Getting a breast cancer diagnosis can be scary, but things have changed a lot in how we treat it. Unlike the old days when everyone got the same treatment, now it's like having a personalized toolkit to fight the disease.
Survival rates have gone up, with only 5% of women at an average risk of dying within five years after a breast cancer diagnosis, down from 14% in the 1990s. Dr. Harold Burstein from the Dana-Farber Cancer Institute explains, We may not always know why someone gets breast cancer, but the good news is that outcomes are improving.
Instead of using a one-size-fits-all approach, scientists can now categorize breast tumors based on cell type. This allows for tailor-made combinations of treatments. Surgery is still common, but chemotherapy might be smaller or skipped. New drugs like immunotherapy and targeted therapies are giving doctors more options.
Breast cancer comes in different types, like ER-positive or HER2-positive. Knowing this helps doctors choose the best treatments. Thanks to research in the last decade, tests can now identify gene mutations, predict tumor growth, and help customize treatments.
For ER-positive, HER2-negative breast cancer, the use of chemotherapy has become more selective. Powerful tools allow doctors to decide if a patient really needs it. Medications like CDK4/6 inhibitors are also used for high-risk cases.
HER2-positive breast cancer, a more aggressive type, has seen progress with targeted therapies like Herceptin. A new approach pairs chemotherapy with proteins for better results with fewer side effects.
Triple-negative breast cancer, a fast-growing type, is challenging, but new drugs and immunotherapy are showing promise. Even more promising is the future use of liquid biopsies, blood tests that can guide treatment based on circulating tumor DNA.
Dr. Burstein is optimistic about the coming years, mentioning new technologies like liquid biopsies. For metastatic breast cancer, which isn't curable yet, patients are living longer with new treatments improving their lives.
Inflammatory breast cancer (IBC) is rare but dangerous. Unlike other types, it doesn't always show a lump. Symptoms develop rapidly, and early signs are often mistaken for less serious issues. Dr. Filipa Lynce advises not to ignore changes in the breast, even without a lump. If symptoms persist, seeking medical attention is crucial.
Finally, for women diagnosed with breast cancer, a multidisciplinary care team is essential. Collaboration among specialists and communication with your healthcare team are key to better outcomes. Don't hesitate to ask questions and be an active part of your treatment plan.
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Seasonal affective disorder can be treated and managed with the use of light therapy and medicines.
The winter season brings chilly days and cozy vibes, but for some, it also ushers in a condition known as Seasonal Affective Disorder (SAD). SAD is a form of depression that kicks in during late fall and winter, easing off with the arrival of spring. While the exact cause remains a mystery, researchers believe a lack of sunlight plays a pivotal role.
Dr. Richard Schwartz, an associate professor of psychiatry at Harvard-affiliated McLean Hospital, emphasizes the significance of recognizing SAD as a serious condition. He notes, "People should not ignore the signs of SAD and should seek treatment if they appear, as left alone, SAD can escalate to serious health issues."
Sunlight and Your Mood
Sunlight exposure has a profound impact on our brains. It stimulates the hypothalamus, a brain region housing our internal sleep-wake clock. Insufficient light disrupts this clock, leading to an overproduction of the sleep hormone melatonin and a decrease in serotonin, the feel-good brain chemical. This chemical imbalance can result in feelings of low energy, lethargy, and depression.
SAD comes with other telltale signs, including diminished sexual desire, an inclination to overeat (especially comfort foods), and sleep disturbances. It also correlates with cognitive challenges like difficulties in concentration and memory. Dr. Schwartz adds, "As you become more lethargic from SAD, you are also less likely to exercise or socialize."
Several factors heighten the risk of SAD, such as a family history of SAD or depression and geographic location. People residing in northern states, where daylight diminishes significantly in fall and winter, are more prone to SAD than those in the south.
How to keep people from getting too angry at gatherings.
The holidays, envisioned as a time of joy, love, and festive lights, sometimes take an unexpected turn into disagreements when family and friends gather. However, with a little planning and awareness of potential triggers, you can avoid getting caught up in arguments.
Understanding Holiday Stress
The holiday season can be stressful due to financial worries, colder weather, and the juggling act of work and time off. Emotional vulnerability is heightened during this time, making it challenging to manage feelings and communicate effectively. Factors like painful memories or a lack of family support can add to the emotional strain.
Alcohol consumption during holiday gatherings can escalate tensions, as it lowers inhibitions and makes it harder to stay calm. In a survey, 57% of respondents noted family members becoming argumentative after consuming too much alcohol.
Childbirth, a timeless and sometimes unpredictable journey, has been an integral part of human experience. In the United States, where rates of avoidable complications and maternal deaths are surprisingly high, the demand for doulas is on the rise. Natalia Richey, interim chief midwife at Massachusetts General Hospital, notes an increasing interest in additional care during pregnancy and birth.
But what does a birth doula do? Unlike midwives or doctors, professional doulas offer emotional and physical support to women throughout pregnancy and the birthing process.
Here's a glimpse into doula care if you're considering it.
Doulas vs. Midwives
While midwives and doulas share some responsibilities, a crucial distinction exists: midwives provide medical care, whereas doulas focus on emotional and physical support. Midwives, like certified nurse-midwives, are trained nurses responsible for maintaining the physical health of both mother and baby during childbirth. On the other hand, doulas don't perform medical tasks; they specialize in helping laboring women stay comfortable and calm, employing various techniques like suggesting comfort measures and optimal positions.
Doula Training and Licensing
It's important to note that doula training lacks standardized rules. Certification from over 100 independent organizations is common, although no formal licensing is required. While private insurers often don't cover doula care, some employers, like Walmart, assist in covering costs. As of February 2023, ten states and the District of Columbia offer Medicaid coverage for doula services.
Impact on Birth Outcomes
A 2023 analysis spanning 22 years and 16 studies found that doula support correlated with improved birth outcomes, including fewer C-sections, premature deliveries, and shorter labor. Emotional support from doulas was associated with reduced anxiety and stress in mothers, with notable improvements in breastfeeding success, especially among low-income women.
Collaboration with Doulas
Agreements regarding care may vary, but typically, doulas meet with expectant individuals throughout pregnancy to discuss birth goals and build rapport. Doulas, akin to obstetricians, are available 24/7 to support clients during labor. This constant support, especially for those with limited resources, can be invaluable.
Doula and OB/GYN Collaboration
Collaboration between doulas and OB/GYN teams is generally seamless. Whether a hospital arranges for a doula or if hired privately, coordination ensures everyone sticks to their roles. Doulas suggest nonpharmacological ways to ease pain, respecting boundaries when medical intervention is necessary.
Questions to Ask When Considering a Doula
Interested in working with a doula? Natalia Richey suggests asking yourself questions like:
- What are my hopes and goals for the childbirth process?
- How do I envision my support team during delivery?
- Do I have friends or family members who have used doulas, and what were their impressions?
When contacting a doula, inquire about their training, the number of births attended, how they can assist during pregnancy and labor, and their approach to collaboration with your partner, spouse, and the medical team.
Take the time to meet with any doula you're considering and make sure they're a good fit, advises Richey. "Because this is someone who will be there during one of the most vulnerable times of your life. Having someone there who doesn't make you feel safe and comfortable can affect birth in a major way.
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Oh, and if you've been rocking nail polish for ages without a break, your nails might rebel with some dry, white spots. It's like they're saying, "Hey, let us breathe!" There's also a chance a sneaky fungal infection is behind the scenes, leaving a white film on your nails. Sometimes, more serious stuff like low iron, kidney issues, or liver scarring can play a part in turning your nails half or mostly white.
If you're scratching your head because none of these seem to fit, it's cool to chat with your doctor about it. Waiting for the spots to vanish on their own might take a while – like six months or more – because, you know, nails take their sweet time to grow out.
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