BREAST CANCER: The Month to Be Aware

Cancer occurs when abnormal cells grow and multiply uncontrollably. The buildup of these extra cells often forms a mass of tissue called a lump, growth, or tumor, which can be benign (non-cancerous) or malignant (cancerous). Malignant tumors are dangerous because they are cancerous, can be life-threatening, can grow back after being removed, and can spread to and damage nearby organs and tissues.

Breast cancer can occur in both men and women, although male breast cancer is rare. Except for skin cancer, breast cancer is the most common cancer among American women, in which 1 in every 8 women will be diagnosed with breast cancer in their lifetime. Nearly 200,000 women are diagnosed with breast cancer each year in the United States. In addition, 2,000 men are diagnosed with breast cancer. Male breast cancer is a very serious disease and needs to be treated as soon as possible.

What is a normal breast?

What is normal for you may not be normal for another woman. The way your breasts look and feel can be affected by getting your period, having children, losing or gaining weight, and taking certain medications. Breasts also change as you age.

Although there is no exact cause for breast cancer, there are several risk factors that may increase your chance of getting breast cancer:

·    Age – Risk increases with age. Most women are diagnosed when they are over 60 years old.

·    Personal history – Having breast cancer in one breast increases your risk of getting cancer in your other breast.

·    Family history – Your risk of breast cancer is higher if your mother, father, sister, or daughter had breast cancer. Your risk is even higher if your family member had breast cancer before age 50. Having other relatives (on either side of your family) with breast or ovarian cancer may also increase your risk.

·    Certain genetic mutations – Mutations in the BRCA1 or BRCA2 genes increase the risk of breast cancer. Tests can reveal the presence of these gene mutations in families where many women have had breast cancer. In these cases, health care providers may recommend ways to try to reduce the risk of breast cancer and screening at an earlier age.

·    Race – Certain ethnic groups have a higher risk of breast cancer.

·    Breast density – During a mammogram or breast x-ray, breasts appear as having dense and non-dense (fatty) tissue. It is felt that women whose mammograms show larger areas of dense tissue are at increased risk.

·    Being overweight or obese after menopause – The chance of getting breast cancer after menopause is higher in women who are overweight or obese.

·    Lack of physical activity throughout life.

·    Drinking alcohol – Studies show that the more alcohol a woman drinks, the greater her risk of breast cancer.

Additional reproductive risk factors:

·    The older a woman is when she has her first child, the greater her chance of breast cancer.

·    Women who never had children are at an increased risk.

·    Women who had their first menstrual period before age 12 are at an increased risk.

·    Women who went through menopause after age 55 are at an increased risk.

·    Women who take menopausal hormone therapy for many years have an increased risk.

Having a risk factor does not mean that a woman will get breast cancer. Most women who have risk factors never develop breast cancer; however, if you experience risk factors it is important to discuss them with your doctor.

Symptoms

The early stages of breast cancer usually do not cause symptoms, however, as the tumor grows, it can change how the breast looks or feels. Common changes include:

·    A lump or thickening in or near the breast or in the underarm area

·    A change in the size or shape of the breast

·    Dimpling or puckering in the skin of the breast

·    Discharge (fluid) from the nipple, especially if it’s bloody

·    Scaly, red, or swollen skin on the breast, nipple, or areola (dark skin at center of breast). The skin may have ridges or pitting, similar to the skin of an orange.

You should see your primary care physician if you are experiencing any of these symptoms. Although these symptoms may be caused by other health problems besides breast cancer, it is important to have them checked in order to diagnose and treat the problem.

Detection and Screening

Doctors recommend that women have regular clinical breast exams and mammograms to find breast cancer early and before symptoms are present. Treatment is more effective when the cancer is found in an early stage.

Clinical Breast Exam – Your health care provider will check your breasts for differences in shape or size between your breasts, as well as for lumps and other symptoms listed above. If symptoms are present your doctor will recommend further testing. Clinical breast exams should be done annually by your Gynecologist or health care provider, beginning at age 18.

Mammogram – This is an x-ray of breast tissue that can often show a lump before it can be felt. It is important for women, beginning at age 40, to have a mammogram every year. Women who are younger than 40 and have risk factors should talk to their doctor about when to have their first mammogram and how often.

Breast Self-Exam – This exam is not recommended as a screening tool for breast cancer. However, it is a tool that helps women become familiar with their breasts, which is an important step to recognizing symptoms early. Knowing what is normal for your breasts, in the way they look, feel, and change throughout the month is the purpose of practicing a breast self-exam. Visit BSE for more information.

Prevention

·    Know your family history and discuss it with your doctor

·    Have your screening done when prescribed by your doctor

·    Maintain a healthy diet, rich in fruits and vegetables with vibrant colors

·    Maintain regular physical activity, recommended at 30 minutes a day, 5 times a week

·    Maintain a healthy weight; Body Mass Index is an accurate measure for most

·    Limit your intake of alcohol

·    Practice regular breast self-exam. Know what is normal for your breasts and recognize symptoms early and seek treatment.

During the month of October, be aware of your risk for breast cancer. Make it a priority to talk to your doctor about your family history and any risk factors you may have. Stay on top of your screenings and join the fight against breast cancer by protecting yourself. Encourage loved ones and friends to do the same!

Additional Resources:

Contact your local American Cancer Society chapter to learn how you can become involved in the fight against breast cancer or visit http://www.cancer.org/index for additional resources.

Find a race near you: Susan G. Komen Race for the Cure 

National Breast Cancer Foundation, Inc.

The Importance of Knowing CPR

Would you know what to do if an adult was suffering a heart attack or if a child was choking? Calling 911 is the first step, but immediately following up with cardiopulmonary resuscitation (CPR) will greatly increase his or her chance for survival.

CPR helps to maintain some blood flow to the brain and heart when the heart stops pumping on its own. This “buys time” until paramedics arrive and can save lives. When an individual suffers a heart attack outside of a healthcare setting, their survival could rely on receiving immediate CPR from a bystander. However, the American Heart Association (AHA) reports that less than one-third of these individuals receive the help they need because most bystanders are untrained in CPR and are afraid they will do something wrong.

In adults, heart attacks account for more than 350,000 deaths which occur before the victim reaches the hospital. The most dangerous period of a heart attack is during the first two hours after the onset of symptoms. In children under 5 years of age, choking is the fourth-leading cause of accidental death due to children putting small objects in their mouths and choking on certain foods such as raw carrots, grapes, hot dogs, and nuts.

CPR should be used in these situations to keep individuals alive until professional medical personnel have arrived.  It is the only way to keep someone alive when both their heart and breathing have stopped.

New guidelines for CPR were released nearly a year ago on October 18, 2010 by the AHA. The original 3 steps have been rearranged in a more effective order. The old way was A-B-C – first establish an airway, perform mouth-to-mouth, and then apply compressions. The NEW way is C-A-B – for compressions, airway, and then breathing. It has been determined that it is more important to initiate the chest compressions immediately in order to increase the circulation of blood, which delivers oxygen throughout the body in order to keep the brain and cells alive.

You do not need to be a medical professional to know or use CPR. It is a life-saving skill that everyone should know, especially if you are a parent or caregiver. It can enable you to help someone in need. Once heart beat, lung function, and respirations have stopped, CPR can be performed. It is most effective when begun as soon as possible. The human body can only be deprived of oxygen for very few moments before irreversible damage and death occur. Waiting for an ambulance to arrive can waste precious minutes.

Providing CPR could mean the difference between life and death for someone who’s unconscious. Proper training is advised so that CPR can be performed safely and correctly when needed.

For CPR certification, contact your local hospital or American Red Cross chapter to see when they are offering certification courses. Getting certified can be accomplished in as little as one afternoon. Many of the SCA plant locations offer certification courses at specific times during the year. Talk to your Plant Nurse if you are interested in learning about when the next course begins.

SCA’s Barton, Alabama location is currently providing CPR certification classes to all employees throughout the fall. At this time, 48 employees have signed up, of which 10 have already completed the training. The course lasts about 2.5 hours and is provided by 2 certified employees. Barton employees are becoming skilled and ready to provide CPR in emergency situations in or out of the work setting. SCA's Bowling Green, Kentucky location will offer a course in early October.

Greg Robinson (left) and Jeff Curtis observe Bruce Newton practicing chest compressions on “Annie.”

Additional resources:

CPR illustration guides and video demonstrations http://depts.washington.edu/learncpr/

WALKING FOR HEALTH AND EXERCISE

We are happy to hear that many of you are currently participating in SCA’s walk challenge!  Hopefully the friendly competition with yourself and others will be a motivator to begin (or restart) one of the healthiest habits around.  In this article, you will find information about how to make the most of your walking time and the benefits you can expect to experience!

START SLOWLY

If you are a long-time couch potato, don’t expect to walk out the door and get 10,000 steps on your first day.  Starting too quickly can create soreness, fatigue, and even injuries that could ultimately prevent you from meeting your walking goals.  Instead, start smart.  Take one day to simply measure your current activity without trying to change it.  From there, set small goals for increasing your daily walking until you reach an optimal level of activity.  For example, if you begin at 4,000 steps per day, see if you can increase it by 500 additional steps each day.  Most importantly, decide on a routine that seems manageable and enjoyable for you.  If walking seems like a hassle instead of a pleasure, it won’t become a healthy habit.  Here are more ideas about how to get started: http://www.thewalkingsite.com/beginner.html

DRESS SMART

Be sure to walk in comfortable, supportive shoes.  Walking sneakers should be replaced every 6 months for those who are walking daily.  Relying on the old tennis shoes that you’ve been using around the yard for 5 years may result in pain and/or injury.  You may even want to go to a specialty store where you can be fitted for shoes that match your body frame, foot shape, and walking style.  If you are walking outside, make sure that your clothing is weather appropriate so you don’t get chilled or overheated.  If you are walking in the sun, apply sunscreen right before your walk.  If possible, choose to walk at a time of day that provides more mild temperatures.

HYDRATE

Whether you are sweating in the heat or not, every cell of your body needs water to function optimally.  This applies to everyone, but especially people who are physically active and increasing their level of physical activity.  This calculator can help you to determine the amount of water you should be drinking each day: http://nutrition.about.com/library/blwatercalculator.htm.  If you don’t like plain water, try adding a bit of lemon, mint leaves or orange juice for flavor.  Avoid adding powders with sugar or artificial sweeteners.

WALKING FOR HEALTH

Walking is a great low-impact, low-fuss activity.  It requires no special facility, no fancy equipment, and no advanced training.  Here are some of the health benefits of a regular walking routine:

-          Lower blood pressure

-          Higher HDLs (“good” cholesterol)

-          Lower LDLs (“bad” cholesterol)

-          Prevention or management of type II diabetes

-          Weight management

-          Physical fitness

-          Improved mood

-          Better sleep quality

-          Reduced risk of heart disease

-          Longer life!

To achieve these health benefits, it is recommended that adults participate in 150 minutes of moderate aerobic activity per week (such as walking) plus some strength building exercise twice per week.  This can also be measured with steps, with 10,000 steps per day being considered optimal.  For even greater benefits, increase the intensity or duration of your activity.

WALKING FOR WEIGHT LOSS

One pound of body fat is made up of 3600 calories.  If you gain a pound, you consumed 3600 more calories than your body needed.  To lose a pound, you must use 3600 calories more than you consume.  This calculator can help you determine how many calories you are burning when you walk: http://health.discovery.com/centers/cholesterol/activity/activity.html.  The faster you walk, the more calories you will burn.  It may seem like a lot of effort is required to burn a single pound.  However, as you walk more, you will increase your muscle mass and metabolic rate.  Your body will be burning extra calories even when you are not active.  Be aware that a single walk can be easily undone by a poorly chosen snack.  For ideal weight loss, combine physical activity with healthy food choices and appropriate portions.  If you would like additional guidance with healthier eating, contact Dr. Haaz at shaaz@corporatehealthsolutions.com to get started.  (Note: while it may be tempting to add hand or ankle weights to your walk for increased resistance, the risk of injury is greater than the benefit.  Instead, try walking faster, longer, or on an incline.  To build strength, try using weights independently, not during your walking routine.)

WALKING FOR MENTAL HEALTH

Physical activity is one of the most effective ways to help manage stress, prevent depression, and improve sleep quality.  For the greatest mental health benefits, you should be moving quickly enough to feel an increase in your heart rate.  This type of activity will release endorphins that help to regulate mood.  A heart rate monitor can be helpful, but is not necessary.  A simple breathing test can determine if you are working at an optimal heart rate.  While you are walking, try to speak.  If you can say a full sentence without having to take a breath, your heart rate is not elevated very much.  If you can’t say 2-3 words without taking a breath, you may be working too hard.  Somewhere in between those scenarios is ideal for challenging your body and improving mental health.  If walking faster is not comfortable, try walking up hills, steps, or a treadmill set on an incline.

WALKING AND YOUR JOINTS

If you experience pain in your joints when you walk, or if you know that you have arthritis, it is important to be gentle with your walking program.  Check with your family doctor, orthopedist or rheumatologist before beginning a walking program and be sure that you have very supportive shoes.  You may want or need inserts in your shoes or a knee/ankle brace (prescription or over-the-counter) to sufficiently protect any affected joints.  For many individuals with joint conditions, walking can help to stabilize the joint by increasing the strength of surrounding muscles.  Walking can also help to retain joint mobility, so that you are able to continue being active in other ways.  If you experience joint pain with extended walking, try breaking your activity into shorter sessions.  Walking for 10 minutes, 3 times per day is as effective in many ways as walking for 30 consecutive minutes.  When you start to feel pain in your joints, stop walking and start again when your joints have had a chance to recover.

NO PAIN, NO GAIN?

Pain in a joint is a signal to stop your activity and let your body rest.  You should also stop if you feel a sharp or shooting pain anywhere in your body.  There are some types of sensation, though, that are a normal consequence of increasing your physical activity.  When you first begin a walking program, you may notice some muscle fatigue or soreness, especially after the activity or over the next 1-2 days.  As you gain strength and endurance, that will diminish.  If you feel some soreness after activity, it is a good idea to make your walk a bit easier for the next day or two, so that your muscles have a chance to recover.  To reduce muscle soreness, drink plenty of water and stretch all major muscles AFTER your activity.  Stretching while your body is cold is not very effective and could lead to injury.  Stretching after your muscles are warmed up will release tension and lactic acid (which can lead to soreness).  If you are unsure whether the sensation in your muscles is normal, contact your doctor.

GO FOR IT!

Good luck with the walking challenge!  We hope that this is the start of a healthy habit that continues for a lifetime.  If you have questions about walking or would like any additional support, let us know!

HOW HEALTHY IS YOUR KITCHEN?

We make choices every day about when to eat, what, and how much.  But did you know that our choices are impacted by the design of our kitchens?  Here are some strategies for aligning your home décor with your weight loss and nutrition goals!

PLATE SIZE

What we generally call a “dinner plate” can fit far more food than anyone should be eating for dinner.  And when we put a smaller amount of food on the plate, it looks meager and unsatisfying.  Instead, try using a salad plate for your dinner.  Fill it with colorful, nutritious food.  Your eyes and your stomach will be more content with this small feast.

LIGHTING

When you are cooking, keep the lights as bright as necessary.  But when it is time to eat, try to use about 240 watts (Four 60 watt lightbulbs will accomplish this).  In very bright light, people are more energized and tend to eat quickly.  When you eat quickly, you take in more food than you need before even realizing you are content with what you have eaten.  Eating more slowly allows you to appreciate and savor your meal, which will leave you feeling more satisfied with fewer calories.

DECLUTTER

A cluttered kitchen can make it difficult to find the ingredients, tools, and space you need for preparing healthy meals.  People who have a cluttered kitchen are more likely to eat for convenience, choosing packaged meals or fast food instead of home-cooked nutrition.  A cluttered environment can also increase stress, which leads to unnecessary eating.

SKINNY GLASSES

Tall, thin glasses give the appearance that they hold more liquid.  Fill up a tall thin glass and you will feel satisfied with a smaller portion of your beverage.  Of course, when it comes to water, take a nice hefty glass and fill it up over and over again!  Drinking more water all day long will assist in weight loss efforts.  Often thirst is mistaken for hunger, leading you to eat a snack when you really just need a big glass of water.

DOWN-SIZE

It is appealing to save money by buying in bulk.  Unfortunately, large packages often lead to large portions.  When you buy a large package, prepare small portions in baggies or Tupperware for easy use.  Use measuring cups to serve yourself and stay aware of how much you are eating.  Research shows that visual estimates tend to get larger over time, so measuring cups can keep your portions honest.

EYE-LEVEL

Keep the healthiest food at eye level in the refrigerator and on shelves, so it is the first option you see.  If you must have a cookie jar, make it difficult to reach and try to avoid a clear cookie jar that brags of its contents.  Put a bowl of fresh fruit on the countertop or table where it becomes an easy choice for a quick snack.

MINIMIZE DISTRACTIONS

Many people eat while watching television, reading a magazine, or working at their desks.  When your mind is on other matters, you may eat more than you need without actually tasting or appreciating the food.  The lack of satisfaction resulting from this “mindless eating” can lead you to seek out more food when your body has already had enough. 

FOREGO FAMILY STYLE

Instead of putting a large pot of food on the table, keep it on the stove.  Put a small portion on each plate before taking it to the table.  When a mountain of food is right in front of your eyes, you are more likely to take extra food that your body doesn’t need.  If you finish your small plate and are still physically hungry, go back to the stove and take a little bit more.

Weight loss success depends on a variety of choices you make every day.  The easier it is to make healthy choices, the more likely you are to succeed.  Setting up your home environment for healthy eating can help steer you in the direction of healthier choices that add up to long term benefits.

What to Screen For & When

Medical screening means looking for early stages or warning signs of disease, often before any symptoms appear. Screenings allow us to detect, and sometimes prevent, cancers and other diseases in their early stages when they are most treatable, which can save lives. Not all screenings are recommended for everyone. Most are specific to age and some are specific to gender.  The following cancers and diseases have screening tests available to help keep you healthy and disease free.

Recommended health screenings for both men and women include:

Colorectal cancer – Cancer that occurs in either the colon or rectum. Both men and women aged 50 years are recommended to be screened for colorectal cancer. There are three main tests to screen for colorectal cancer:

·      High-Sensitivity FOBT (Stool Test) – a simple take-home test kit allows you to take samples of your stool. After returning it to your doctor, your stool will be tested for the presence of blood, which is often a symptom of colorectal cancer. This is recommended once a year.

·      Colonoscopy – known as the GOLD STANDARD for colorectal cancer screening. It is recommended every 10 years if no abnormalities are detected. If there are polyps or a family history, your doctor may recommend screening at earlier intervals.  The test consists of a long, flexible and lighted tube inserted in the rectum to check the entire colon for precancerous polyps. During a colonoscopy, the doctor may remove a polyp if present.

·      Flexible Sigmoidoscopy – this test is just like a colonoscopy except a shorter tube is used to view the lower third of the colon. It is recommended every five years. It is not, however, as complete an examination as a complete colonoscopy.

Skin cancer – There are two common ways to screen for skin cancer:

·      Full-body skin exam by a doctor – each year your primary care physician (PCP) or dermatologist should look over your body to check for abnormal moles or lesions, as well as changes to pre-existing moles.

·      Skin self-exam – each month you should examine your own skin to check for new, abnormal, or changing moles, lesions, or sores. By checking yourself on a monthly basis you will begin to recognize what is normal for your skin.

Depression – Your emotional health is as important as your physical health. If you have felt hopeless or uninterested in doing things you normally enjoy, you may be depressed. Screening for depression should be done on an annual basis during your check up. If you think you might be feeling depressed, contact your EAP for immediate assistance (COMPSYCH 1- 800-379-0243).

At your annual check-up with your family physician, you can have your cholesterol, blood sugar, body mass index (BMI), and blood pressure checked to determine if your levels are healthy. Cholesterol and blood sugar screening require blood to be drawn after fasting for 12 hours. BMI and blood pressure screening can be done within minutes by a doctor or nurse. These tests screen for high cholesterol and blood pressure, diabetes, and overweight and allow your doctor to determine if you need medication to help normalize your levels, adjust your prescription, or recommend dietary and lifestyle changes. These screenings are also done annually at the health assessment.  Attend this event at your workplace and bring your results to your PCP to discuss them and ensure up-to-date records and proper medical care.

Men: Additional screenings recommended for men include:

Prostate cancer – A complete check of the male prostate includes BOTH of two commonly used tools to screen men for prostate cancer and is recommended for men at age 50, or for those men who are part of an ethnic group that experiences more prostate cancer:

·      Digital rectal exam (DRE) – allows doctor or nurse to estimate the size of the prostate and to feel for any abnormalities in the structure of the prostate.

·      Prostate specific antigen test (PSA) – a blood test to measure the level of PSA in the blood. An elevated level of PSA in the blood can be caused by prostate cancer or other conditions. It is important to note that the PSA should be drawn prior to the digital rectal examination.

To read more about prostate cancer, see last week’s blog.

Breast cancer – Although this cancer is more common in women, it is important for men to check their breasts for lumps on a regular basis and to see a doctor immediately if lumps or symptoms are detected.

Women: Additional screenings recommended for women include:

Breast cancer – There are three main tests to screen a woman’s breast for cancer before signs or symptoms are present. If a woman has a family member with breast cancer, especially a mother, sister, or daughter, she should be screened at an earlier age and should discuss with her doctor when to begin.

·      Mammogram – an X-ray of the breast, recommended for women on an annual basis, beginning at age 40. 

·      Clinical breast exam – an examination by a Gynecologist or PCP to feel for lumps or changes recommended on an annual basis, beginning at age 18.

·      Breast self-exam – examine yourself for lumps or changes in size or shape, recommended on a monthly basis (same time in menstrual cycle every month due to changes in breast tissue) beginning at age 18.

Osteoporosis – A bone density test is recommended every two years for women beginning at age 65. If you have the following risk factors, talk to your doctor about being screened earlier: female, Caucasian, underweight, post-menopause or amenorrhea, chair-bound or sedentary, family history of osteoporosis. Read about osteoporosis prevention.

Cervical cancer – The method of screening women for cervical cancer is a Pap test done by your Gynecologist or PCP, which is recommended annually or every 2-3 years, beginning at age 21 or within 3 years of sexual activity, whichever comes first. 

Timing is Everything

Screening guidelines always include an age at which screening is recommended to begin. However, if you have a higher risk for a disease due to other medical conditions, a family history, or symptoms, talk to your doctor about being screened earlier. See a doctor immediately if you are experiencing symptoms.

Your risk for cancer and other diseases can also be reduced by practicing prevention:

·         Maintain a healthy weight by eating right and exercising

·         Limit use of alcohol

·         Don’t smoke

·         Visit your doctor on an annual basis and discuss with him/her your family history

·         Have your screenings done when recommended

Additional resources:

CDC: Cancer Prevention and Control