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I revisited the Dodge Theatre last night. It was for an incredible night of music. Fusion as defined by Merriam Webster. The Phoenix Symphony performing the music of Queen and Led Zeppelin. Not as bizarre as it sounds. They had vocals, base and lead guitar, electric violin, and the most incredible set drummer! All supported by the richness of the symphony. I must say it was the first time I had ever seen a symphony conductor leap and jump into the air!

What was even more significant, for me personally, was that I could enjoy myself. You see, I have had a negative association with the Dodge Theatre. I had received my diagnosis of breast cancer (ILC - later to find out its Stage III) just hours before I attended a YES concert there back in July, 2009. At the time, my husband kept asking: Are you sure you want to do this? We can find someone to take the tickets! I was adamant. I wanted normalcy. I had been looking forward to this concert for months. Besides, I am singly most happy when I am at live concerts. (Which, hopefully, explains my 4 Stones concerts during their Big Bang tour that I attended in two different states. I know, the word groupie comes to mind...but that is the stuff of another TMZ moment!)

So I went.

So, it was an emotional disaster.

First mistake. The 3 double Cosmopolitans I drank in fairly short order.

Second mistake. Underestimating the emotional effect that music can have.

Look around - Got no place to stay.
God I hate this town, depending on the day.
You look me up, you look me down - Alright, OK.
While I got no life, I got no hope;
I'm falling in love.
Help me through the fight;
Help me win tonight - I'm calling.
What to do I find it hard to know;
The road I walk is not the one I chose
Lift me up and turn me over;
Lead me on into the dawn.
Take me to the highest mountain;
Tie me up, love in a storm.
Have you decided on my fortune?
Facing the future in your eyes,
With your imperial behaviour
We fight amidst the battle cries.
Open doors - They may be closed to me;
The fire's still burning in my heart...
What to do I find it hard to know;
I want to turn my life around...

Those lyrics, plus having a bladder the size of walnut, sent me into the ladies room where I had a complete emotional breakdown. The brunt of this breakdown borne by a dear friend whom I woke up two time zones away. Damn cell phones!

I have not wanted to remember this moment of vulnerability, because it was just that...a moment of vulnerability. (I do not do well flaunting my vulnerabilities.)

It was a moment of base, raw emotion -- fear / anger / hostility / desperation / despair all rolled into a maelstrom of unplugged emotion (forgive the concert pun). I did not want to remember how much I scared my poor husband, disappearing on him like that; or the horrific car ride home I had inflicted upon him.

It was all so primal that I was not ready to claim it until last night.

Interestingly, or trite...depending on your personal level of cynicism, it was a set of back-to-back songs that allowed me to make peace with myself regarding my prior indulgence. And both belonged to Queen.

There's no time for us
There's no place for us
What is this thing that builds our dreams
Yet slips away from us
Who wants to live forever?
Who wants to live forever.....?
There's no chance for us
It's all decided for us
This world has only one sweet moment
Set aside for us
Who wants to live forever?
Who wants to live forever.....?
Who dares to love forever
When love must die?
But touch my tears with your lips
Touch my world with your fingertips
And we can have forever
And we can love forever
Forever is our today
Who wants to live forever?
Who wants to live forever?
Forever is our today
Who waits forever anyway?

Is this the real life?
Is this just fantasy?
Caught in a landslide,
No escape from reality
Open your eyes, Look up to the skies and see,
I'm just a poor boy, I need no sympathy,
Because I'm easy come, easy go, Little high, little low,
Any way the wind blows doesn't really matter to me, to me

What can I say? I am a child of the '70s who has always taken refuge and found self-forgiveness in prose, lyrics and rock 'n roll.

This time when I left the Dodge Theatre I did so without needing to be supported. But enjoying the long-haired crowd, humming Stairway to Heaven (no kidding, it was the final song!) and enjoying the full moon illuminating the 65 degree night-time in the desert.

Questions...

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QUESTION

Hello TC,

We are trying to locate a doctor in for my daughter, and it's not easy. Do you have any suggestions on find the best MD?

We have the name of an Oncologist (a highly recommended woman doc), and thought that it was the Onco that did the surgery. Now we understand that a surgeon does the operation and the Onco handles the case afterwards. Are we correct about this?

Thanks much.


RESPONSE:

The “traditional medical team” is made up of the following:

Surgical oncologist – this person is integral in the initial stage, but a transitory person in the long haul of the journey. They are the person who your daughter will work with on determining if and if so, which sort of surgery is appropriate (e.g. lumpectomy, mastectomy, nipple-sparring, tissue-sparring, NO surgery at all). Once healed from the surgery, and margins are clean, this medical professional ceases to have a role.

The surgical oncologist, however, is the doctor you request to have the tumor and tissues sent to Genomics in California for the Oncotype DX test. If the surgical oncologist won't do it, then insist that the medical oncologist does. Don't be talked out of this test - it is the only reliable determiner available to us in the U.S. to gauge the efficacy of chemotherapy on our individual cancer. (There is a Mammaprint test available now as well. The problem, the only lab that has the patent on this is in Phoenix, and a Mammaprint can only be conducted on "fresh" from the slab tumor/tissue.) I was also told by several pathologists that the particular patent that the Phoenix lab obtained is not quite the same caliber as the one in Europe.

It is also after the surgery and the pathology analysis that she should then have her results sent to Michael Lagios, MD in Marin County for re-evaluation and adjuvant treatment recommendations. (See blog entry dated January 23, 2010.)


Medical oncologist – this is the person whom you have a life time relationship. They advise and help you determine if and what type of adjuvant treatment she will have (i.e., chemo and other drug protocols [tamoxifen, etc.])They follow you for the first year or two every 3 months, 2-5 years every six months, and thereafter annually – they follow you to track recurrence. This is the medical person that you use to determine your long term quality of life. (And, this is the person that I personally am having a tremendously difficult time in finding that fits with my perspective on my cancer. I have interviewed four so far.)


Radiation oncologist – this is the person who, if you choose to do radiation, will handle that portion of the adjuvant treatment. There are great variances in this field so interview radiation oncologist thoroughly. Ask what type of equipment they have and how they target the chest wall. Radiation can have serious side-effects ranging from skin-burning to weakening of the heart. Make sure that if you choose radiation, that you do your homework!

NO TREATMENT DECISIONS SHOULD EVER BE MADE OUT OF FEAR...! The only long term decisions that you can live with are the ones you make from a point of knowledge.

Reconstructive surgeon – (aka a plastic surgeon who specializes in reconstructive surgery). This specialization is absolutely necessary to have any sort of livable outcome. A good surgical oncologist will work with the reconstructive surgeon and allow them to determine the incisions, since they do so from a perspective of your long term, dare I say . . . aesthetic, outcome.


For me, the integral person has been my naturopathic oncologist. Not many reputable ones around, but I found the one who developed and formalized this area of alternative medicine. It is this doc, Daniel Rubin, ND FABNO, whom I am working with in developing my adjuvant treatment -- I have opted out of the traditional protocol of chemo/drugs/radiation.

Finding is a good medical oncologist is difficult. I suggest that your daughter speak to the surgical onc and get a few names of whom they work with. I would also google med oncs in your area and get names and then start looking up their medical profiles and histories. I also found that using “healthgrade.com” (it’s a paid on line service) was good in reading patient reviews of doctors. Once she has a short list, and has done her due diligence, start face-to-face interviewing – go in with her notebook and questions ready!

The most important thing to remember is that the patient needs to do the interviewing (not the other way around). The patient, is the “employer” and/or “general contractor” of her own healthcare.

TC

TC's Post...Post Script

I completely forgot to mention the involvement of a geneticist! Early on this journey, after my first interview of a prospective surgical oncologist, I met with and got tested by a geneticist. This was to help answer the WHY??? The purpose was to determine if I had any genetic predisposition toward cancer. Having no information or contact of and with my biological father in 42 years, I could not definitively say there was no family history of cancer. The answer to this question would help guide me on this journey, and help answer questions regarding my children's future. This is the testing for the BRCA1 and BRCA2 - in addition to looking at other genetic markers.

I pleased to say I passed the test -- no genetic predispositions!

If you are a women of Ashkenazim descent, there is an additional genetic screening that should be done.

PSA - Overdiagnosis Is Not a Trivial Matter

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One in Three Cancers Diagnosed with Free Mammogram Screening Is an "Overdiagnosis"
by David Gutierrez, staff writer

(NaturalNews) In countries with public breast cancer screening programs, one in every three diagnosed with invasive breast cancers would never have produced symptoms in a patient before she died of other causes, a new study has revealed.

"Screening for cancer may lead to earlier detection of lethal cancers but also detects harmless ones that will not cause death or symptoms," wrote the researchers, from the Nordic Cochrane Center in Denmark, in the British Medical Journal.

"The detection of such cancers, which would not have been identified clinically in someone's remaining lifetime, is called overdiagnosis and can only be harmful to those who experience it."

Researchers analyzed breast cancer diagnosis rates among both screened unscreened women in Australia, Canada, Norway, Sweden and the United Kingdom for at least seven years before and after the public breast cancer screening programs in those countries began. As expected, they found that breast cancer diagnosis rates in every country increased in conjunction with the introduction of screening programs. Breast cancer rates among older women did not undergo a corresponding decrease, however – suggesting that rather than detecting cancers earlier, screening was merely detecting cancers that would otherwise never have produced a detectable effect on a woman's life.

When all forms of breast cancer were taken into account, the rate of overdiagnosis after public screening programs were introduced ranged from a low of 46 percent (in Sweden) to a high of 59 percent (in Canada), with an average overdiagnosis rate of 52 percent. When only invasive breast cancers were taken into account – cancers that have spread beyond the mammary tissue and are more likely to be lethal, and thus more likely to be treated aggressively – the average rate of overdiagnosis was still 35 percent, or more than one in three.

This was the second time that this research team had found evidence that overdiagnosis is a serious consequence of public screening programs.

"[The study] means that screening for cancer, in this case breast cancer, is a much closer call than has been previously advertised," wrote Gilbert Welch of the Dartmouth Institute for Health Policy in an accompanying editorial. "It has the opportunity to help some women but it also has the consequence of leading others to be treated needlessly for cancer and that's not a trivial thing."

Because no tests exist that can predict how aggressive or dangerous a cancer will be, all women diagnosed with breast cancer are referred to similar treatment programs, many of which – such as chemotherapy, radiation and breast surgery – carry serious and even dangerous side effects.

Screening advocates insisted that the benefits of screening still outweigh the risks of overdiagnosis.

"Without screening, women would face the prospect of having to wait for a visible symptom of cancer, such as a lump, to become apparent before treatment could start," said Emma Pennery of Breast Cancer Care.

Sarah Cant of Breakthrough Breast Cancer agreed, but said that women should be given clear information about screening in order to make informed decisions.

Welch also believes that better information is essential, saying that doctors should show women a simple statistical table quantifying the relative risks and benefits of screening for them, based on their own risk profile.

"Mammography undoubtedly helps some women but hurts others," he said. "No right answer exists, instead it is a personal choice."

Researchers do not know how many lives are saved for every case of overdiagnosis, with estimates ranging between one in two and one in 10.

Welch noted, however, that "the amount of overdiagnosis is a function of the mammographer's threshold to recommend biopsy."

"The time has come for a randomized controlled trial to test higher thresholds, such as only recommending biopsy for breast masses larger than a certain size," he wrote.

Sources for this story include: news.bbc.co.uk; www.cancerpage.com ; www.tehrantimes.com; www.oncologyupdate.com.

TC Postscript: What the above article does not delve into is that mammogram is not an effective diagnostic tool to detect Invasive Lobular Carcinoma ("ILC"). Each time I confirmed my diagnosis with another health care professional, I asked each of them the question: If I had had regular mammogram screening (as my "Buddy Check 12" -- AZ reference) reminded me to do via email, and which I did not heed, would my ILC been detected at an early stage? The unanimous answer by all was, NO. It has something to do with the pattern of infiltration in and outside of the mammary tissue and the indolent nature of ILC.

Consequently, I will continue in not having regular mammograms, but rather, will be having diagnostic ultrasounds.

Questions...

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Hi TC,

Happy twenty ten. I hope this is a better year for you.

My daughter has been diagnosed with breast cancer. I wonder if you can share information you feel may be helpful for her.

The preliminary report was that it is the most common type of breast cancer they see (whatever that means) and she was told it was encapsulated. She is able to see her test results on-line, and said she saw that it was the aggressive type. She hasn't seen the surgeon yet, so this is all I know to date. BTW, she is 44 years old. Anything you can share will be greatly appreciated.

Thanks in advance.


Response (I am not so arrogant as to believe I have any answers):

First, I am so sorry that you are being so touched by b.c. It sounds like it is ductal carcinoma. She needs to research, research, research! She should not make any decisions from a position of fear (or emotionally bullying) by the medical professionals. Cancer is typically indolent, and if it has been detected in an early stage she need not feel pressured to opt for any course of action immediately before she fully explores all of her options.

My own cancer is Invasive Lobular Carcinoma -- less common, but generally: DCIS is encapsulated within the milk ducts and there are different types - Comedo happens to be the more aggressive type in that of the types of DCIS - it would spread more quickly than the other types. Having said that it is a very early form of breast cancer, and is still classified as stage -0-.

She should pay the $500 and have her diagnostic records sent to Dr. Michael Lagios in the Bay Area. I know she is out-of-state, but he does phone consults. He will go over her diagnosis and fully advise her as to a course of action, in addition to re-evaluating her diagnosis. I found Lagios to be informed, sensitive, a “non-cookie cutter" doc who was integral in my own research and exploration.



Breast Cancer Consultation Service
Michael D. Lagios, M.D. • (415) 789-0965 http://www.breastcancerconsultdr.com/ - The Breast Cancer Consultation Service.

PSA - "Kissing Under the Mistletoe" Takes on a Whole New Meaning . . .

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The Dry & General Information (as of Summer 2009)

Mistletoe, a semiparasitic plant, holds interest as a potential anticancer agent because extracts derived from it have been shown to kill cancer cells in vitro Reviewed in and to stimulate immune system cells both in vitro and in vivo. Two components of mistletoe, namely viscotoxins and lectins, may be responsible for these effects. Reviewed in Viscotoxins are small proteins that exhibit cell-killing activity and possible immune-system-stimulating activity. Lectins are complex molecules made of both protein and carbohydrates that are capable of binding to the outside of cells (e.g., immune system cells) and inducing biochemical changes in them. In view of mistletoe’s ability to stimulate the immune system, it has been classified as a type of biological response modifier. Biological response modifiers constitute a diverse group of biological molecules that have been used individually, or in combination with other agents, to treat cancer or to lessen the side effects of anticancer drugs.

Preparations from mistletoe extracts are most frequently used in the treatment of cancer patients in German-speaking countries. Commercially available extracts are marketed under a variety of brand names, including Iscador, Eurixor, Helixor, Isorel, Iscucin, Plenosol, and ABNOBAviscum. Some extracts are marketed under more than one name. Iscador, Isorel, and Plenosol are also sold as Iscar, Vysorel, and Lektinol, respectively. All of these products are prepared from Viscum album Loranthaceae (Viscum album L. or European mistletoe). They are not available commercially in the United States.

In addition to European mistletoe, extracts from a type of Korean mistletoe (Viscum album coloratum Kom.) have demonstrated in vitro and in vivo cytoxocity in laboratory studies.

Mistletoe grows on several types of trees, and the chemical composition of extracts derived from it depends on the species of the host tree (e.g., apple, elm, oak, pine, poplar, and spruce), the time of year harvested, how the extracts are prepared, and the commercial producer.

Mistletoe extracts are prepared as aqueous solutions or solutions of water and alcohol, and they can be fermented or unfermented. Some extracts are prepared according to homeopathic principles, and others are not. In addition, the commercial products can be subdivided according to the species of host tree. Iscador, a fermented aqueous extract of Viscum album L. that is prepared as a homeopathic drug, is marketed as IscadorM (from apple trees), IscadorP (from pine trees), IscadorQ (from oak trees), and IscadorU (from elm trees). Helixor, an unfermented aqueous extract of Viscum album L. that is standardized by its biological effect on human leukemia cells in vitro, is marketed as HelixorA (from spruce trees), HelixorM (from apple trees), and HelixorP (from pine trees). Eurixor, an unfermented aqueous extract of Viscum album L. harvested from poplar trees, is reportedly standardized to contain a specific amount of one of mistletoe’s lectins (i.e., the lectin ML-1; refer to the History section of this summary for more information). Some proponents contend the choice of extract should depend on the type of tumor and the gender of the patient.

A recombinant ML-1 from E. coli bacteria known as rViscumin or aviscumine has been studied in the laboratory and in phase I clinical trials. Since this is not an extract of mistletoe, it is out of the purview of this summary.

Mistletoe extracts are usually given by subcutaneous injection, although administration by other routes (i.e., oral, intrapleural, and intravenous) has been described. In most reported studies, subcutaneous injections were given 2 to 3 times a week, but the overall duration of treatment varied considerably.

Viscum album is listed in the Homeopathic Pharmacopoeia of the United States, which is the officially recognized compendium for homeopathic drugs in this country. Although the U.S. Food and Drug Administration (FDA) has regulatory authority over homeopathic drugs, this authority is usually not exercised unless the drugs are formulated for injection or there is evidence of severe toxicity. At present, the FDA does not allow the importation or distribution of injectable preparations of mistletoe, including homeopathic formulations, except for the purpose of clinical research. The extracts are not available commercially in the United States and are not approved as a cancer treatment.

Before researchers can conduct clinical drug research in the United States, they must file an Investigational New Drug (IND) application with the FDA. IND approval is also required for clinical investigation of homeopathic drugs. The FDA does not disclose information about IND applications or approvals; this information can be released only by the applicants. At present, at least two U.S. investigators have IND approval to study mistletoe as a treatment for cancer.

The Second Unveiling: The Truth & Consequences About Reconstruction

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The look on my husband's face and the unintentional, yet critical, queries threw me for a loop. I thought boob jobs did not create so much scarring! Why are you so cut-up?

I was not angry or hurt by his spontaneous utterances. They just echoed the incredulous feelings I had been having since December 11 (the most current "slice 'n dice" day). Its not that I did not have an intellectual appreciation of what was going to happen to me. Unlike the amputation (aka mastectomy) it would seem that I was not as prepared as I thought for what the reconstruction and masteopexy was going to truly look like, post-surgery. Yes, the reconstructive surgeon had showed me his book of before and after pictures. And, yes, I did study them. But studying that surreal "coffee table" book was like looking at a police mug-shot book -- blurs of unfamiliar images that don't look like they belong in your personal universe.

Upon reflection, it seems that I had, and still am, spending so much time researching and analyzing my cancer, optional paths for survival, and adjuvant treatments to forestall the recurrence of my cancer, that when it came to the reconstructive portion of my journey I had done just enough research to assure myself that I was in good hands with the surgeon. Then I placed my ladies (literally and figuratively) in his hands.

To respond (versus emotionally react) to my husband's own visceral reaction and questions to seeing me completely unveiled (sans gauze and surgical steri-srips), I went back and got the hard facts for him. . . .

Reconstructive Surgery

Immediately after the full mastectomy of the left breast, the reconstructive surgeon began the process of a two-stage reconstruction (sometimes referred to as "two-stage delayed" reconstruction). After the surgical oncologist finished her amputation (with no skin or nipple sparring), and while I was still under general anesthesia, the reconstructive surgeon implanted a tissue expander. A tissue expander is like a balloon that is put under the skin and chest muscle. (And, no, there is no sugar-coating the pain and discomfort the expander can cause under the chest muscle.)

Every 6-8 weeks thereafter, through a tiny valve under the skin, the reconstructive surgeon injected (with a 2-inch needle) a salt-water solution to fill the expander. The valve was always located with what I thought of as a mini-divining tool. My reconstructive surgeon fondly called it a stud finder!? When the magnet stood straight up, EUREKA, the valve opening was found! I was expanded 3 times (I was aiming for a B+ cup-size).

After the skin over the breast area had stretched enough, the second slice n' dice was done to remove the expander and put in the permanent implant on the mastectomy side. Initially it was only going to be a 2 cm incision for the removal and replacement, but due to my petite size the reconstructive surgeon had to cut about 3.5 inches along the breast, coming in from the armpit. Luckily, this was all done along the existing mastectomy incision. As a result, however, that area continues -- even after 5 weeks post-op, to have sharp pulls and stabs of pain.

In the Interest of Beauty?????

In the interest of aesthetic symmetry (which in retrospect, I am having difficulty reconciling this goal with the visual scarring and painful sensory onslaught I am currently experiencing), the surviving breast underwent a mastopexy.

This was done utilizing the anchor incision technique. An anchor incision is made around the perimeter of the areola, vertically down from the areola to the breast crease, and horizontally along the breast crease. (Think, a nautical anchor shape.) This technique produces the most scarring, and is actually a highly invasive series of incisions used in many cosmetic breast surgery procedures.

While the technique creates a surgical wound comprised of a circular top section, a vertical mid section and a horizontal crescent shaped bottom section, the placement of these incisions allows the reshaping and re-sculpting of the entire breast mound, which is necessary during a mastopexy procedures.

Apparently an anchor incision it is still one of the most widely used and reliable methods of achieving excellent breast lift results to compliment a mastectomy reconstruction. (Yipee skipee!)


Everything comes with a price-tag. Like any surgical wound, the anchor shaped incision carries certain risks and can cause several potential complications. The large size and prominent placement of the incisions make visible scarring a strong possibility. Hence, husband's reaction. Most women who undergo this technique will have permanent scars which will be noticeable on the breast and/or areola. (They do say that the scars start to loose their punk-red coloring after 1-2 years...good thing I am working on a 10-year survival plan!)

Additionally, the anatomical positioning of the incisions also might cause damage to the sensitive neurological, vascular and glandular tissues of the breast. This type of injury (the medical professions descriptive word, not mine) can cause temporary or permanent sensory perception issues in the nipple or throughout the breast. Interestingly, my issue at this time is the sensory assault, not the long-term potential degeneration -- the burning around the incisions, the stabbing pains through the sternum and the electrical-like shocks that emanate from the chest wall (this latter pain good, means nerves are trying to find their way back "home").

. . . . then there's the 3d unveiling to come. . . .

You can decide if you want to have your nipple and the dark area around the nipple (areola) reconstructed. Nipple and areola reconstructions are optional and usually the final phase of breast reconstruction. I've opted. (In for a penny, in for a pound...so why not in for a boobie, in for a nipple!) This is a separate surgery - again done in the interest of the self-propelling concept of symmetrical beauty. It is usually done after the new breast has had time to heal from the second round of reconstruction (about 3 to 4 months).

Tissue used to rebuild the nipple and areola will be taken from my body, either from the newly created breast, opposite nipple (except there's not much there to share), ear, eyelid, groin, upper inner thigh, or buttocks -- where-ever I have it to spare. Six to eight weeks after the nipple is created I will get with the tattoo-artist to match the color of the nipple of the other breast to create an areola facsimile. Truth be told, I have threatened to have a lotus flower done in place of the traditional areola. Husband had a visceral reaction to that statement too! (Hee Hee!)

With that last reaction, I threatened to have the eye of Sauron tattood instead!

What's YOUR Breast Cancer IQ?

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This last week I noted that women all over Facebook were "flying their colors," ostensibly to heighten awareness of breast cancer. What woman (or man) on Facebook is NOT aware, on some level, as to the existence & insidious prevalence of breast cancer? The REAL challenge is testing your breast cancer IQ.

How many are aware that despite the collective million steps taken and the commensurate millions of $$$$ raised that the treatment of breast cancer has changed little in the last 50 years?

How many of us question whether the assertion that deaths related to breast cancer are on the decline have more to do with creative accounting than medical successes?

Who stops to think about the hypocrisy and insult...and downright greed displayed by the tens of thousands of corporate dollar donations to breast cancer foundations while these same corporations concurrently report millions of dollars of profit from their cancer-causing products?

How much do we truly know about the breast cancer INDUSTRY? And how much of what we unwittingly do supports, if not perpetuates the industry, not the cure?

I challenge each of you, before you walk, run, pink, or fly your colors, to first be aware of whose cause you are truly benefiting.

Pomegranates May Help Fight Breast Cancer, Study Finds - Sphere News

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Pomegranates May Help Fight Breast Cancer, Study Finds - Sphere News

TCS' Post Script: The above link informs on the connection between the benefits of pomegranates and breast cancer. In summary, it asserts that: A rare compound found in pomegranates, ellagic acid, helps stop the growth of hormone-fed cancer cells, according to a study published in the January issue of Cancer Prevention Research, a journal of the American Association for Cancer Research.

It does so by inhibiting aromatase, an enzyme that converts androgen to estrogen -- the female hormone that helps certain tumors grow. Without that conversion, the growth of some tumors can be halted.

It needs to be noted that aromatase inhibitors stop the production of estrogen in post-menopausal women. Aromatase inhibitors work by blocking the enzyme aromatase, which turns another enzyme, androgen, into small amounts of estrogen in the body. This means that less estrogen is available to stimulate the growth of hormone-receptor-positive breast cancer cells.

Aromatase inhibitors can't stop the ovaries from making estrogen, so aromatase inhibitors only work in post-menopausal women.

If you are like me, pre-menopausal, indeed pre-perimenopausal -- aromatase inhibitors either in natural or synthetic form is not efficacious in addressing our breast cancers. I do not mean to suggest, however, that I will disregard the importance of phytochemicals and antioxidents that pomegranates offers! And, they are tasty!

QUESTION: Do Prosthetics Cause Chills? (and I am not talking just about visually!!!!!)

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Since my second round of reconstructive surgery on December 11, my body temp is all over the place! Even now, I run a fluctuating daily low-grade temp (99 -101.1). No, it is not related to the reconstruction per se. I have been checked out twice for possible infection. I have been advised that it is likely that the temperature is related to my body's post-surgical healing process. That's cool (nah...not really).

The question I cannot find an answer to, as yet, is: is it possible that my new prosthetics are the cause of my chronic feeling of being cold? I am experiencing a biting, right down to the bone, coldness. Recall, I live in Arizona. It is 74 degrees today! The coldness actually emanates from my breast area and then sweeps my entire body. This occurs in hourly waives! My youngest is quite amused. Being a frenetic 8 year old boy his body temp is always a toasty 150 degrees +/- fahrenheit! He bounces around me and encourages me to place my icy hands on his neck and belly -- which then sends him into throes of laughter.

Now THAT is cool!

Med-Pros Revisited . . .

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For the record...

I never meant to imply that ALL (or even ANY) med-pros are evil, per se. I have never meant to imply that the med-pros that I have been personally dealing with are themselves evil. My personal experiences do not reflect a general banality of evil in the medical profession, but rather, I believe, a critical flaw in the manner in which our medical system is run in this country. (I say, in this country because I am not familiar enough with the medical politics of other country's health care systems (although I have been a patient in a few). My personal experiences have informed me that the "flaw" in the U.S. medical system is that the profit margin of pharmaceutical companies have far too much influence upon the education and training in our medical schools, as well as our "regulatory" government agencies (i.e., FDA). I also believe that med-pros who think "outside of the pharma box" are penalized if not ostracized, because of their potentiality in negatively impacting pharma's bottom-line.

My first medical onc - Kato, was the most pleasant man. I truly enjoyed our conversations. When push came to shove...meaning when I pushed him outside of his comfort zone, his "world weariness" kicked in and he became ineffectual for me. He could only offer me the cookie-cutter approach -- which was confirmed (and he acknowledged) would have little to no effect on my breast cancer and lots of harm. His "medical tool box" was severely limited.

Dr. Lise Walker, my surgical onc for the mastectomy, was more than competent (and had a good beside manner). If and when I have to consider a mastectomy on the right breast, I would go to her again. She was also instrumental on my "quest" to look beyond the prix fixe menu of adjuvant treatment as it was on her office shelf that I was introduced to "What Your Doctor May NOT Tell You About Breast Cancer" by John R. Lee, M.D.

Dr. Coral Quiet -- the radiation onc whom I consulted numerous times and whom I too pushed outside of her comfort zone -- when pushed, gave me the name of Dr. Michael Lagios - a consulting pathologist and head of the breast cancer center at Stanford Medical Center. Lagios was integral in my decision not to pursue conventional adjuvant treatment.

Dr. Bryan Gawley - reconstructive surgeon. . . well, as I wrote on his holiday card: "All the king's horses and all the king's men couldn't put Humpty Dumpty together again; but Bryan and his nurse Brenna certainly could!" (Though I still look in the mirror and feel that a black teased hair-style with white bolt streaks on the sides would be more fitting for my new "look.")

Except for the one nurse who unnecessarily assaulted me with a catheter when I was being prepped for surgery this last time (she was stressed that I had not peed for a pregnancy test, and felt that I was unable to waive the test as I had been given a "happy" injection into my IV already) I have not had one single complaint to blog about with regard to the plethora of nurses that have assisted me. I have always known that if you want the true scoop on an individual doctor, get to know the nurses in their practice. It was Oz's belligerent treatment of his own nurse, as well as the general malaise of his entire nursing staff, that solidified my truly negative impressions of him.

Indeed, I do not even view "Oz" as evil. Pompous, arrogant, rude, belligerent, bastard, ass-hole definitely. Evil, no.

"Evil" requires a certain malicious intelligence. And, fortunately, I have not come across any med-pro whose IQ leans in that direction.