Type 2 Diabetes & Breast Cancer

After Speaking to my BC nurse the other day there was something she said that did not sit right with my long term diagnosis’. If someone says something that doesn’t add up. I will investigate especially when I feel they are talking for talking sake. My treatment is being based on breast cancer not diabetes and breast cancer. Within the NHS I have noted that my type two diabetes is not brought into conversation. It is seen as a hindrance, not a trigger of the breast cancer.

On more than one occasion when speaking about my diabetes I was told I am sorry I am an oncologist not a diabetic consultant. You must speak with your diabetes consultant, but I do not see your diabetes to be a issue on treatment.

My BC nurse told me about a condition called Diabetic mastopathy. My BC nurse explained how tumours can develop in the breast tissue that are benign. It seems my last meeting and me mentioning how I was high risk where breast cancer was concerned, into her doing her own investigations on my condition. I had heard of various conditions with diabetes, but this flumped me into a false sense of what is she talking about. Her attempts at trying to reassure me were valid, but I felt she actually really knew nothing, or at least did not have the right info in front of her. I typed up benign breast tumours and diabetes in the task bar, and up came the condition and a small paragraph explaining.

Diabetic mastopathy (lymphocytic mastitis, sclerosing lymphocytic lobulitis/ductitis)

Diabetic mastopathy (also called lymphocytic mastitis and sclerosing lymphocytic lobulitis/ductitis) are small, hard masses that appear in the breast. This rare condition most often occurs in premenopausal women with insulin-dependent (type 1) diabetes. It may appear as a breast lump or an abnormal finding on a mammogram. A biopsy may be needed to confirm the diagnosis. Diabetic mastopathy does not need treatment.
Although still under study, diabetic mastopathy may be due to an autoimmune reaction. It does not appear to increase the risk of breast cancer.

Now anyone else who had not read my medical records would look at this piece of information and say, well yes that is it, but I am not a Type 1 diabetic and I am not insulin dependent. The differences between the two diagnosis is considerable with treatment. This is why I truly believe there should be a consultant that knows about these two conditions together rather than two departments that never speak. To me whilst the two departments are not communicating as in my blood results etc then there is a loop hole for error. Diabetes type 2 increases the risks of breast cancer and no-one actually knows why. Thankfully I have sense to sit up and say something and not shy away from a good debate.

My nurse had reminded me about the patient cancer advocate group committee she wanted me to attend. The invitation was due to the self help group that I am still juggling with, and a committee member inviting me along. Personally I will gather the facts together and put it in front of this committee asking why this is not happening considering type 2 diabetes is on the increase within the western world. And more should be done in treatment instead of treating diabetes as a headache. The probability of me developing a reoccurrence is increased because the two condition can thrive off each other. This in turn leaves a big question mark to how they treat me. My BC nurse also informed me I am on a ten year observation list instead of five. To me that makes me think they are aware that my issues have just begun rather than solved. I have not met anyone who is being observed for ten years with breast cancer not unless they are high risk. Being a part of this committee puts me in a place where I can debate with those that are treating me. And develop a better understanding of the treatments involved with diabetes and breast cancer at this current time.      

Type 2 Diabetes Worsens Breast Cancer Prognosis

By Aaron Tabor, MD                                                                                    

Type 2 diabetes and breast cancer are two health conditions that share some of the same risk factors and pathways including obesity, changes in insulin-like growth factors, steroid hormone changes, and changes in inflammatory chemicals produced by fat cells. In fact some research studies suggest that type 2 diabetes is linked to a 20-30% increased risk for developing breast cancer.

The impact of type 2 diabetes on breast cancer outcomes is of particular interest because it has been reported that about 15-20% of breast cancer patients have type 2 diabetes, while more likely go undiagnosed. A new breast cancer research study used data collected from 3,003 women with a history of early stage breast cancer who took part in a larger breast cancer study. For this new study, glycated hemoglobin (HbA1c) levels were used to determine diabetes status with levels between 6.5-6.9% indicating high risk for diabetes and levels of 7.0% and above indicating type 2 diabetes. Analysis of the relationships between type 2 diabetes and breast cancer outcomes in this population of women with a history of breast cancer showed that:

Hb1Ac levels higher than 6.5% (high risk for type 2 diabetes) were associated with obesity and more advanced breast cancer upon diagnosis.

Women with type 2 diabetes were about 2.4 times more likely to die from any cause.

Breast cancer-free survival was reduced with increasing levels of Hb1Ac

These study results show the negative impact that type 2 diabetes can have on breast cancer. Breast cancer patients who also had type 2 diabetes or were at high risk for developing type 2 diabetes generally had more advanced breast cancer and were at slightly greater risk for breast cancer recurrence. The interaction between type 2 diabetes and breast cancer risk appears to be very complex. Interestingly, it has been reported that breast cancer treatment drugs can effect glucose metabolism, while some type 2 diabetes drugs like metformin have been reported to decrease breast cancer risk. More well-designed human studies will need to be done to clarify this potentially important interaction between type 2 diabetes and breast cancer.

Read More

What is Paget's?

What were my symptoms?

Itching, Soreness, Lesions and Weeping of the nipple.

When I first visited my GP January 2009 I was told nothing was wrong. It was eight months later when I was finally diagnosed with two conditions of the breast. These were Paget’s and wide spread high grade DCIS. Both conditions had been caught at a pre-cancerous stage. My first symptom I would say was down to instinct. I knew something was not right even though my nipple looked perfectly fine at that time. My nipple had an itchy tingly sensation and I would rub it constantly. I’d be stood in a queue with people all around me and I would be gritting my teeth to have a good rub. Believe it or not you can clear a queue of people when you start to itch your nipple.

Then in February 2009 I went on holiday and I developed a sore spot on the tip of my nipple. It was raw and weeping so my instinct said try antiseptic cream. I applied the cream on a piece of cotton wool and place it on the tip of my nipple, but when I took my bra off it would wrench the cotton wool off and the scab that had formed. So my next trial was to use a cream for cracked nipple and I tried this for a few months alternating between the two creams. I went back to my GP July 2009 and he started me on a course of antibiotics. It was already common practice for me to have regular bloods taken because I am a type two diabetic. So I had the full set of bloods taken and told to return in two weeks time.

What are you looking for?

Most doctors misdiagnose Paget’s because it has similarities to cracked nipple or eczema. Even I thought I had a reaction maybe to detergent or the water whilst away. It is a common mistake made and that is why it is a rare cancer. On my diagnosis I was used for an example so students could see what Paget’s looked like.

I was lucky that my cancer had remained in situ and was caught at a pre-cancerous stage. A tumor 6cm was growing laterally down my duct which was HER+++. If I had left it more than six months my story could have been different. If it wasn’t for the Paget’s I would of been sent away and told there was nothing wrong with my breast. On October 16^th 2009 I lost my entire breast and had a LD reconstruction done the same day, but I am here to tell my tale and you are able read it.

My advice for any breast complaint would be; if in doubt go to your doctors and if you are not happy seek a second opinion. It is only your vigilance that can lead to your diagnosis.

Read More

Yum-Yum Soup... with Anti-toxins

Almost empty pan of sweet potato, red pepper & carrot soup

Lately I have gone right off eating meat and I’m in search of something that can bring my taste buds back to life. A television program called Lorraine was discussing the properties of certain foods, which I personally already knew all about. I’m just like most people too bloody lazy to put it into practice.

I was driven to my fridge to see what was on offer. I needed colour anything with colour has anti-toxin properties...

Various types of Cheese (Love cheese but my cholesterol is high right the mo)
Various sauces & jams
Milk
Fruit juice
Apples
Kiwi fruit
Potatoes
Carrots
Mushrooms
Onions
Celery
In other words not much... with colour

Anyone who knows anything about a diet for diabetes (musts) is to look for fresh vegetables or fruit with colour. You must avoid the beige coloured foods such as potatoes, pasta, white bread etc... I mean there is a reason why honey bees go mental on a deep yellow flower. And buzz right on by when they see a white crusty loaf.

So after completing some more glossing of skirting boards and cleaning up the window frames of grease etc I popped to the shops in my paint covered jog pants. (This is London not down with the crew when you're covered in paint, but what the hell!)

I browse the Vegetable area in co-op to see what they have to offer. Ha-ha I say to myself a nice red pepper. Lucky me they also had sweet potato which beats the beige white potato’s in my fridge. I also grabbed a French stick sorry I love my white bread too much, not keen on wholemeal.

I head home with my booty of colour in hope my taste buds will be thankful and stomach.

First I grab two cloves of garlic and roughly chop them up. Followed by an average onion from the fridge (I wanted red but co-op failed to help on that one) which I diced up. I place both of these in a large saucepan with some olive oil to sweat off. Next I peeled my large sweet potato and cubed up. Grabbed four small carrots from the fridge peeled and sliced. Then deseeded the red pepper and roughly diced. I placed two small Maggie vegetable stock cubes in some boiling water to dissolve. Once my onions and garlic had finished sweating I added the stock and prepped vegetables into the large sauce pan with a pinch of mixed herbs. I leave to boil until the sweet potato is soft. Then I transfer all into a blender and zap... 20 mins later a fresh bowl of soup and my taste buds loved it... has a very unusual rustic earthy flavour yum-yum!

Read More

Letting The Dust Settle

My month has been full off plaster dust due to my home finally getting the much needed attention it deserves. My stress levels have been up and down with a few choice words swopped between myself and my husband. The past couple of weeks my husband has resorted to sleeping on the sofa whilst my young daughter sleeps with me. Her bedroom is getting a fresh coat of plaster and alterations. Hopefully all will be complete very soon with some normality/routine.

The new self help breast cancer group which involves setting up various activities (i.e. yoga, art, theatre day outs) I am already facing problems with. On my first private meeting I had mentioned a friend who was looking for a volunteer position to gain experience within such a group. My friend is doing a masters in this field of work and it would of been ideal. I spoke about it in detail with the BC nurse and if I could introduce her to my friend at the next meeting.  

I understand the formalities of setting up community groups I was trained to setup those very groups, but what happened was unforgivable/embarrassing for myself and my friend.

As someone who has worked as a youth worker/activity leader for sixteen years I understand the importance of volunteers within a group to make it work, but it seems what this group wants and what the group needs is right now in the hands of one individual with a upper crust accent or should I say Mrs Bouquet, but Mrs Bucket in real life.

This is why I have personally decided that this group is not for me. I explained to my friend that she was not to worry and she can use it as experience. The breast nurse said she would speak to me in private later, but she will be in for a big shock, after all it was for my friend to speak to her and get advice not what took place. Thank fully the group comprised of four breast cancer patients including myself, one BC nurse and a patient cancer advocate guest who was also shocked at what occurred. It seems I am not the only one who feels this group is not for them because the previous week it comprised of seventeen women and advisors. I was under the impression the group was an activity group which would need regular volunteers so people who attend can concentrate on an activity rather than minor details. I must of miss read the small print..... opps what small print...

Read More

John Carter UK Premiere & Keeping Busy

<><>

John Carter Premiere Opening Performance

I and Sophia had the good fortune of going to another premiere and watching the movie ’John Carter' before anyone else in the UK. I would encourage people to see this movie as it is child friendly even though it is a 12A. Andrew Stanton (Director) I think was impressed with Sophia and the fact she had the loudest voice at the premiere. He approached Sophia asking who she was with and I replied she was with me. In return he fished out two tickets for her to walk the red carpet. Only ten minutes before she was asking when she could see the movie, so the look on her face and the scream of glee was priceless.

Although some folk might find our new hobby pretty sad, to me it is building Sophia’s confidence up. The fact she is slowly realising she can actually talk to people that normally she would not have access too is brillant. My young daughter will not have a picture taken with celebs, and I do not encourage her either. Many of the A-listers Sophia has met have asked her if she would like a picture, but she is happy just to have a squiggle and I make that clear to the celebs. Her collection which begun because of the cancer bubble is a who’s who and even I am surprised. My daughter has managed to walk the red carpet of three big premieres, and that I know would not have happened if I had not got breast cancer. Whether people agree or not cancer personally woke me up, and made me realise I was letting opportunities slip by due to fear of being judged.

Meantime I have been busy writing a movie script myself. It is about greed, lust, love and ignorance. Time period 600ad when England was Mercia and Northumbria etc. You had Anglo-Saxons tribes fighting amongst themselves whilst the Vikings were raiding the coast lines. It has me excited because it has a twist which I cannot mention. I just hope I can work out how to get it on film.

As well as the writing I have got involved with a project my oncologist and breast cancer nurse are organising, a Self help group for breast cancer patients. The fact I have done a course in setting up community projects back in 2001 means I’m in my comfort zone. I have even designed a logo, so the group has a visual to work with until one is designed by the group.

Read More

Hair Harvesting & What You Can Do...

Yesterday I visited the hairdresser to get my hair cut. I wanted to have six inches cut off, so my hair would be shoulder length. The hairdresser was hesitant about cutting so much off, but I cannot manage my hair at its current length. One of the other customers in the shop mentioned I should sell my hair. She had read an article in a paper about people who grow their hair to sell it. Western hair is like gold dust in the wig making industry, so why not make a few pounds. Realistically the amount that was cut off you could do nothing with. But then I went into override thinking well could I save my hair if I wanted a wig made for my head. After all it is my hair and god forbid if the wrath of breast cancer darkened my door again, could my hair be harvested?

On returning home I started browsing the various websites that talk about selling your hair and I was surprised at how much I could earn. This could be from forty to two hundred pounds plus deepening on length, condition and hair type. The fact I have not dyed my hair at forty one or smoked makes all the difference if I wanted to sell my hair.

I find a UK site called Bloomsbury and I email them to get more information on this subject.

Hi
I am a breast cancer patient and currently my treatment does not require
 chemotherapy or radiotherapy, but if I was to try salvage my hair, which
 is long. Would I be able to have it made into a wig for personal use? And
how much would this cost me to do?

Regards

Sarah M

Within ten minutes I get a reply....

Dear Sarah,
 
Yes it would be possible to have a wig made for you. The pricing for it
varies from client to client. However, for example, if you were to buy a
whole system from us (not using your own hair) the average price is £1100
(for the base and 6-in of hair). From there it can fluctuate depending on
the type of hair used, the style, density, etc.
 
If you would like to book an appointment with us, or have any other
enquiries, don't hesitate to call us at 0207 404 6040.
 
Hope that helps and best wishes,
Bloomsbury of London

It still does not tell me how much if they were to use my hair rather than some strangers for a wig.

Out of curiosity I decide to phone them up to find out what my options are. Bloomsbury answered all my questions and even gave me bits of advice that even I had not thought of. The young woman on the phone explained that during treatment normally doctors advise you to use a synthetic wig because your hair should grow back as normal. But they never mention about your hair becoming thinner etc, so some women save their hair just in case. I mean they talk about egg or sperm storage, but not hair. By saving your natural hair it is giving you options and it is not all about wigs. They advised me that a free consultation has to take place first to check my hair and from there a decision could be made. Personally I feel the options Bloomsbury spoke of are very good and are not spoke about enough.

On keying in certain words into the browser I realise I am not the only one who is asking questions on hair harvesting. There are many other breast cancer women wanting wigs made from their own hair. And they feel the options given like the push to use a synthetic wig is not good enough, after all their hair is perfectly fine...

It works out cheaper in the long run, but could you use your hair if long enough to fund a readymade synthetic wig? The answer is yes you can.

After all you would only bin your hair, so why not make something positive from a negative situation. And get a decent wig rather than a cheap alternative on the NHS.

I found it quite frustrating at first, but understandable because this subject is very sensitive and how could someone approach it without causing upset. Yet I know of plenty women who are not happy with the wigs they are given. Why not be given the option or it be integrated into a leaflet with all the other options with our treatment? Well yes it could be...

I personally would not wear a wig myself because I already have enough issues maintaining the hair on my head now. I know I would lose my temper and most probably sling the wig. Making my own headscarves’ etc to ease the transition would be more suited to me. I don’t mind the Sinead O’Conner look to be honest, less shampoo. As for my hair I would sell it giving half the monies to a BC charity and the remaining I would put aside for a day out.

Cancer treatment brings up all sorts of questions, some we would sooner not discuss because the reality hurts too much, but at some point we have to say you know what yeah... why bloody not...

If you decide you would like to save your hair and it is ten inches long or more then it is easy to do.

Here is the link to Bloomsbury hair harvest...

I’m sure the BC community or cancer patients would not turn their back on this service if the options out there were discussed more freely.

Read More

Sunflower, Laughter and a Butterfly

The other day I sat in a room with seventeen other women all affected by BC. I looked around thinking so this is it. This is where the rainbow lands and theses ladies are the crock of gold. Some are in deep thought searching for reassurance whilst others have beaming defiant smiles. There are no answers because no-one has asked any questions. The silence is broken by laughter and that’s the one thing that breaks the tension in the room. Laughter is the release button, Laughter is a safety button because if we lost the laughter then it be a room full of tears.

Breast cancer drags you from the comfort zone of complaining about menial issues into a new reality of frailty and vulnerability. As I look in the mirror at my imposter I still cannot believe my story is actually my reality. When I talk it is like I’m not that person, but the story teller. I’m the jester not the queen in the pack forever laughing at my health issues. Sometimes I lay in bed wondering what next. I listen to the echo of footsteps and people arguing after a skin full of booze, and I think what a waste. I envy the fact they have a body full of healthy cells that may never explode. Then I think, but I’m glad it is me because the argument they are having is really pathetic.

Dear Dr S

Re: Ms Sarah Mendoza – DOB: 29/07/19** NHS: *** *** ****

18 **** **** Road, Northolt, Middx, *** ***

Diagnoses:

1.    Left breast cancer

2.    Left latissumus dorsi and implant reconstruction, November 2009

3.    Capsulotomy and implant adjustment February 2011

4.    NAC reconstruction, June 2011 and tattooing November 2011

I reviewed this lady in Mr W clinic today as she was incorrectly booked under this Consultant. She is generally very happy with the result of her reconstruction and not keen for and re-tattooing of the NAC. She has achieved a reasonable cosmetic result although the implant is slightly high and lateral but she has excellent in bra symmetry. She is not keen to have further intervention and therefore i have arranged for her to be reviewed in Mr H clinic in one year’s time.

Your sincerely

Dr M

SpR in Plastic & Reconstruction Surgery

Read More