October is Breast Cancer Awareness Month, and an opportunity for us to consider ways in which women can empower themselves when facing the possibility of this disease. A woman can make lifestyle decisions for prevention, choose to access early detection methods for diagnosis, and understand her options if diagnosed with breast cancer.
With respect to prevention, it can be as basic as diet and exercise choices. We know that diets focused on richly colored vegetables and fruits, low in saturated fats, and limited to one alcoholic drink per day can lower risk of developing breast cancer. Maintaining an ideal body weight and exercising just 30 minutes five days per week is also beneficial. If you are unsure about the use of hormone replacement therapy, meet with your primary care physician or gynecologist to discuss the pros and cons in your particular situation. For those women with a strong family history of breast cancer, ask your primary care physician about the need to see a breast surgeon or genetics counselor about more aggressive ways to manage potential higher risks.
There has been some debate in the press recently regarding the usefulness of mammograms. It is important for women to know that the American Cancer Society, American Society of Breast Surgeons, and the American College of Radiology continue to recommend that women of average risk begin screening mammography at age 40. This recommendation is based on many studies that have shown screening mammography improves survival from breast cancer, and that newer digital mammography is more effective in younger women with dense breasts than the older film mammograms, leading to earlier detection. Patients diagnosed at an earlier stage are less likely to require mastectomies and chemotherapy, and have improved survival rates. You may be advised to start screening at an earlier age if you have other risk factors, including a strong family history. In some patients, there may be additional tests available to help with early detection. If you feel a mass, you should seek an evaluation with your primary care provider regardless of your age. While there is still debate about recommending self-breast exams, I continue to advocate them for women who feel comfortable performing them. Many women in my practice found their own breast cancer with a thorough self- breast exam.
If you are facing a diagnosis of breast cancer, here are some things to remember:
- Most women have early stage disease, which is often curable.
- There are effective treatment options available for all stages of breast cancer. Discuss options for seeking care with your health care provider.
- Each woman’s treatment plan needs to be planned carefully and individualized. When looking for a surgeon, inquire if they focus their practice on treating patients with breast disease. Most surgeons who focus on the most up-to-date treatment of breast cancer also partner with medical oncologists, radiation oncologists, pathologists, radiologists, nurses, reconstructive surgeons, social workers, and research coordinators in a team approach to offer cohesive, compassionate and exemplary care to each and every patient.
In the end, you should feel that your team of physicians and other care providers partner with you and your loved ones to obtain the best outcomes possible.
Diabetes means there is a build-up of sugar, or glucose, in the blood stream. Glucose is the body’s primary source of fuel and is needed in all cells in order for all systems to work. Insulin is a hormone in the blood stream that works like a key to open cells to allow glucose to enter. If a person doesn’t make enough insulin, or if the body doesn’t use insulin correctly, the result will be high blood glucose, or diabetes. Understanding the different types of diabetes, the risk factors, and ways to reduce risk are important because if not controlled, diabetes can lead to serious complications such as heart disease, blindness, kidney disease and nerve damage.
The most common forms of diabetes are type 1, type 2 and gestational.
- Usually discovered soon after it develops due to a severe lack of insulin that happens in a short amount of time.
- Leads to symptoms such as extreme thirst, frequent urination, blurry vision and unintentional weight loss, which are usually severe enough to cause a person to see a doctor quickly.
- Treatment: taking insulin and learning to adjust your diet to keep the blood glucose levels in a safe range.
- Develops during some pregnancies when pregnancy hormones interfere with how insulin works. Too much blood sugar in the mother can cause complications in the baby.
- There are usually no symptoms, so every woman should be screened during routine pre-natal care.
- Treatment: usually diet control, although some women need medication as well.
The most common type of diabetes is type 2, when blood sugar levels rise over time resulting from a lack of insulin or insulin not working correctly. Eventually, when the blood glucose level gets high enough, people may feel extra tired or may have vision changes. Unfortunately people who rarely see a doctor for routine lab work may go years having diabetes without even knowing it.
Risk Factors for type 2 diabetes
- Family History: having a blood relative with type 2 diabetes
- Ethnicities at greater risk: Hispanic, African American, Latino or Asian
- Being overweight
- A lack of physical exercise
While some risk factors such as family history or ethnicity can’t be changed, studies show that people who control their weight and are physically active can significantly reduce their chance of developing type 2 diabetes. In 2002, the Diabetes Prevention Program study concluded that people who were overweight and had slightly increased blood glucose levels sharply decreased their risk of developing type 2 diabetes after following a reduced fat diet and exercise program. The study participants who lost between 5 and 10% of their weight and were able to maintain 150 minutes per week of physical activity had their blood glucose level return to normal.
What should you do to reduce your risk for type 2 diabetes?
- Eat a diet rich in fruits and vegetables, lower in fat – especially animal fat – and including moderate amounts of whole grains. The USDA Healthy Plate (myhealthyplate.gov) is a great tool to show how to balance food choices in a healthy way. You may also consider seeing a dietitian to help you plan a healthy diet.
- If you have any risk factors for type 2 diabetes, it’s is important to talk to your doctor about getting regular screenings. Because most people won’t have any specific symptoms right away, the only way to know if you have high blood sugar is with a simple blood test.
- Discuss your weight and physical activity with your doctor