Breast Cancer Awareness Month

Breast Cancer Facts: 5 Common Myths Debunked

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One of the toughest parts about researching breast cancer online is trying to sort fact from fiction. The internet is full of half-truths, conflicting reports and flat-out myths about the disease. Provision CARES Proton Therapy is committed to our Culture of CARE, putting the patient experience first. So, for Breast Cancer Awareness Month, we’re debunking five of our most commonly heard myths. All of these breast cancer facts have been verified for quality and accuracy by our cancer care experts to help you make an informed decision about your healthcare.


MYTH: I found a lump in my breast, so I have cancer.

TRUTH: Lumps don’t always indicate cancer. Likewise, the absence of lumps doesn’t always mean you don’t have breast cancer.

While the most common symptom of breast cancer is a lump, most breast lumps are caused by conditions other than cancer. According to the Centers for Disease Control and Prevention (CDC), the two most common causes are fibrocystic breast condition and cysts. Fibrocystic condition causes noncancerous changes in the breast that can make them lumpy, while cysts are small fluid-filled sacs that develop in the breast.

The American Cancer Society (ACS) says lumps are more likely to be cancerous if they are painless, hard and have irregular edges. However, some breast cancers can be painful, soft or round. That’s why you should always check with your doctor if you notice any changes in your breasts.

There are many other symptoms of breast cancer, even if a lump is not detected. These can include swelling of the breast, skin dimpling, breast or nipple pain, nipples turning inward, red or flaking breast skin, nipples discharging fluids other than breast milk, and swollen lymph nodes under your arm or around your collar bone. The ACS recommends contacting your doctor if you experience any of these symptoms.


MYTH: Breast cancer only happens to older women.

TRUTH: Breast cancer can develop in younger women, too, as well as men.

While your risk does increase with age, the NCI reports women in their 30s have a 1 in 208 chance of developing breast cancer. By the time a woman reaches her 40s, that risk has increased to 1 in 65. Overall, it’s estimated that 1 out of every 8 women in the United States will develop breast cancer at some point in her life.7

Breast cancer in men accounts for less than 1% of cases in the United States. However, the ACS says male breast cancer is on the rise.1 Unfortunately, a higher percentage of men are diagnosed with advanced-stage breast cancer, likely a result of less awareness and fewer early-detection screenings.

If you’ve been diagnosed with breast cancer and would like to learn more about proton therapy as a possible treatment, please visit our Proton Benefits page or contact a Care Coordinator.


MYTH: My family has no history of breast cancer, so I am not at risk.

TRUTH: While a family history of breast cancer does put you at greater risk, most women who develop breast cancer do not have a family history of the disease.1

According to the CDC, a family history of breast cancer may put you at higher risk for the disease, but is not indicative of whether you’ll actually develop cancer.2 In fact, the ACS says most women with one or more affected first-degree relatives (parents, siblings, children) will still never be diagnosed.

The CDC provides a table with examples of average, moderate and strong family health histories, along with suggestions for preventative measures each group can take. Regardless of your family history, the CDC recommends you get mammograms and other breast exams as recommended by your doctor, maintain a healthy weight and exercise regularly. As family history of breast cancer increases, genetic counseling becomes an option to test for hereditary breast cancer. Be sure to talk to your doctor about what screenings are best for you and when you should get them.


MYTH: A double mastectomy will eliminate my risk of breast cancer.

TRUTH: If the cancer is detected early enough, other treatment options can eliminate the cancer without removing the entire breast.

A mastectomy involves removing the entire breast and is typically performed when breast-conserving surgery (lumpectomy) is not an option. However, women with early-stage cancers can typically choose between the two types of surgeries. The ACS notes that while it’s normal for your gut reaction to be to “take out all the cancer as quickly as possible” with a mastectomy, the fact is that, most of the time, a lumpectomy combined with radiation therapy results in the same outcome.

Many patients at Provision CARES Proton Therapy choose to combine a lumpectomy with proton radiation therapy. Proton therapy for breast cancer treatment is non-invasive and painless, causing less cosmetic damage than conventional x-ray radiation. It is extremely precise and therefore more effective at targeting cancerous cells without causing damage to surrounding breast tissue. Because proton radiation has little to no impact on a patient’s energy level, quality of life during treatment is improved.

For women who do opt for a mastectomy, it’s important to remember that post-surgery treatment is still necessary. Even after removing the breast, there’s a small chance the cancer could recur on residual breast tissue or the chest wall. You should continue to perform self-breast exams and see your doctor on a regular basis.


MYTH: Antiperspirants and wire bras can cause breast cancer.

TRUTH: There has been no conclusive evidence linking antiperspirants or bras to breast cancer.

Rumors have swirled across the internet claiming underarm antiperspirants cause breast cancer. The National Cancer Institute (NCI) says the basis of these claims is the aluminum-based active ingredient in antiperspirants. Some scientists have suggested that absorbing these aluminum compounds into your skin could increase your risk factor for breast cancer.4 Still, no clear link has ever been established between antiperspirants and breast cancer. In fact, the NCI even cites a study from 2002 that concluded there is no increase in risk for breast cancer among women who reported using an underarm antiperspirant.3

Another rumor making its rounds across cyberspace is that wearing a wire bra can increase your risk of breast cancer. This myth was debunked by a 2014 study published by the American Association for Cancer Research. According to the authors, it had been suggested in the media that bras impede lymph circulation and drainage, interfering with the process of waste and toxin removal.6 However, the study concluded that wearing a bra had no effect on your risk of breast cancer.


Sources:

  1. Breast Cancer Facts & Figures 2017-2018. American Cancer Society. https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/breast-cancer-facts-and-figures/breast-cancer-facts-and-figures-2017-2018.pdf
  2. Breast and Ovarian Cancer and Family History Risk Categories. Centers for Disease Control and Prevention. https://www.cdc.gov/genomics/disease/breast_ovarian_cancer/risk_categories.htm
  3. National Cancer Institute. Antiperspirants/Deodorants and Breast Cancer. https://www.cancer.org/cancer/cancer-causes/antiperspirants-and-breast-cancer-risk.html
  4. Darbre PD. Aluminium, antiperspirants and breast cancer.Journal of Inorganic Biochemistry 2005; 99(9):1912–1919. [PubMed Abstract]
  5. Mirick DK, Davis S, Thomas DB. Antiperspirant use and the risk of breast cancer.Journal of the National Cancer Institute 2002; 94(20):1578–1580. [PubMed Abstract]
  6. RayCC. Q and A – Bras and Cancer [Internet]. NY times; 2010 [cited 2013 Dec. 16]. Available from: http://www.nytimes.com/2010/02/16/science/16qna.html?ref=science.
  7. Howlader N, Noone AM, Krapcho M, et al. (eds). SEER Cancer Statistics Review, 1975-2016, National Cancer Institute. Bethesda, MD,https://seer.cancer.gov/csr/1975_2016/, based on November 2018 SEER data submission, posted to the SEER web site, April 2019.

 

proton therapy for breast cancer treatment

Proton Therapy for breast cancer treatment ‘safe and effective’ concludes new study

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Proton therapy for breast cancer treatment is “safe and effective.” That’s the conclusion of a new study released in the Journal of Clinical Oncology, which highlighted proton therapy’s ability to control cancer cells with much less toxicity in the heart and lungs as compared to conventional (x-ray) radiation therapy.

“In our prospective trial of women with locally advanced breast cancer who required treatment of the internal mammary nodes, proton beam radiation therapy was safe and effective,” says Shannon M. MacDonald, MD, of Massachusetts General Hospital in Boston, and colleagues.

Breast cancer tumors usually occur in the lobules and ducts of the breast, which are used in the production and delivery of breast milk. Breast cancer is the most common cancer among women aside from skin cancer. Men are also susceptible to breast cancer, although the disease is rare among males.

As with other cancers, the best possible outcomes for breast cancer treatment come through early breast cancer care. Proton therapy has unique attributes that reduce radiation exposure to normal, healthy organs3,4. This is especially important in left-sided, node positive breast cancer patients (those who need the internal mammary nodes irradiated), as the cancer is close to critical organs such as the heart and the lungs.

How Massachusetts General Hospital conducted the study

Researchers enrolled 70 prospective patients with nonmetastatic breast cancer who required radiation therapy to the chest wall and regional lymph nodes. The average age of enrollees was 45, with patients ranging from 24 to 70 years old. The vast majority (91%) of evaluable patients had left-side breast cancer, and all but four patients had stage II-III disease. Only one patient did not receive chemotherapy in conjunction with proton radiation therapy.

The study, which lasted from 2011 to 2016, specifically chose patients whose treatment would include irradiation of the internal mammary nodes (IMNs). This made them suboptimal candidates for conventional radiation therapy, since exposure to the IMNs would also increase radiation to the heart and lungs. According to the study’s authors, that has been associated with an increased risk of cardiac events.

The benefits of proton therapy, however, significantly reduce exposure to the heart and lungs. It’s an advanced form of radiation therapy that precisely targets a tumor using a single beam of high-energy protons to kill cancer cells. Unlike conventional photons, which have almost no mass and extend beyond a tumor through the body, protons are relatively heavy and will hit their target – then stop. This spares nearby healthy tissues and organs from receiving unnecessary radiation.

Summary of the study’s results

Proton therapy for breast cancer treatment received high marks from this study. Of the 69 evaluable patients, the 5-year cancer recurrence rate was just 1.5% and the 5-year overall survival rate was 91%. Those positive results go hand-in-hand with low rates of severe side effects. Study authors reported no patient developed grade 3 pneumonitis (inflammation of the lungs) or grade 4 or higher toxicity in the lungs. They also reported no significant changes in cardiac function or key cardiac biomarkers.

Dr. MacDonald and colleagues concluded that “Proton beam radiation therapy (RT) for breast cancer has low toxicity rates and similar rates of disease control compared with historical data of conventional RT.”

Dr. Ben Wilkinson, MD, FACRO, Radiation Oncologist and Medical Director at Provision CARES Proton Therapy Knoxville says the findings of this study support the success he’s seen at Provision.

“Among mostly young women with left-sided breast cancer receiving regional nodal irradiation, proton therapy produces excellent target coverage with miniscule cardiac doses and low rates of lung toxicity,” Dr. Wilkinson says about the study’s conclusion. “When we treat breast cancer, those lymph nodes run very close to the heart. Proton therapy allows us to deliver the dose to the tumor site and spare the surrounding area – the heart, lung, chest wall, and even the esophagus.”

What’s next for proton therapy research?

The authors of the study from Massachusetts General Hospital say their findings open the door for more extensive studies in the future. “No early cardiac changes were observed,” they note, “Which paves the way for randomized studies to compare proton beam radiation therapy with standard radiation therapy.”

In fact, the results of the study bode well for a more comprehensive trial already underway to compare proton therapy with conventional x-ray therapy. The Radiotherapy Comparative Effectiveness (RADCOMP) Consortium Trial, which began in 2016 and will continue until at least 2022, is being conducted by the University of Pennsylvania, in conjunction with the Patient-Centered Outcomes Research Institute.

According to the U.S. National Library of Medicine, it is a pragmatic randomized clinical trial of patients with locally advanced breast cancer. More than 1,000 patients will be randomly assigned to receive either proton therapy or x-ray therapy. Each patient will have a 50-50 chance of getting into either treatment group. Both groups will be followed for at least 10 years after completing radiation therapy. The trial’s ultimate goal to is to study the patients’ quality of life outcome to help decide which is the best treatment option for future patients with breast cancer – proton therapy or x-ray therapy.

The Benefits of Proton Therapy for Breast Cancer Treatment

Proton therapy shows remarkable promise and advantages over conventional therapy in the treatment of breast cancer. It is a type of radiation that stops at a very specific point in the targeted tissue; conventional radiation continues beyond the tumor. In breast cancer, this means on average no radiation to the heart and on average 50% less radiation to the lung5 as compared with conventional radiation.

Proton therapy is extremely precise and therefore more effective at targeting cancerous cells without causing damage to surrounding breast tissue. It is not a substitute for a lumpectomy. Rather, it is used as an alternative to conventional radiation therapy. After surgery a breast cancer patient may receive 2-6 weeks of proton therapy.

Sources:

  1. Phase II Study of Proton Beam Radiation Therapy for Patients with Breast Cancer Requiring Nodal Irradiation. Journal of Medical Oncology
  2. Pragmatic Randomized Trial of Proton vs. Photon Therapy for Patients with Non-Metastatic Breast Cancer: A Radiotherapy Comparative Effectiveness (RADCOMP) Consortium Trial. ClinicalTrials.gov
  3. MacDonald S, Specht M, Isakoff S, et al. Prospective pilot study of proton radiation therapy for invasive carcinoma of the breast following mastectomy in patients with unfavorable anatomy – first reported clinical experience. Int J Radiat Oncol. 2012;84(Suppl 3):S113-S114. Abstract 281
  4. Moon SH, Shin KH, Kim TH, et al. Dosimetric comparison of four different external beam partial breast irradiation techniques: three-dimensional conformal radiotherapy, intensity-modulated radiotherapy, helical tomotherapy, and proton beam therapy. Radiother Oncol. 2009;90:66-73.
  5. Early Toxicity in Patients Treated with Postoperative Proton Therapy for Locally Advanced Breast Cancer. U.S. National Library of Medicine, National Institutes of Health

 

Educational and Cognitive Late Effects of Cancer Survivors

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By Marriah M. LCSW, Medical Social Worker at Provision CARES Proton Therapy, Knoxville

Cognitive health is just as important as physical health, especially following cancer treatment. Depending on your diagnosis you may have had chemotherapy or radiation, both of which may affect memory, concentration, or the ability to perform well in school or at work.  These side effects may last for a short time or they may persist for many years following treatment.  Additionally, it is important to know that you may not notice signs of side effects from your treatment until a while after treatment has ended. Side effects which occur a few months or even years after treatment are called late effects.

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Maintaining a Healthy Nutritional Status When Diagnosed with Head & Neck Cancers

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Content and information provided by Casey Coffey MS, RD, LDN Registered Dietician for Provision CARES Proton Therapy Knoxville

As we raise awareness of head & neck cancers during the month of April, it is important to be aware of the unique challenges that are at risk when diagnosed with head and neck cancer. Studies for patients who choose proton therapy treatment for head and neck cancers have shown less side effects during first 3 months after treatment and quicker return to normal function. The potential side effects for head and neck cancer patients make swallowing food and fluids difficult and sometimes painful. Malnutrition affects an estimated 40 – 80% of cancer patients – particularly those with gastrointestinal or head and neck cancers.

The four main nutritional goals for cancer patients include:

  • Strive to maintain a healthy weight
  • Consume foods and beverages for managing cancer and treatment-related side effects
  • Select and eat healthy foods that supply the body with fuel and nutrients for repair and healing
  • Reduce risk of cancer recurrence and the development of a second malignancy

Many patients do not realize the importance of nutrition while under treatment. Primary goals of nutrition therapy are to prevent or reverse nutrient deficiencies, preserve lean body mass, support the immune system, and minimize and manage the impact of nutrition related symptoms and side effects to maximize quality of life. Adequate nutrition is more than just maintaining body weight. The foods we eat contain nutrients necessary to support healing and restoration but also to support our healthy cells as well. Adequate nutrition has been shown to improve outcomes in cancer patients, improve strength and energy, avoid dose reduction or treatment breaks.

Make Every Bite Count.

Initially, it is recommended patients eat what they can tolerate while focusing on protein with each meal and including whole foods (minimizing the processed nature of foods). Why? Well, quality counts. High quality foods, which are those that are less processed, are more nutritious due to their higher nutritional value. As treatment progresses and possible side effects begin, the ability to swallow can become difficult. If difficulty to swallow becomes a problem for head and neck cancers, here are three ideas on how to maintain nutritional value through your diet:

  • Graze throughout the day on nutrient dense foods: Nutrient dense foods that have been fortified with protein and additional calories without adding volume and lots of sugar or highly processed foods. Some examples are olive oil, butter, coconut oil, coconut butter, peanut butter, heavy cream, half & half, or any nut butter.
  • Alter texture of foods to improve tolerance: focus on soft or smooth foods such as, bananas, watermelon, canned fruits, peach, pear, and apricot nectars, pureed or mashed vegetables, oatmeal, cooked cereal, cottage cheese, yogurt, milkshakes, custards, puddings, gelatin, macaroni and cheese, scrambled eggs, and ground meats.
  • Avoid irritating foods, such as, citrus fruits or juices, spicy or salty foods, pickled or vinegary foods, tomato-based foods (salsa, spaghetti sauce, and pizza), rough or dry foods, hot spices (pepper, chili powder, nutmeg, cloves, and curry).

For more information about how to overcome nutritional challenges when diagnosed with head & neck cancers or to learn about proton therapy, contact our CARE Team at 865-229-4689.

 

how to reduce radiation-induced heart disease

The Heart of the Matter: Proton Therapy Can Prevent Radiation-Induced Heart Disease

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Content and information provided by Rebecca Bergeron, RN, BSN, OCN Director of Clinical Services for Provision CARES Proton Therapy Knoxville

February is American Heart Month, and it is the perfect time to talk about preventing unnecessary radiation dose to the heart, often times causing radiation-induced heart disease. When people begin their fight against cancer, they are most likely not thinking about reducing their future risk of heart disease; however, this is certainly something we are thinking about at Provision CARES Proton Therapy.  (more…)

Dale C. Prostate Cancer

Proton Stories: Dale C.

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Dale Clayton first heard about Provision CARES Proton Therapy through a TV commercial. Not knowing he had cancer, he tucked the words “proton therapy” in the back of his mind, hoping that he would never have to remember them. It was February 2015 when Mr. Clayton learned he had prostate cancer. Dale had always been proactive when it came to his health. He said, “my mom always taught me to be proactive.” He went in for regular checkups, yearly physicals, and was well aware of his PSA and gleason score. At his appointment in 2015, all test scores came back normal, but he insisted on a biopsy, just to be sure. Both the doctor and Clayton were shocked, his biopsy came back positive. Dale was diagnosed with low risk, non-aggressive prostate cancer and decided on active surveillance.

Two and a half years later, things started to change. His PSA remained normal but his biopsy showed the cancer had doubled in size. “It’s a miracle we found it,” said Clayton, “I believe God placed the right doctors, urologists, and friends around me to help me make an informed treatment decision.” He researched prostate cancer and treatment options, from surgery to brachytherapy to protons, and there were two things that were very significant to his treatment decision process:

  1. Cure Rate
  2. Quality of Life

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National particle therapy conference boosts proton therapy’s profile

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Proton therapy got positive billing at the recent Particle Therapy Cooperative Group, as researchers from across the country presented findings that showed proton therapy reduced potentially life-altering side effects and improved survival rates for cancer patients.

The National Association for Proton Therapy (NAPT) released a summary of the results, which included the findings of studies focused on esophageal, prostate and breast cancer. (more…)

Latest research shows benefit of proton therapy for children with head and neck cancer

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Thousands of cancer patients have and could benefit from proton therapy, and children definitely top the list.

This week, exciting news has emerged from the renowned Children’s Hospital of Philadelphia confirming that proton therapy effectively treats pediatric cancers of the head and neck and reduces the side effects often experience with conventional radiation treatment.

It’s one more step toward growing and full recognition of proton therapy in the medical community as a state-of-the-art treatment option for cancer. (more…)