Keeping the balance

Over the next couple of weeks, we will be posting a series of recipies that will help you as you go through treatment. The Cancer Lifeline recipies are divided into three phases:

  • Tough Times, for use when you are very ill, during treatment, while the appetite is poor and the weight low.
  • Clean Machine, for detoxification of the body, post cancer treatment, or to kickstart a holistic health creation programme.
  • Eat Right, to set the right style of eating for the rest of your life to generate optimum health.

The recipies have been created by celebrity chef and nutrition consultant, Jane Sen, for the nourishment and healing of people with cancer. The recipies are part of the Cancer Lifeline Kit by Dr Rosy Daniel, which she has generously shared with us.

balance

Reconstruction after mastectomy

There are various types of reconstructions that can be offered to a patient after a mastectomy. There are many factors that need to be considered before one can decide on a reconstruction and this needs to be discussed between the patient and the surgeon. Each person is different and the type of reconstruction is based on many various factors including:

  1. The choice of the patient as discussed with the surgeon and multidisciplinary team
  2. The type of cancer
  3. The location of the cancer
  4. The build of the patient
  5. Involvement of the nipple
  6. Whether the patient will still need radiotherapy or not

 

There are many types of reconstruction, most of which are available in South Africa. Reconstruction can be done as an immediate reconstruction or a delayed reconstruction.

  1. A flat chest: many people will request a flat chest. Women will often choose this procedure as it is a fairly quick operation with minimal pain post operatively and has a low risk of complications. A prosthesis with a special mastectomy bra can be fitted a few months after the operation. The patient can also have a reconstruction a few years after having a flat chest mastectomy, this is known as a delayed reconstruction.
  2. A reconstruction using expanders: this is where an expander is placed beneath the muscle in the chest wall. It is then inflated every few weeks until it reaches the appropriate size. An operation to remove the expander and replace it with a prosthesis will follow.
  3. An immediate reconstruction using prosthesis: this is done in certain cases where a skin sparing mastectomy is performed and the tissue is immediately replaced with a prosthesis.
  4. Reconstruction using body tissue:
  5. A flap from your back (latissimus dorsi flap) – the surgeon will make a new breast by using the muscle, skin and fat from your back.
  6. A flap from your abdomen (a TRAM flap) – the surgeon uses part of the muscle with its skin, fat and blood vessels to make a new breast.
  7. A flap from your abdomen (a DIEP flap) – the surgeon takes only the fat and skin from the abdomen to make a new breast. This procedure often has a very good outcome as the breast looks and feels natural as it consists of fatty tissue.
  8. A flap from the thigh (TMG or TUG) – the surgeon will use the fat, skin and muscle from the thigh, either making use of the outer or inner thigh.

Once a mastectomy with reconstruction has been performed, a nipple can also be made. This would be done only once the reconstruction has entirely healed and would involve small procedures. A tattoo can be done to give the nipple areolar its colour.

Reconstruction is a very personal decision and the patient should not be rushed into something that they do not feel comfortable with having. It is important as a patient to look into the various options that are offered before making a decision.

 

Sr Lieske Wegelin

ABC - Advocates for Breast Cancer - Breast Course 4 Nurses

Finding out more about surgery

Surgery for breast cancer includes surgery to the breast and surgery to the axilla (armpit).

Surgery to the breast. 

Although there are many operations that we do, they fall into two groups: breast conservation surgery (wide local excision, lumpectomy) and mastectomy.

Breast conservation means removal of the cancer and some surrounding tissue.  It is important that there is no cancer or precancer in the surrounding tissue. (We refer to the normal tissue around the cancer as the margin.  A negative margin means all the cancer has been removed and normal tissue surrounds the tumour). Breast conservation surgery is generally followed by radiotherapy.  If it is not possible to have radiotherapy, breast conservation is not generally advisable.

Mastectomy means removal of the breast.  It may be done with or without reconstruction.

On some occasions, the outcome for an individual is better if a mastectomy is performed. Indications for a mastectomy include:

  1. Patient preference
  2. Widespread pre cancer (DCIS)
  3. More than one cancer in the breast
  4. A strong family history of breast cancer
  5. If the cancer is large/the breast small, the cosmetic result may be better after a mastectomy with reconstruction than after breast conservation.

Axillary surgery

Axillary surgery refers to the management of the lymph nodes. The reasons to do axillary lymph node surgery are:

  1. To see if the cancer has spread. This is very important as we generally base our adjuvant treatment of breast cancer on the behavior of the cancer rather than only on the size or grade.  The commonest way to do this is with a sentinel node biopsy.  Before surgery, the breast is injected with a dye.  At the time of surgery, the lymph node containing dye is removed and is tested.

There are several variations on the techniques used

  1. The dye used may be blue dye or radioactive dye or both
  2. There may or not be a preoperative scan
  3. The lymph nodes may or not be tested at the time of surgery.
  4. To remove the lymph nodes if they are involved with disease.

Commonly used terms:

Simple mastectomy: removal of the breast

Modified radical mastectomy: removal of the breast and the axillary lymph nodes

(Radical mastectomy is rarely done any more: it involves removal of the underlying muscle).

by Jenny Edge

ABC - Advocates for Breast Cancer - Breast Course 4 Nurses

Time flies, and we heal, and life carries on

Lisa Fuller is a two-time breast cancer survivor. “When it came back the second time I was extremely angry. I didn’t really want to go through chaemo again, and it has been much more hard on my son, because he is older now.” She explains that life doesn’t stop for cancer – you still have to look after your family, you still have to work and you have to just deal with it.

 

 

walk

Breast Cancer Survivor Story: A Friend’s Perspective

My name is Lisa, and I am very proud and blessed to be one of the bloggers in ABC’s advocacy campaign. Today we are meant to be sharing another breast cancer survivor’s story but my special friend who was going to send me her story for publishing today is so immersed in pre-wedding organising chaos that sending me her story must’ve slipped her mind! 🙂

In lieu of that, I thought I would tell you her story from my perspective, as her friend, with the hopes that you will find some value in it. (My recall of some of the important details are unfortunately a bit sketchy because I was living overseas at the time and was only receiving snippets of information via my mom.)

Leila is, through and through, one of the most shiningly beautiful souls I have ever been blessed to know. She is an artist with a special talent for making life beautiful – whether it is a feast of a braai, how she wraps a birthday present or even a ‘how are you’ Whatsapp. She also has an uncanny knack for bringing out the best in others with her gentle heart – yet which emanates a deep-rooted strength I know, while she always was a strong person, was deepened by two parallel situations she fought back against with grace and tenacity: breast cancer and an abusively damaging ‘love’ relationship.

advocates for breast cancer_weddingShe tackled both situations with an attention to beauty, staying creative, as well as a prosaic practicality which, I believe, was what gave her a map to follow when her physical and emotional energy were at their lowest. She got to the top of her ‘insurmountable’ mountain one step at a time, one day at a time. Sometimes she walked alone – which is inevitable when one faces situations which frighten friends and family away. Sometimes she had others of us walk beside her. I don’t know if Leila would have said the same about how having a practical plan with strategic, one-step-at-a-time goals was one of her cancer management tools, but from a friend’s perspective, this is one of the things I learnt from her which helped me turn my own personal tabooed ‘tragedy’ into more of a ‘situation I lived through’ and came out on the other side of stronger, wiser and more compassionate – with both myself, my child, family, friends and strangers.

Thank you, precious friend, for being such a magnificent inspiration and powerhouse of humble, warrioress strength! You are LOVED, cherished and celebrated! May your wedding and marriage be all the blessing you deserve!

 

Anthea’s story

IMG-20150121-WA0004My story began when I went to the gynaecologist for a scan to see my baby. What happened was that I got much more than a scan: the doctor did a head to toe examination. He found a lump in my breast and he sent me to a surgeon for a biopsy the following day.

My happiness changed to sadness because the doctor told me I had cancer.

I had a lot of questions that only God could answer. I woke up at 3am the Saturday morning with a song, God is the alpha and the omega and God can do anything and then I cried nonstop for an hour.

I took the Bible and opened it on Job, and read where Job’s wife asked him why he doesn’t curse God for letting bad things happen to him. Job replied “why do you just want to accept good from God and not the bad?” I got my strength from those words.

The next step was a visit to an oncologist. He did a lot of tests to see if I was strong enough for treatment. He said that if not, they would have to abort the baby. In the year 2008 I was the 27th women who was pregnant and had cancer. I was lucky, I could have treatment because I was strong. God was so good to me. I never got sick, no side effects except for losing my hair. I accepted it and decided to beat cancer.

I received four chemotherapy sessions and on 23 July 2008 I gave birth to a healthy baby girl. The next day she was sent home and I went to the surgical ward for my mastectomy. That morning, as I was preparing myself for surgery, I looked at myself in the mirror and I started to cry. That was when it really hit me – this would be my last moments as a perfect woman. I was scared but God was so good to me.

I did not receive any blood. Even the doctors were amazed and said it was a miracle after I lost so much blood. I went home a few days later and I looked after my own baby with a lot of assistance from family and friends.

I had four more chemo sessions and radiation after that.

Now, six years later, I have dedicated my life to teach women how to do breast self examinations, and to awareness, support groups, counselling. I know my volunteer work could change lives. Women need to know what to look for. They must make time for themselves to check their breasts once a month and to go for a mammogram once a year.

 Anthea Martin

Would you like to share your story? it can be written, it can be a voice clip, it can be a video: we can make it happen! Please contact lynne@hippocommunications.com.

 

 

Moipone’s story

Moipone Sebiya shares her journey with breast cancer and encourages young women to remember that a diagnisis is not a death sentence