Thoughts from Rural America

What is One Life Worth?

As you know by now, mammogram recommendations changed this week. No longer are women supposed to get mammograms once a year starting at age 40, women need to wait until they are 50, and then only have a screening mammogram every two years! This is supposedly to cut down on unnecessary biopsies. Right. The god doctors are saving women pain. I have heard this song and dance before. Throughout history women have been on the receiving end of such "benevolence" (think chastity belts, hysterectomies, forced sterilizations). Thank you, but no thank you.

I heard a proponent of the new recommendations talking about the supposed reasons for the change. He said, basically, that it took too many mammograms to find the one woman who had cancer in her 40s. I believe it was something like 1900 mammograms to find one case of breast cancer in a woman in her 40s. The reporter pointed out that at age 50 it took around 1300 mammograms to find one case of breast cancer. She wondered why it was okay to screen 1300 50+ year old women, but not worth it to do 600 more 40-49 year old women. The doctor said that the data simply did not support doing the test in a woman's 40s.

Next week I turn 43. Under the recommendation of my doctor, I started having mammograms at 36. A year ago this past July I got a call from the mammography department at Dartmouth. They had seen something on my mammogram. I ended up having a biopsy. Fortunately, the sample was clean. I guess that makes me a poster child for the new mammogram recommendations camp. The new recommendations could have saved me from the biopsy. Do I care? Do I feel imposed upon because my biopsy turned out to be okay? No, of course not. I think most women would rather be safe that sorry, especially if you are the one woman out of 1900 whose biopsy picked up cancer.

Despite denials that the recommendations were  changed to save money, I personally have my doubts. I am even more suspicious that money is involved in the decision making since the PAP smear test recommendations are also being changed. Couple that with the health care legislation being debated and the fact that insurance companies are looking at potential loss of revenue, I am not one bit surprised that these two foundational screening tests are under fire.

Take one look at the news and you can see I am not alone in my opinion. The new mammogram recommendations have created a furor among doctors and women. I am glad to see that people are not taking this supposedly independent panel's recommendations completely at face value. If we, as women, are not advocates for our own health care, we will see other screening procedures scaled back and eventually may not be covered by insurance at all.

photo by merfam

Over One Quarter of Pet Products Tested Contained Detectable Amounts of Lead

What is Santa bringing your pet this Christmas? A new bed? A chew toy? What about a ball or new collar? Let’s hope Santa and his elves have read the latest information on pet products over at HealthyStuff.org or your furry friend may end up being exposed to hazards any responsible pet owner would frown upon.

The pet product industry is booming. People love shopping for their pets almost as much (or maybe more than) their children. Of course, nobody would deliberately expose Fluffy or Fido to toxic chemicals. The question is whether or not you are exposing your pets to toxic materials, such as lead, arsenic, mercury, chlorine, or bromine. Chances are there is at least one pet product you’ve purchased over the last year that contains one or more of these toxic compounds.

HealthyStuff.org tested over 400 pet products, including collars, beds, chew toys, stuffed toys and tennis balls. Since there are no restrictions on hazardous materials being used in the manufacture of pet products, it was no surprise that HealthyStuff.org found varying levels of highly poisonous elements, especially lead, across all of the different types of pet products they tested. Twenty-five percent, that’s 100 different products, had detectable levels of lead. More than half of all collars contained detectable levels of lead. Tennis balls sold as dog toys contained the most lead, while tennis balls sold for playing tennis often had no detectable levels of any toxin. (At this writing I tried to locate the reference I’d read a year or so ago stating that a dog should not play with tennis balls meant for the tennis court because they have metal embedded in them; unfortunately, I couldn’t find the reference, but will keep looking and post it once I find it.) Take a look at the results of the research over at the HealthyStuff.org website. It’s user-friendly and easy to understand.

A word to the wise as we approach the holiday season and you are buying goodies for your pet’s stocking. Keep your pet healthy. Make sure all the products you use are free of any toxins.

photo by Cindy Funk

It's Time for More Moms to Breastfeed, U.S. Officials Say

Deb's Note:  I think it's about time breastfeeding becomes the norm. This article is from MedicineNet.com.
*************
By Amanda Gardner

HealthDay Reporter

THURSDAY, Aug. 13 (HealthDay News) -- With breastfeeding rates still not at the levels health-care providers and policymakers would like, two U.S. health agencies have decided it's time to take action.

Latest Womens Health News

Representatives of the U.S. Centers for Disease Control and Prevention and the Office of Women's Health, which is part of the Department of Health and Human Services, are spending much of Thursday at CDC headquarters in Atlanta listening to breastfeeding experts tell them what needs to be done to get more women to breastfeed.

Then, by the middle of next year, the agencies say, they plan to issue a "Call to Action" -- a federal document that recommends specific policies and activities to address what they refer to as "an urgent public health priority."

"Helping women breastfeed is a no-brainer in the health and well-being of mother and baby," said Dr. Sheela R. Geraghty, medical director of the Center for Breastfeeding Medicine at Cincinnati Children's Hospital Medical Center. "It's a completely cost-effective mechanism to improve maternal and infant health in the U.S. And, it's an economic benefit, with less formula costs, less bottles."

"Everybody welcomes this," Geraghty said of the government's efforts. "Basically, they are trying to gather information to identify the need. We know moms in lower socioeconomic categories don't breastfeed as often as other moms and that the workplace environment [can be a hindrance]."

In the decade since the federal government issued a "Blueprint for Action on Breastfeeding," some gains have been made but not nearly enough, say many experts.

According to CDC statistics, about 68 percent of women in 1999 breastfed in the days right after birth, increasing to about 74 percent in the 2005-2006 period.

By the time their babies were 6 months old, only 32 percent of women were still breastfeeding in 1999, compared with 43 percent in 2005-06. And by the time the babies were 1 year old, the number had declined even further: to 15 percent in 1999 and 22 percent in 2005-06.

"We have come a long way in helping moms start," Geraghty said, but "those are still pathetic numbers."

The American Academy of Pediatrics and the World Health Organization recommend that mothers exclusively breastfeed their infants for the first six months of life and then continue the practice with other nutrition thereafter.

But just 12.3 percent of mothers exclusively breastfed their babies for the first six months of life in 2005, according to the CDC.

Breastfeeding has been shown to benefit both babies and mothers. Breastfed babies, for instance, have a lower risk for sudden infant death syndrome, diabetes, obesity and asthma. And by breastfeeding, women can reduce their risk for ovarian and breast cancer along with hip fractures and osteoporosis later in life.

But there are obstacles to getting more women to breastfeed. A big one, according to Geraghty, is the American "culture of maternal-infant separation," which she said is partly driven by women working and going to school. Also, many hospitals separate mothers and babies.

"If you want to be successful with breastfeeding, you need to keep the mother and baby together as much as possible," said Dr. Michael Giuliano, director of neonatology at Hackensack University Medical Center in New Jersey. "There are routines in hospitals that do not do that very well."

Most women of childbearing age in the United States now work, and some women return to their jobs as early as six weeks after their baby is born. That can interfere with breastfeeding, Geraghty said, because "it can take a month to six weeks just to establish breastfeeding."

To deal with this, women sometimes "pump" their own breast milk so their babies can be given breast milk while they are at work, but this can be difficult for some.

"Pumps are expensive, and often people don't have a place to pump at work," Geraghty said.

In addition, many women becoming mothers today were not breastfed as babies, nor did they see their mothers breastfeeding siblings, so they have few role models. "Women are just starting from scratch, and that's very hard," Geraghty said. "You add all of that together, and women are having such a challenging time."

Giuliano seemed to agree. "Lots of moms have difficulties breastfeeding, and most don't have three generations of family members around to help them," he said. "We've found that lots of mothers need support, and that takes lots of time and specialized training. Our institution has just hired another lactation specialist."

The goal, Geraghty said, is for "moms to breastfeed as long as they can and ... to have a good experience."

SOURCES: Sheela R. Geraghty, M.D., medical director, Center for Breastfeeding Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati; Michael Giuliano, M.D., chief, neonatology, Hackensack University Medical Center, Hackensack, N.J.; American Academy of Pediatrics, Elk Grove Village, Ill.

Copyright © 2009 ScoutNews, LLC. All rights reserved.

I'm Too Young to Have Breast Cancer, Aren't I? (part 3)

 Is there anything a young woman can do to prevent breast cancer? Like with older women, the chance of developing breast cancer is determined by risk factors. The more risk factors, the higher the chances of getting breast cancer. Some risk factors, like genetics or gender, can’t be changed. Other risk factors, such as consuming the so-called “meat-sweet” Western diet (high fat, meat, sugar, milk, bread, dessert), lack of physical activity and obesity, are changeable. Exercise alone has been shown to decrease risk 30-40% for average and overweight women! Eating a diet high in soy foods has been shown to decrease risk in premenopausal women, including teenagers. So, simply taking care of your body will go a long way to minimizing your risk of breast cancer.

Yes, young women, including teens, can develop breast cancer. But, the odds are low. The best advice to minimize your risk is to live a healthy lifestyle. Eat right, don’t do drugs, don’t smoke, don’t drink, exercise regularly, and keep your body fit.  Pay attention to your body, so you will recognize any changes. If something seems suspicious, see your doctor right away.

I'm Too Young to Have Breast Cancer, Aren't I? (Part 2)

So, although breast cancer is the main cause of death for females between the ages of 15 and 54, the younger you are, the less likely it is for you to develop it. In fact, if you are younger than 19 years old, you have a 0.00025% chance of developing breast cancer. In other words, out of 100,000 females under 19, 25 of them will develop breast cancer. This is according to the National Cancer Institute.

When a young woman is diagnosed with breast cancer her concerns tend to be different than the issues and concerns facing older women. In a younger woman, the cancer is more likely to be very aggressive, more advanced and have a lower survival rate (see my article, You Don’t Have to Have a Lump to Have Breast Cancer).

Body image is more of an issue. Should she have reconstructive surgery or not? How will she pay for it if she doesn’t have insurance? Cancer treatment can mean time out of work. How will she survive without an income? If she’s planning a family, what is chemotherapy going to do to her fertility? What if she does get pregnant after her breast cancer is cured? What if she’s pushed into early menopause by chemotherapy? That’s a problem if she wants children. Early menopause may also raise the risk of osteoporosis and heart disease, which are typically seen in older post-menopausal women.

(to be continued)

I’m Too Young for Breast Cancer, Aren’t I? (Part 1)

 The American Cancer Society estimated that in 2008, 182,460 females in America will be diagnosed with breast cancer. Approximately 10,000 of these females will be under age 40, and 23,000 under age 45. The incidence for females under 20 is even fewer. Young women can and do get breast cancer.

For females ages 15-39, breast cancer accounts for 26% of all cancer, and in the 35-39 year old age group, breast cancer accounts for 39% of all cancer. The leading cause of death in young women between the ages of 15 and 54 is breast cancer. These statistics sound scary. But before you panic, let’s take a closer look.

To make this simple, let’s say we have 100 females in our 15-39 year-old age group. Every one of these 100 female has some type of cancer (breast, lung, leukemia, etc.). Out of these 100 females with cancer, 26 of them will have breast cancer. The remaining 74 females will have some other type of cancer. Out of those 26 females with breast cancer, 10 of them (39%) will be between 35-39 years old. The remaining 16 females will be 15-34 years old.

(to be continued)  

You Don’t Have to Have a Lump to Have Breast Cancer?

What? What are you talking about? What about those self-breast exams I do regularly every month? And my yearly mammogram, what about that?! I feel fine, except for my breast is itchy and hot. I must have an infection. Or a bug bite. I do a lot of stuff outside. Cancer? Of course it’s not cancer. There’s no lump.

What do you mean, there’s more than one kind of breast cancer? I can have breast cancer without any lump? Nobody ever told me that! Why not?

Why not? That’s a question women all over the world are asking when their doctors tell them they have Inflammatory Breast Cancer, or IBC.

IBC is not a newly discovered type of breast cancer. it’s been there all along. It’s just that the push has been to get women checking for lumps, which is good and needs to be done, but that’s tended to sideline the other forms of breast cancer that don’t have lumps involved, like IBC.

Out of all breast cancer cases, about 6% of people with breast cancer have IBC. But, out of all the deaths from breast cancer, about 25% of people who die from it have IBC. So, it’s rare in terms of total number of cases, but not so rare in terms of total number of deaths.

IBC is extremely aggressive and fast moving. All cases of IBC are stage III (locally advanced) or stage IV (advanced, spread to other organs) when diagnosed. IBC strikes younger women, rather than older women. Sometimes it’s noticed in pregnancy or when nursing a baby. A lot of times it’s “written off” as mastitis or something relatively mundane. African American women tend to get IBC more than Caucasian women.

If you notice anything out of the ordinary with your breast, get it checked out. Don’t wait. Some things to watch out for are red, swollen, itchy or warmth of the breast. Skin may be dimpled like an orange peel, the nipple may be inverted. The breast may be sore, ache, burn or feel heavy.

For more information on IBC visit the IBC Research Foundation, the Inflammatory Breast Cancer Foundation or the Inflammatory Breast Cancer Association.