, is by her side as she's hooked up to an IV drip and administered chemo. Her doctors don't think the cancer has spread, but Dr. Gabram says IBC can be tricky and is more likely to metastasize than other cancers.
Despite her health crisis, Sandra believes she's lucky, and she's been told her prognosis is good. She advises other women not to wait and make an appointment with their doctor immediately if they notice any unusual changes in their breasts.
She says "it's a totally different world. You really have to shift gears and look at everything in a totally different way...it's definitely not easy. Having the support of doctors and nurses, friends and family makes a world of difference."
- Judy Fortin, CNN
For more information about diagnosing and treating Inflammatory Breast Cancer, check out the National Cancer Institute fact sheet.
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| Health & Fitness Tips: Is Lack of Sleep Linked to Weight Gain? |
By Marjie Gilliam
New York Times Syndicate
Every two years for 16 years, the Nurses Health Study collected data from more than 68,000 women ages 40 to 65, which included information on sleep habits and body weight. The study found that participants who slept five hours a night were 32 percent more likely to experience a weight gain of 33 pounds or greater, and 15 percent more likely to become obese, compared with participants who slept seven hours a night.
The group who slept for six hours were 12 percent more likely to experience major weight gain and six percent more likely to become obese when compared with those who slept seven hours a night. One possible explanation for these differences is that lack of sleep causes the body to burn calories less efficiently. Variations in eating habits and exercise among the groups also explained some of the weight gain, although no single factor can be pinpointed.
The amount and quality of sleep affects hormones that regulate appetite and metabolism. A study at the University of Chicago found that participants who slept only four hours a night for two nights had an 18 percent decrease in leptin and a 28 percent increase in ghrelin. Leptin is a hormone that suppresses appetite by affecting how full and satisfied we feel after eating. Ghrelin is a hormone that stimulates appetite.
With sleep deprivation, levels of leptin fall, while ghrelin levels increase. Participants in the study, all healthy young men, showed a 24 percent increase in appetite along with elevated cravings for sweets, salty foods and starchy foods like bread and pasta. Leptin is only one of a large number of genes that can influence body weight, while environment and lifestyle behaviors remain the primary causes of weight gain.
When a person is fatigued from too little sleep, they are also less likely to exercise, making it easier to put on extra pounds.
Lack of sleep affects other hormones such as cortisol, insulin and growth hormone, potentially causing a desire for high-calorie foods.
It is believed that decreased amounts of REM sleep can lead to increased food intake. REM stands for "Rapid Eye Movement" and is the "dream" phase of the sleep cycle. During REM sleep brain activity increases with less muscle activity.
Aside from the potential increase in body weight, sleep deprivation can have serious effects on physical and mental health.
When the brain has to work harder in an effort to counteract sleep deficit, its ability to function deteriorates quickly. Memory, concentration and problem-solving capabilities decrease. The ability to handle everyday stress, maintain a healthy immune system and control emotions is also compromised.
It is recommended that children ages 3 to 5 years get 11 to 13 hours of sleep per night; ages 5 to 12, 9 to 11 hours; and adolescents, 8.5 to 9.5 hours. Although most experts recommend seven to nine hours of sleep a night for adults, the exact amount needed to function at our best varies from person to person.
What about napping? A study at NASA on sleep-deprived military pilots and astronauts showed that taking a 40-minute nap improved performance by 34 percent and alertness 100 percent. Naps that are too long or taken too late in the day, however, affect the quality of nighttime sleep, so proper planning is important. Generally, a 20- to 30-minute nap is enough time to reap the benefits of increased alertness and performance and improved mood.
Marjie Gilliam is an International Sports Sciences Association Master certified personal trainer and fitness consultant.
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| Health & Wellness Q&A: Moving Beyond Holiday Indulgence |
Still recovering from holiday excess and stress? Cammie Agatep, Bay Area Boot Camp’s Certified Massage Therapist, and Denise Bradley, our in-house Physical Therapist, offer their tips for reclaiming your health and rebalancing your body in the new year.
Q: What are the best ways for people to bounce back from holiday indulgence from a fitness perspective?
Cammie: Get all the Christmas candy and cookies out of your office and home. And team up with someone that has the same fitness goals so you can motivate each other. A lot of times when people try to get back on track with working out, it’s easy to fall out of the routine.
Denise: My answer is two-fold. 1. Set some realistic short-term goals to get back on track. Be patient when looking for results and be prepared to work 4-6 weeks before you see true changes. 2. Try to get motivated in the new year, to change up your old routine in some way. Try a new activity or class and [as Cammie suggested] try to get together with friends/others to help motivate you and keep you accountable.
Q: What do you recommend people do to rebalance after stressful times like the holidays?
Cammie: Once the Christmas tree is down, come in for a massage! I think everyone should treat themselves to a massage on a regular basis. Working out the knots in your body helps relieve stress. It gets the blood flowing. A lot of people hold tension in their neck and shoulders – and it doesn’t go away by itself.
Denise: I take more time for rest/recovery. That includes more ‘off’ days and even more body work/massage. Stress, whether mental or physical, takes its toll on the body. I find working it harder leads to be over-tired and over-training.
Q: Why else would people want to get a massage – besides the fact that it feels good?
Cammie: It helps with ailments. It helps people release toxins. Also, it’s good for people who are dealing with soreness from sports-specific training. And naturally it’s a great compliment to boot camp workouts, as it helps people improve their flexibility.
Q: From a physiological perspective, why is it just as important for people to rest as it is for them to exercise?
Denise: Rest is the time your body’s tissues recover from insult. All training, specifically resistance training, is breaking down tissue in order for the body to repair and thus increase size/strength. Without rest the tissue begins to break down and eventually become injured. This is the main problem with overtraining and inadequate recovery.
Q: What are other some tips you can offer people to prevent themselves from getting run-down?
Cammie: Ask for help. Try not to do it all yourself! I also do a quick meditation where I sit down and focus on breathing into and relaxing every part of my body, starting at my toes and going all the way to the top of my head. It only takes a couple of minutes, but it’s really helpful.
Q: How can people prevent themselves from getting injured in the process of intensifying their exercise routines?
Denise: ALWAYS progress slowly. Allow time to see how the body is going to react to the new level of work before increasing it again. Increase only one aspect of your workout at a time, to avoid overuse injury. For example, if you’re increasing intensity, DON’T increase duration and vice versa.
Q: What else do you do personally – in addition to exercise - to stay in balance?
Cammie: I work in an office and most of the time I’m hunched over my computer. When I get caught up in a project, my body gets tense and I don’t realize it. This leads to a lot of neck and shoulder pain. So I’ve made sure that my desk and my equipment are ergonomically correct. I also bought a hand-held massage roller that I keep at my desk, and I roll it between my shoulders to relieve tension. At the same time, I flex my feet and my toes to keep the blood flowing.
Denise: I try to keep very consistent with both my resistance training and cardio workouts. I am in the gym 4x/week, and do some form of cardio activity 5-7 days a week. I try to mix up the activities to keep from getting bored mentally, but also to keep surprising my body (running, obstacle courses, soccer, etc.). Nutritionally, I try to maintain a certain calorie count per day. I fluctuate my intake to match my output. I eat less overall and less carbs on days where I’m doing less cardio/endurance activity and more protein on heavy resistance days. Not everyone has to be that focused, but they need to be aware of the input/output ratios.
For more information – or to schedule a massage or physical therapy session - please contact us at 415-567-7411 or info@alaviefitness.com
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