Dr Jane O'Brien-Specialist Breast Cancer Surgeon

23/09/2023

In the first few days, you might want to limit who you tell about your diagnosis or keep your news private to give yourself a chance to adjust without interference. Because, although well meaning, some people will react in unexpected ways and might cause you distress rather than be truly supportive or helpful.Some people will be inclined to ask lots of questions, but you may not have all the answers. They might want to tell you other people’s stories, which you might not want or be ready to hear.

There’s a lot to learn, understand and organise when you receive a cancer diagnosis. But you don’t need to do it all at once.

22/07/2023

Season 23 still alive 🐯🐯💪🏻

24/06/2023

Cancer-related fatigue is a common symptom of cancer and its treatment. Unlike regular tiredness, cancer-related fatigue can remain even if you are getting enough quality sleep. While cancer-related fatigue can impact your daily life, there are many ways to help manage it, including through exercise.

Download MP3 (27.37 MB/29:54) Fatigue is a common symptom of cancer and its treatment, and it can be very difficult to treat. However, exercise is one simple method that’s been shown to help people with cancer manage and cope with cancer-related fatigue. In this podcast, Dr. Anna Roshal talks with...

03/06/2023

Regular exercise may boost pain tolerance new research suggests. In a large observational study of more than 10,000 adults, researchers found those who consistently engage in moderate-to-vigorous physical activity over the 7- to 8-year study period reported the highest pain tolerance. However, the results also showed that even light exercise was associated with greater pain tolerance. There was no significant difference in pain tolerance between men and women and all participants experienced a decline in tolerance over time.
There are many potential explanations for the link between higher levels of physical activity and pain tolerance. One is that exercise brings with it some level of pain – from stitches and muscle aches to that burning sensation you feel when trying to squeeze out that last rep. Because of this, exercise has the power to change the way we appraise pain. Exposing ourselves to these unpleasant experiences during a workout can help build resilience – our ability to function in the face of stressful events, such as pain. Physical activity can also build self-efficacy – our belief that we can do certain things despite pain.

There are many physiological and psychological reasons why exercise may boost our pain tolerance.

23/05/2023

MindOnLine
A mindfulness program for people with breast, bowel or prostate cancer

mindonline – a supportive online mindfulness program led by Deakin University for people after treatment for bowel or prostate cancer.

23/05/2023

Patients at high-risk of breast cancer recurrence who adhere to lifestyle recommendations are 37% less likely to experience recurrence and 58% less likely to die from the disease than those who don’t, a new US study reveals.
The findings provide some of the first data detailing the compounding influences of BMI, exercise, diet and smoking before, after and during chemotherapy.
The prospective cohort study of 1300 women with pathologic stage I to III high-risk breast cancer found those who maintained strict adherence to lifestyle recommendations had the longest periods of both overall and disease-free survival.
In examining the role of individual lifestyles, strongest adherence to recommendations for smoking, physical activity, fruit and vegetable intake, and sugar-sweetened beverage consumption were associated with the most significant reductions in recurrence and mortality.
Never smoking and meeting the physical activity guidelines were among the most effective interventions, with strict adherence to either dropping the risk of death by 45% and the risk of recurrence by 35% compared to those who were least adherent.
Patients who were most adherent to fruit and vegetable intake advice benefited from a 31% reduction in death over the study period and 36% reduction in recurrence and avoiding sugar-sweetened drinks led to a 44% reduction in deaths and 27% reduction in recurrence.
However, there appeared to be no advantage for either mortality or cancer recurrence for people who were adherent to BMI, red and processed meat consumption or alcohol guidelines.
Baseline characteristics such as age, menopause status, number of positive cancer nodes, hormone receptor status, tumour subtype, physical activity, smoking status and alcohol consumption were significantly associated with mortality and disease outcomes.
Patients in the normal BMI range were classified as adherent, overweight patients were semi-adherent and obese/ underweight patients were classified as non-adherent.
In relation to alcohol consumption, individuals who abstained from drinking were categorised as fully adherent. Moderate adherence was defined as consuming one or fewer standard drinks per day. Consumption exceeding this limit was classified as non-compliant.
See:
https://jamanetwork.com/journals/jamanetworkopen/articlepdf/2804477/cannioto_2023_oi_230364_1682516035.35199.pdf

While exercise improved outcomes, cutting out meat and alcohol did not.

07/05/2023

Our lovely patient Alana (pictured) appeared in the Herald Sun last week in an article about newly released guidelines for anaethetists regarding intraoperative Intravenous access and blood pressure monitoring in patients who have previously undergone axillary nodal dissection as part of their breast cancer treatment, which official endorses the relaxation of many of the longstanding, but non evidence based restrictions placed on patients following axillary nodal surgery.
It was mentioned in the article, that Alana, who was diagnosed with hormone receptor positive breast cancer in mid 2019, is currently pregnant, with her first baby due in October.
Women have often in the past been discouraged” from becoming pregnant after breast cancer, in addition to which, adjuvant endocrine therapy for the standard 5-10 years “compromises conception” in women with HR+ disease, however a recently published study offers hope for some women with hormone receptor–positive breast cancer to be able to interrupt cancer treatment and still have good outcomes.
Research which was presented at the San Antonio Breast Cancer Symposium in Dec 2022, and published last week in The New England Journal of Medicine (NEJM), has shown that women who have survived hormone receptor–positive (HR+) breast cancer can interrupt their endocrine therapy for up to 2 years to pursue pregnancy without affecting their short-term disease outcomes.
The POSITIVE trial provides prospective data showing that the temporary interruption of endocrine therapy to attempt pregnancy after hormone receptor-positive early breast cancer does not appear to increase the risk of recurrence or of contralateral breast cancer in the subsequent three years.
The trial involved more than 500 premenopausal women from 20 countries who had received at least 18 months of endocrine therapy for HR+ breast cancer. After a 3-month washout, they were given 2 years to conceive, deliver, and breastfeed a baby before resuming treatment.
Taking a treatment break had no impact on recurrence rates, with the 3-year breast cancer–free interval (BCFI) failure rate of nearly 9% comparing favourably with historical controls.
Almost three-quarters of women achieved at least one pregnancy, the majority within 2 years, and the vast majority had resumed endocrine therapy by the end of the study period.
This study offers hope for some women with hormone receptor–positive breast cancer to be able to interrupt cancer treatment and still have good outcomes.
See links below for NEJM article and accompanying editorial:
https://bit.ly/3nGeaLB
https://bit.ly/42wBtGp

07/05/2023

The strongest adherence to cancer prevention lifestyle recommendations is associated with reductions in disease recurrence and mortality among patients with high-risk breast cancer, according to a study published last week in JAMA Network Open.
Researchers examined whether adherence to cancer prevention recommendations before, during, and one and two years after breast cancer treatment was associated with disease recurrence or mortality in the prospective, observational cohort Diet, Exercise, Lifestyles, and Cancer Prognosis Study.
They found that patients with the highest versus the lowest lifestyle index scores experienced significant reductions in disease recurrence and mortality (hazard ratios, 0.63 and 0.42, respectively) and concluded that the strongest adherence to recommendations for smoking, physical activity, fruit and vegetable intake, and sugar-sweetened beverage consumption was most consistently associated with improved outcomes, and that importantly, significant survival advantages were consistently observed in patients diagnosed with more aggressive breast cancer subtypes.
Lifestyle factors potentially play an important part in maximising breast cancer outcomes, and all women should be encouraged to address, and if relevant, modify lifestyle factors, particularly exercise, weight control and smoking.

See:
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2804477

Published in Oncology News · May 06, 2023 Adherence to Healthy Lifestyle Cuts Breast Cancer Recurrence, Mortality Significant reduction seen in disease recurrence and mortality for those with highest versus lowest lifestyle index scores HealthDay    Save  Recommend  Share Facebook Twitter Linke...

03/05/2023

In a recent study published in the journal "Cancer" having depression before or after a breast cancer diagnosis was associated with a lower likelihood of survival.

In a recent study, having depression before or after a breast cancer diagnosis was associated with a lower likelihood of survival. The findings are published by Wiley online in CANCER, a peer-reviewed journal of the American Cancer Society.

25/04/2023

Link to new NCCN Guidelines for Patients®: Inflammatory Breast Cancer:
https://www.nccn.org/patients/guidelines/content/PDF/inflammatory-breast-patient.pdf

25/04/2023

The US National Comprehensive Cancer Network® (NCCN®) has this week published a new addition to its library of patient resources. The new NCCN Guidelines for Patients®: Inflammatory Breast Cancer explain that treatment typically includes systemic therapy to shrink the tumour, followed by surgery to remove the breast and lymph nodes, and then radiation therapy.
Inflammatory breast cancer (IBC) is a rare, aggressive form of breast cancer-;estimated to account for 1-6% of all cases.
It is important not to dismiss any unusual skin changes to the breast, including redness, swollen ni**le area, or warmth to the touch.

Today, the National Comprehensive Cancer Network has published a new addition to its library of patient resources, expanding the information available for breast cancer.

23/04/2023

BCNA Webcast: Prioritising me - Setting healthy boundaries
•Thursday 27 April at 7.00 pm AEST
•Link to register: https://bcna.live/PrioritisingMeWebcast

Focusing on treatment and recovery can leave you feeling mentally and physically exhausted, and during this time, it’s more important than ever to establish boundaries in your relationships, including those with your family, friends and work colleagues, in order to take the best possible care of yourself and focus on living well during and beyond breast cancer.
me

Breast Cancer Network Australia (BCNA) works to ensure a better journey for all Australians affected by breast cancer.

09/04/2023

Join the “Look Good Feel Better” virtual exercise workshop next week.
•Register at: lgfb.org.au/workshop

This is Hope from The Positive Health Project. She is a qualified
oncology and lymphoedema physiotherapist and will be joining us for next week's Feel Better Fridays unisex exercise virtual workshop.

Hope's 'Next Steps' session involves yoga stretching movements, aerobic steps, resistance exercises, and relaxation at the end. The session will get your heart rate up, show you how to build strength in the major muscle groups, and is appropriate for anyone at any level of physical fitness and at any stage of diagnosis, treatment and recovery.

To join us, register at lgfb.org.au/workshop

09/04/2023

The good news is that we can all improve our happiness levels with daily practice.

01/03/2023

"For most people with cancer and survivors, there is one long-term effect that hinders our ability to “think positive”: the dread of a cancer recurrence and/or spread. Many of us feel this dread after a cancer diagnosis, yet we are often afraid to talk about it. Many cancers can and do recur, so it’s almost impossible to box off this fear."

Cancer survivor and psychologist Dr. Cordelia Galgut shares the challenges cancer survivors face in feeling like they should always be positive and grateful to have survived, the problems with this way of thinking, and how survivors can cope with a spectrum of emotions.

01/03/2023

Only about half of U.S. adults meet the guidelines of getting at least 150 minutes of moderate-intensity physical activity or at least 75 minutes of vigorous physical activity a week (or an equivalent combination of the two).
If you look at individuals who meet physical activity guidelines on a regular basis, they have lower risk of strokes, heart attacks kidney problems, high blood pressure, anxiety, depression. You can take almost any medical condition, apply exercise to it and you can significantly improve or reduce the symptoms.

These doctor-recommended strategies make it easier to get more physical activity.

01/03/2023

"In the past few weeks, a series of analyses published by highly respected researchers have exposed a truth about public health officials during Covid. Public health officials refused to change their directives in the face of new evidence, and when a study did not support their policies, they dismissed them and censored opposing opinions."

In the past few weeks, a series of analyses published by highly respected researchers have exposed a truth about public health officials during Covid:

31/12/2022

Wishing everyone a happy and healthy year in 2023.