Breast Cancer Awareness
Featuring local women who fought and continue to fight
As October is Breast Cancer Awareness Month, this chapter of èBella èXtra features local women who share their stories — one via podcast — of enduring an insidiously common disease that will take an estimated 44,130 lives this year. These are stories of courage, resilience and hope.
Naples breast cancer specialist and surgeon Dr. Elizabeth Arguelles provides updates on innovation, treatment and women’s sometimes changing views of reconstruction; Leo Flanagan Ph.D. offers insight into emotional healing; and yoga professional Thara Natalie presents an uplifting way to start your day.
To counterbalance this issue, we’d be remiss if we didn’t delve into what is also National Pizza Month with a sampling of the most interesting toppings our foodie friends have ever tried.
As autumn is upon us, we wish you health, happiness and a piece of the pie. Take care, and be well.
One Breast Cancer Survivor’s Journey
Debra Newman’s goal is for everyone to be educated in order to overcome the disease
by Kathy Grey
She went in for a routine mammogram, albeit a year overdue, and never imagined she would be diagnosed with breast cancer. She had no family history of breast cancer and regularly performed self-exams. But at the age of 41, Debra Newman was diagnosed with stage 1 breast cancer.
That was 26 years ago.
“At the same time, two of my closest friends were also diagnosed,” Newman says. “We all had small children.”
Sadly, those two friends, Arlene and Cheryl, didn’t survive beyond two years.
As heartbreaking as that was, Newman says, “I feel so fortunate that I was able to see my children grow up and have families of their own.”
Her three children are now ages 41, 37 and 36, and have daughters of their own. Newman will likely pursue BRCA genetic testing to learn if her granddaughters are predisposed to the disease.
It’s that family connection that keeps Newman fighting for herself and for other women and men who receive the diagnosis, including those who are medically underserved and in need of breast cancer education.
She’s overwhelmingly grateful to be a 26-year survivor of breast cancer, but admits there are drawbacks to surviving, too.
“It’s stressful being a long-time survivor,” Newman says. “It’s a blessing and a burden. Having cancer is a scary proposition, especially when you start to think about whether the cancer has spread to other areas. Any time you get an ache or pain, you think it’s cancer. Now they tell you to be aware of the changes in your breasts. I’ve watched my affected breast shrink a little bit each year from the effects of radiation,” she says. “Who knew?”
Indeed, following an agonizing two-week wait for the lymph node diagnosis those years ago, Newman was treated with surgery, radiation and the drug Tamoxifen.
“Fortunately, the cancer was contained, and after two surgeries and intense radiation therapy, I became a survivor,” she says.
Today, Newman is not only a survivor, she’s a board member of the Florida Breast Cancer Foundation, advocating for education, screening and early detection of the disease.
“(The Florida Breast Cancer Foundation) just funded a grant to temples for breast cancer awareness,” she says, noting that people of Ashkenazi Jewish ancestry have a one in 40 chance of carrying BRCA1 or BRCA2 gene mutations from either of their parents. (According to MayoClinic.org, a positive test result means you have a mutation in one of those breast cancer genes and a much higher risk of developing breast cancer or ovarian cancer, compared with someone who doesn’t have the mutation.)
Zack, Zoey, Debra, Joe, Emma and Hudson Newman
“Seventy-five percent of Jewish women risk breast cancer in their lifetimes. Fifty percent risk ovarian cancer,” Newman says. “There’s a higher risk for Black women, too,” she says, noting that studies are ongoing.
“My biggest regret was pretending that I was totally in control and not in need of anyone’s sympathy or help,” Newman says.
“I remember that after one of my surgeries I went to an Indians game — I’m originally from Cleveland, Ohio — with a drain sticking out of my incision. I just put that drain in my pocket and pretended to have a great time. In retrospect, I desperately needed the care and attention of my family and friends, and now recognize that I robbed them of providing that care and support. I really needed the support, and I basically pushed it away. That’s my biggest regret, because I needed it, but pretended (the condition) didn’t exist.”
Newman acknowledges that she had experienced that “push-away” previously, when she lost a baby at six-months’ gestation. She says she’d done the same thing: “pretending this didn’t happen and not opening up to the support people want to give.”
She knows now that it’s critically important to acknowledge the magnitude of the grief life’s losses present and to allow others in so you don’t have to go through the journey alone.
In addition to sharing the burden with loved ones, her final counsel is this: “Know your risk through genetic testing and get your mammograms on time, every time.”
in this issue
BREAST CANCER MEDICAL UPDATE
Innovations in Breast Cancer Care
Breast cancer surgeon explains improvements in treatments and the critical importance of early detection
by Elizabeth Arguelles, M.D.
What a year it has been. With the pandemic still affecting our daily lives, routine medical care has often fallen to the wayside.
Screening mammograms ceased early in the pandemic to help limit the spread of COVID-19 and to conserve valuable health resources, such as gowns, gloves and masks. Only recently has the rate of screening mammography rebounded to close to pre-pandemic levels. Still, it lags significantly in certain subgroups, such as Asian and Hispanic women, as reported in the Sept. 2021 issue of the Journal of the National Cancer Institute.
In spite of the decrease in annual doctor visits and screening health care exams, the treatment of breast cancer has continued to improve. New innovations treat patients more effectively, with more precision, convenience and customization.
The pandemic forced clinicians to think about what treatments patients really need to maximize benefit and minimize risk. As operating rooms were closed due to shortages in personal protective equipment needed to perform surgery, cancer patients and their doctors were forced to triage patient care and think about cancer treatment differently than ever before.
New genomic tests have become more widely used. These tests look at the genes in the cancer itself to help determine if it is likely to recur. They can also be used to help determine if chemotherapy will provide a significant benefit or if radiation is absolutely indicated.
The increased use of these tests helped decrease the use of chemotherapy significantly, therefore reducing side effects and risk of other infections such as COVID-19, while the patient is immunocompromised on active chemotherapy.
The tests have also been used to help determine which patients have a more aggressive tumor and need treatment as priority versus those with more indolent disease who can safely be watched for some time. Sometimes, those with less aggressive disease were able to be treated with medical management while awaiting an operating room date.
Data collected from these different treatment pathways has enabled us to learn that some forms of cancer may need less aggressive treatment or respond better to certain treatments, allowing for more individualized care.
Ongoing research comparing the efficacy of longer or more complex treatments to simpler treatments has streamlined care in selected patients. Recent validation of shorter courses of radiation treatment, for example, allow for select patients to be treated sometimes in as little as five days. Genomic assays have also found subsets of patients who are unlikely to benefit significantly from radiation and for whom it is reasonable to consider holding off on radiation treatments completely.
Breast cancer surgery changed, as well. While elective procedures were on hold, many patients chose to delay or reconsider reconstruction. Lymph node biopsy for select patients with favorable cancers was deemed unnecessary, putting into use what had been learned from recent studies but had not yet been routinely practiced. The use of more neoadjuvant (before surgery) chemotherapy and endocrine treatment (pills) also allowed for data collection on how certain tumors respond to treatment, sometimes leading to changes in standard treatment paradigms.
Even with all of the innovations in treatment, there is no doubt that a diagnosis of breast cancer will change your life. The pandemic may have temporarily put mammographic screening on hold, but it is important to remember that the cancer can develop whether you go for screening or not.
Take the first step and go have your mammogram. Talk to your doctor. If we find breast cancer early, we can more easily develop a personalized treatment plan with a greater probability of leaving you cancer free, and that will change your life.
Dr. Elizabeth Arguelles is a board-certified breast surgeon who specializes in the care of patients with both benign and malignant breast disease. She is a member of the American Society of Breast Surgeons and is the first breast surgeon in Collier County to receive Hidden Scar Certification. https://www.genesiscare.com/us/our-locations/naples-abs1/; 239-430-3260.
CANCER TREATMENT: ALTERNATIVE VIEW
Podcast: Tamara Paquette’s Personal Battle
Naples resident takes on breast cancer with a hybrid of therapies
Tamara Paquette Photo Credit: Bob Lasky
Hear Naples resident Tamara Paquette’s breast cancer experience in this podcast conversation with Girls with Guts.
Paquette reveals that she had kept the cancer a secret from her friends and planned to make it to one more big bash before she kicked the bucket — but as her “death day” approached, something unexpected happened that reignited her will to live.
Tips to calm your state of mind and bring you to relaxation faster
by Leo F. Flanagan Jr., Ph.D.
We have been in a state of hyperarousal for well over 500 days. The result is that most of us are highly anxious all of the time and the CDC reports that four out of 10 adults in the U.S. are experiencing clinical symptoms of anxiety and depression (CDC Report).
Given these circumstances, the most important thing to understand is that the reason our mental health has deteriorated is because the brain is doing its job. The limbic system, led by the amygdala, is responsible for perceiving threats and mobilizing the mind and body to either take flight or fight. Since the onset of COVID-19, we have been bombarded with threats, and the limbic system has kept us at a constant state of hyperarousal.
The second thing to understand is that anything we experience for about 70 days rewires our brain. At this point, hyperarousal, the need to take flight or fight, anxiety and depression have been wired into our brain.
Fortunately, you can also use the fact that our brains rewire themselves based on what you experience for 70 days to calm your state of mind and become more relaxed and focused, overall.
Here are five practices to make “relaxed and focused” your default mode.
1. Keep your smartphone out of your bedroom.
Your smartphone in your bedroom keeps you from sleeping properly. Your brain knows it is there and signals you to check your texts and emails. That keeps you hyper aroused and disrupts your sleep.
Waking up, you will most likely pick up your smartphone to “just check” your emails/texts/social media. Since you likely will gloss over them and won’t respond to them, you’ll be multi-tasking. Each time you multi-task, your productivity for the day is decreased by 3.5%. Check just 17 texts/emails and you will drop your productivity down to 40%. You’ll spend much of the day staring at screens without actually accomplishing anything. All that input feeds your hyperarousal.
2. Wire your brain to stay present.
Meditation strengthens the parts of the brain that allow you to stay focused on what is in front of you, wiring your brain to stay on task and not respond to distractions. By staying in the present, you significantly reduce your worry about the future.
Meditate 20 minutes a day to wire your brain to stay calm and present.
Do three-minute meditations three times a day. These act as neural circuit breakers. When you feel your anxiety building, meditate on your breathing for three minutes. You’ll be amazed at the difference it makes.
3. Build your pragmatic optimism.
You open that email that announces a setback. You didn’t get a new client. Your boss didn’t approve your request. You experience three emotional tidal waves:
This will never end! I’m going to lose everything! I don’t know what to do!
It can take a few hours to a few days to recover from being overwhelmed by these thoughts and the feelings of anxiety and desperation they generate. Every time you experience a disappointment, answer these questions to wire your brain to respond optimistically and calmly in the face of setbacks.
Will this last forever?
No, the pandemic will end, and the real economy will recover.
Will I lose everything?
No. In fact, you will gain new relationships, new knowledge and new experiences.
How can I use my talents to make things better?
I can pick at least one action to make today better for myself. Better yet, I can do something to help someone else.
4. Go forward; don’t return.
We are not returning to our old workplaces, our old schools, our old favorite restaurants or our favorite arena. What we have now are places where vaccine requirements, COVID-19 testing, temperature-taking, plexiglass and social distancing are in place.
In addition, the people who work in these places are often not the same. When you focus on “returning” or “going back,” you set yourself up for hyperarousal when you enter the new that replaced the old.
Go forward with a sense of curiosity. What will it be like? How will we do things differently? This will greatly reduce the degree to which your anxiety and fear is triggered.
5. Get vaccinated.
Things have shifted. The delta variant spreads twice as quickly as the initial virus and creates a viral load about 1,000 times greater in those infected (UC Davis Health). Also, about 97% of those hospitalized are unvaccinated.
FDA final approval of the Pfizer vaccine means it has met or exceeded the standards of the vaccines we routinely take.
Leo Flanagan has been studying and developing resilience for more than 30 years and has responded to such disasters as 9/11, Sandy Hook and Hurricane Sandy. In the aftermath of 9/11, he developed and facilitated programs for first responders, including over 300 who served at ground zero. He is the author of “Thriving in Thin Air: Developing Resilience in Challenging Times.” Learn more at www.centerforresilience.com.
HACKS & SNACKS
It’s National Pizza Month
Can you top these peculiar pies?
by Kathy Grey
National Pizza Month in October has been a time-honored tradition since 1984. It was the brainchild of the publisher of Pizza Today magazine, and we think it was a brilliant idea.
Some pizzerias offer specials on pizzas during the month or create unusual pizzas they don’t usually offer. For example, a pizza kitchen in Levelland, Texas came up with a pizza topped with rattlesnake meat. And that got us thinking: What are the weirdest toppings out there?
We queried our foodie friends who shared curious concoctions you might want to try … or not.
However you slice it, we hope you’ll celebrate National Pizza Month in your own unique way.
Mac & cheese and hot dogs (“Surprisingly not bad!”)
Octopus and squid
Tuna and corn
Caramelized apples and onions, bleu cheese, prosciutto and mozzarella (“Outstanding!”)
French fries (“Surprisingly good!”)
Crushed tortilla chips, jalapeños and nacho cheese
Roasted pumpkin, corn, mascarpone, bacon, sage and fontina cheese
Pickled pigs’ feet
Gold leaf, caviar, truffles and foie gras
Thin-sliced lemons, asparagus and prosciutto (“Absolutely delicious!”)
Sliced egg rolls
Cream cheese, Cincinnati chili and cheddar
Pecans, sweet onion marmalade and gorgonzola
Figs and honey
Bean-less chili, white cheese, hot dogs, onion and mustard (“It’s out of this world!”)
Hard boiled egg slices
Bay scallops, sauteed spinach and toasted sesame seeds
Chicken curry (“Surprisingly delicious.”)
Cruciferous vegetables (“In Alaska. ’Twas good!”)
Turnip greens and fennel sausage (“Delicious.”)
Shishito whole peppers
Kung Pao Chicken (“So yummy!”)
Potatoes, veggies and shrimp (“Still craving it!”)
Spicy hot honey, Canadian bacon and pineapple
Refried beans and iceberg lettuce
Grapes and pesto
Prosciutto, peach and balsamic glaze
White pizza with lemon, capers and chicken breast
Mayo and corn
Custard, strawberries and bananas (“Had it in Rome. I dream of this pizza!”)
Peanut butter and jelly
Apple butter and chicken
Pistachio cream sauce
TO YOUR HEALTH
Mind, Body, Breath
Yoga professional shares paths to setting your daily vision at home
by Thara Natalie
“Yoga. Union. To yoke. The mind, the body and the breath.”
As a yoga practitioner, I was lucky to learn this definition over 20 years ago. It wasn’t about the fancy poses or being able to twist my body into a pretzel. The goal was simple: to connect my body with my breath. We can all do that, and if we start our days this way, it’s a major win.
As a mom of two and an owner of multiple businesses, I totally get what it’s like to live the mom/wife/ entrepreneur life. The alarm goes off. We roll out of bed, go straight to the coffee maker and wait for the day to ensue.
A few years ago, I realized that routine needed to change. I needed to start my day a little earlier, a little slower and a lot more mindfully. I wanted to stop feeling like life was happening to me. Rather, I was making my life happen. I wanted to create the moments. I wanted to start my day more grounded, more present.
Now, as a 500-hour certified yoga teacher, my goal is to share these simple tools with as many people as possible. The key to this is to pause, breathe and move mindfully. When we start our day with a little more thoughtfulness, it can completely change the outcome.
This brings us to our morning yoga routine. Here are some simple moves you can do from the comfort of your bed before you roll out. It just takes a few minutes, but it can make all the difference in helping you gently wake your body and your organs and get that morning sludge moving with ease.
1. Sit on the edge of your bed and start with a moment of gratitude. Place both hands in your lap like bowls ready to be filled. Close your eyes and bring to mind at least 10 things that you are grateful for as you begin your day. This is the simplest way to start your day from an immediate space of joy and gratitude. Doing this at the beginning of your day sets the tone for abundance in your life instead of being caught up in what we lack. If we focus more on what we have, we will attract even more of that into our lives in a simple and beautiful way.
2. Inhale with your arms over your head and interlace your fingers. Press your palms up to the sky and feel the beautiful opening in your arms and chest. Breathe into your heart space and feel the expansion for at least three breaths.
3. Exhale, your arms down, and then reach and extend your right arm up and over to the left side. Feel the stretch in your side body and the opening in your rib cage as you continue to breathe deeply. Keep your opposite arm gently tented on your bed to lend support. Keep reaching up and over so as not to collapse your body. Repeat on the other side.
4. Bring your right hand to the outside of your left knee and gently twist to your left. Begin to engage your belly, then your ribs, then your shoulder and eventually your neck. Always be mindful and gentle and use your breath to go a little deeper. Twisting is a wonderful cleanser for the body and especially great in the morning to wake up your digestive organs. Come back to neutral and then switch to the other side.
5. Come down off your bed, separate your feet about six inches, bend your knees and take a nice gentle forward fold. I stress the bending of the knees, especially in the morning. Also, many people suffer with tight hamstrings. Bending the knees is totally OK, since we are focused on finding length in the spine and letting the vertebrae have some space to breathe and align. This pose is also wonderful for bringing fresh blood to the brain by getting your head below your heart. Always make sure you inhale when you rise so you don’t get dizzy.
6. Inhale to rise into your mountain pose. Feet grounded underneath you, palms facing away. Feel the earth underneath your feet. Be reminded that you are grounded here. You are stable here. From this space, you are ready to set your intention for your day. Stay where you are or have a seat on your bed once again.
Now you are ready to set your vision for the day.
Thara Natalie is a yoga studio owner and teacher, a health coach and a Karuna Reiki healer who found a connection between physical movement, mental stillness and nutrition. Her greatest gift is helping others make shifts through mind, body and spirit.
Mentoring Through the Journey
Breast cancer survivor shares her story and the need to give back
by Kelly Nelson
As I look back over the past few years, I am amazed at just how strong a person can become. My mother showed me that when she fought her way through her breast cancer diagnosis and treatment 22 years ago.
I was raised by two very strong people. My father is a minister, and we were always helping others, praying with them through tough times, counseling and cheering them on whenever needed.
I have always felt the need to make a difference for others, so after going through breast cancer myself, I knew I had to find a way to help others through this devastating disease.
July 16, 2018 is a day I will never forget. My husband and I casually strolled through the hospital for my mammogram. I thought something might be wrong, but I quickly dismissed that ugly feeling with the fact that “it was never anything serious before.”
I had found the lump in my left breast four months after a clear mammogram, so I thought there was no possible way it would be anything more than just a lump that would go away. After my mammogram showed a large tumor, I was told by the radiologist that I would need a biopsy.
At that point, I knew I had cancer. I don’t know how I knew, but my gut told me we were about to embark on a journey I never wanted to be on. I had cared for my mother during her journey — who, today, is alive and thriving — 20 years ago to the month of my diagnosis, so I had an idea what I was in for.
On July 20, I was officially diagnosed with stage 3c, HER2-positive breast cancer. My chemotherapy was scheduled, and my port was put in within a week.
I felt lost. I had no one to whom I could ask questions about this whole process. The doctors could only tell me what the textbooks said and what the research showed.
What I really wanted to know was how to deal with side effects of treatment. I found a lot of help on the internet in different forums, but not in a place where I could actually talk to someone. I felt this was an important part that was missing in my treatment and recovery process.
I made it through six cycles of really hard chemo, a year of immunotherapy, 32 radiation treatments and a few surgeries. I am currently in remission, and I am very lucky to be alive.
I believe that everything in our life happens for a reason. Feeling that I am now in the position to give back, I started mentoring women who are going through treatment. I have worked with some wonderful women, some of whom I’ve never actually met, but hope to one day.
I am working now to create a nonprofit for this purpose. Who better to help than someone who already walked the path?
I am excited about the opportunities ahead of me and hope to make each and every one count as I encourage my fellow warriors and make my story bigger than me.
In the coming weeks, Naples resident Kelly Nelson will be actualizing the nonprofit Our Breast Friends, focused on mentoring women through their breast cancer journeys. Visit www.facebook.com/groups/552235809329296 or connect with Nelson directly at firstname.lastname@example.org.