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  • Follow up After Breast Cancer Treatment

    Posted 4/17/2014 by hhill

      This is a second (a bonus?) blog for today. Tomorrow we are traveling to Maine to open our beloved cottage for the season, and I know it will be hard to find time to make the daily entry. One real uncertainty is whether the internet will be working when we get there; it is never very good, but, after a long and hard winter, it is may be completely messed up. If that is the case, I will be back to a library visit to write the blog, and I know that won't happen tomorrow.

      This second topic today is follow up for women after adjuvant breast cancer treatment. Over the years of my employment, standard follow up has changed a great deal. Thirty years ago, women had annual bone scans and chest x-rays, in addition to a lot of blood work, after treatment ended. Perhaps five years later, the bone scans were stopped unless there was a specific concern; the annual chest x-rays continued until about fifteen years ago. Now, the ASCO recommendations are simple: annual mammograms (and perhaps annual breast MRIs for women at high risk) and an appointment with your doctor for a conversation and an exam. That's it. If you are interested in their guidelines:

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  • Stress Does Not Worsen Cancer

    Posted 4/17/2014 by hhill
      I regret that our blogging system will not allow punctuation in the title. I wanted to lead this with: Stress does not worsen cancer !!!!!!". Of my various soap box issues, this is my favorite, the one thing that I hope every single woman who leaves my office can believe. Yes, it surely matters for your quality of life if you are hyper-stressed. However, it matters not one whit vis a vis the cancer. Please lay this particular worry to rest. Read more... Comments (0)
  • A Blood Test to Detect Recurrence

    Posted 4/16/2014 by hhill

      First the caveat: This blood test is probably five years away from clinical use. Second caveat: it is unclear what the absolute value of knowing so soon that breast cancer has recurred might be. At this point, there is no survival benefit in identifying a recurrent breast cancer in, say, March rather than in the following November. Whether it would make a difference to find it a year or more sooner is an unanswerable question.

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  • Understanding Media Reports of Studies

    Posted 4/15/2014 by hhill
      The hype can be huge. Even in serious newspapers (think The New York Times rather than The Inquirer), reports of health-related studies can be presented and read in ways that greatly overstate the realities. I am thinking about the coverage, for example, each year from the San Antonio Breast Cancer Meeting. Inevitably, there is a newspaper story about a new treatment that seems to suggest that, if not a cure, is at least a long extender of life for women with metastatic breast cancer. It is not impossible that the study actually found that disease free interval was extended by a few months, not at all what we are hoping for. Read more... Comments (0)
  • Longterm Effects of AIs

    Posted 4/14/2014 by hhill
      The very good news is that many women treated for breast cancer go on to live long and healthy lives. The less good news is that sometimes these lives are affected by cancer treatments. Obviously, the greater risk to us all is dying of cancer, so it is appropriate and smart and necessary to have prescribed radiation, chemotherapy, and/or hormonal treatments in spite of the fine print on consent forms. I often compare these forms to those we sign before any surgery. The surgical consents list possible death as a consequence, but we sign them anyway. Read more... Comments (0)
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About the Blogger

Hester Hill Schnipper, LICSW, OSW-C is the Manager of Oncology Social Work at BIDMC. For more than thirty years, her daily work at BIDMC has been primarily focused on supporting women with breast cancer. A nationally known writer and speaker, she was the Susan G Komen Breast Cancer Foundation's first Hatcher Survivorship Professor. In 1993, and again in 2005, she was diagnosed with breast cancer and went through the standard treatments of surgery, radiation, chemotherapy, and hormonal therapy. These experiences have given her great credibility with her patients and transformed her life's work to her life. Ms. Schnipper lives gratefully with her husband in an ancient farmhouse outside of Boston and spends as much time as possible in a water front cottage on Mt Desert Island. Between them, they have five adult children and seven grandchildren; she claims biological responsibility for two and three of them.