Cervical Health Awareness Month

Exactly what is HPV? How often do I need a pap smear? What does a pap smear test for? What are the risk factors for cervical cancer?

After many conversations with women over the years, I’ve learned that vaginal health is something some of us know little about. We may not know all the parts and their functions, including the cervix which is located at the lower part of the uterus.  

One brilliant analogy is that of a hallway and door.  Picture the vagina as a hallway. At the end of the hallway is a door. The cervix is the door (Very Well Family, 2020), and includes the endocervix (the part of the cervix leading to the uterus) and the ectocervix (the outer part of the cervix that can be seen during vaginal exam).

What does the Cervix Do?

The cervix:

  • Protects the uterus by limiting access to foreign substances
  • Produces cervical mucus to clean the vagina
  •  Keeps the fetus in uterus

Do I need a Pap Smear and HPV Test?

Every 2-3 years, I make an appointment with my gynecologist for a pap smear. Do I like getting pap smears? Absolutely not. Getting pap smears is what I do to learn about my vaginal health.

Many of us are used to the procedure. It’s something I’ve mastered since getting my first pap smear when I was 21. I scoot up to the edge of the exam table as the nurse is handing my doctor the speculum, place my feet onto the stirrups, lie back, take a deep breath, and look up at the ceiling as my doctor carries out the exam.

It is recommended that women get pap smears every 3 years, beginning at the age of 21.

A pap smear/pap test is used to detect vaginal abnormalities. It’s important to note that a pap test is different from a human papillomavirus (HPV) test. The pap test is used to detect abnormal cells and an HPV test is used to detect HPV, a virus which increases a woman’s risk of developing cervical cancer. Most forms of cervical cancer are caused by HPV. Although both tests are different, a pap test sample can be used to test for HPV.

Image from Pinterest

Cervical Cancer

Once the leading cause of cancer death for women in the United States, the rate of cervical cancer, and cervical cancer deaths, have drastically decreased (Centers for Disease Control and Prevention, 2020).

This year, roughly 13,500 women will be diagnosed with cervical cancer, and over 4,000 may die from the disease. Cervical cancer is mostly diagnosed in women ages 35 to 44. However, older adult women are also at risk.  Twenty percent of cervical cancer is detected in women over 65 years of age (American Cancer Society, 2020).


Image from Singing River Health System

What are the risk factors?

  • HPV Infection
  • Sexual history (increases exposure to HPV)
    • Being sexually active at a young age
    • Having multiple partners
  • Smoking
  • A weakened immune system
  • Chlamydia infection
  • Long-term use of birth control
  • Economic status
  •  A diet low in fruits and vegetables
  • Family history

Source: American Cancer Society, 2020.

Prevention

Smoking increases the risk of cancer development. Smoking cessation can reduce a person’s risk of developing any type of cancer.

Having multiple sexual partners can put someone at risk of acquiring HPV. Women with multiple sexual partners are at risk of developing cervical cancer especially if they have sex with high-risk partners.

HPV vaccines prevent certain types of HPV, which can cause cancer. Children and young adults can get vaccinated, but it is not recommended for someone older than 26.

Although a condom may provide some protection, it may not prevent HPV.

Early detection is key. Pap smears and HPV tests are forms of early detection and can save lives. Make sure you speak with your healthcare provider about your cervical cancer risks and get tested.

Sources:

Centers for Disease Control and Prevention. 2020. Cervical Cancer Statistics. Retrieved from https://www.cdc.gov/cancer/cervical/statistics/index.htm

American Cancer Society. 2020. Key Statistics for Cervical Cancer. Retrieved from https://www.cancer.org/cancer/cervical-cancer/about/key-statistics.html

World AIDS Day

December 1st is World AIDS Day. There are many health topics that I teach on, but this topic is one that’s close to my heart.

Instead of giving the basics of HIV/AIDS, I’ve decided to use this post to share personal stories of HIV/AIDS from my point of view as a woman, as a former HIV tester and counselor, and as a community member/loved one.

Getting Tested

“Do you want to be tested for HIV?” Whenever I’m asked that question, I say yes without hesitation, but inside my heart starts racing and I think back to the times I was foolishly “in love” and didn’t practice what I preached.

I have my blood drawn and wait for my lab results to be posted, constantly checking to see what the results will be. Contracting an STD when I was younger puts me on the edge, especially knowing that having an STD put me at a higher risk of contracting HIV. I think back to when I last had an HIV test and the last time I was sexually active before deciding to practice abstinence. I tell myself that I’m okay. I tell myself that everything will be fine.

After 1 – 2 days, I get my test results back… “negative.” I’m relieved, and forgive myself again for not asking my previous partners questions. Monogamous on my end, but not on theirs. This is the reason why I tell others to get tested even if they are in a monogamous relationship… even if they’re married.

Get tested, even in a monogamous relationship. Married? Still get tested!

Being an HIV Counselor

“You are not going to actually test your partner for HIV, you are only going to practice the steps for doing an HIV test. Someone who was tested in class found out that they were HIV positive. We don’t want that to happen here.” To get my HIV Tester and Linkage to Care certification, I was required to complete a course that would help prepare me for the real world of HIV testing.

For reasons I’m still trying to figure out, I’ve been drawn back into the field of HIV/AIDS time and time again. Throughout different seasons of my life, I’ve taught about practicing abstinence and safe sex, but actually conducting HIV tests would be something completely new to me; and after hearing my trainer tell the story of how one student found out that she was positive during a training, I wondered how I would tell someone that they were positive and how they would react in return.

“Tonja, look at this.” I walked over to my co-worker and looked at the rapid HIV test she just ran. “He was here a few weeks ago and was negative. He told me he isn’t sexually active.” She ran his test again to make sure it wasn’t a false positive. The results were the same.

I stood near as my co-worker explained the results to the older adult sitting across from her. He looked confused. She filled out the rest of his paperwork, explained the test was showing that he was positive for HIV and someone would reach out to him.

I tested people time and time again without having to break the news to anyone that they were positive. I wondered what this older gentleman was thinking when he heard, “HIV positive.” Weeks prior, I was speaking to him and his buddy, telling them that older adults are at risk of getting HIV. That even if they didn’t have to worry about getting anyone pregnant, they still had to think about STDs. I stood there wishing there was something I could do as he quietly walked away.

“According to the Centers for Disease Control and Prevention (CDC), in 2016, nearly half of the people in the United States living with diagnosed HIV were aged 50 and older. Many HIV risk factors are the same for people of any age, but older people are less likely to get tested for HIV.”

National Institutes of Health, 2020

Having an HIV Positive Community Member/Loved One

“Aren’t you afraid?” Someone once asked me when I told them that I’ve worked with people with HIV/AIDS. Am I mindful when testing or if someone has an open wound? Yes, but not afraid. I’ve embraced and been embraced by those with HIV & AIDS. We’ve shared laughs and stories.

A few months ago, I wondered how my Mamas at Lifted Strong were doing. I spent an incredible week with them last summer as I volunteered as an HIV Support Worker for the organization. I went to their Instagram page which led me to the managers page, it was there that I found out that Mama Anna had passed away. I thought back to the brief moments we spent together, and the laughs we shared as she tried to interpret my version of Kisawhili.

This wasn’t the first time I’ve met or known someone who has passed away from complications due to AIDS. Years prior, I learned that a member of my Peace Corps mentor’s People Living with HIV/AIDS group had also passed away. Then weeks later learned that the Peace Corps staff member who shared her story with volunteers had also passed away. As she told her story, I thought about how strong she looked. Even before Peace Corps, AIDS hit close to home. I overheard my mother discussing an old family friend’s diagnosis and how he died because of complications related to AIDS.

Whenever I think of those I’ve encountered with HIV/AIDS, those who have shared their stories, and even those I’ve tested who were relieved when they received a negative test result, I am reminded to appreciate the life that I was given, to love hard, to educate others, and to make better choices.

This post is to honor those who share their experiences to educate and support others. And to honor the Annas of this world. Those who fought as long as they could but lost their life to the disease.

Contact your doctor or local health department to learn about HIV testing in your area.

For more information on HIV/AIDS, visit WHO and UNAIDS.

Resources:

AIDS Healthcare Foundation – Provides HIV & STD testing

National Association of County and City Health Officials – Health department directory

HIV.gov – Information on HIV/AIDS

Diabetes and the Importance of Knowing Your ABCs

Every part of our health is intertwined. Our blood pressure, blood glucose, and cholesterol are interconnected, and an issue with one of those may lead to an issue with another.

For example, someone with diabetes is more likely to have hypertension (high blood pressure). They are also more likely to have high cholesterol leading to coronary artery disease (CAD) and other comorbidities (having two chronic diseases at once). This is why people with diabetes should know their ABCs.

What are the ABCs?

AA1C

A1C is your estimated average blood glucose level over a three month time span. Unlike the normal blood glucose test, the A1C provides an in-depth look at your blood sugar levels.

  • An A1C below 5.7% is normal
  • An A1C between 5.7% to 6.4% is within the prediabetes range
  • An A1C above 6.5% or higher is within the diabetes range

Lifestyle changes can improve blood glucose levels. Read a personal story here.

BBlood Pressure

Two out of three people with diabetes have high blood pressure.1 When your heart beats, blood moves through your body providing blood and oxygen throughout. When someone has high blood pressure, blood vessels can become constricted, limiting the flow of blood and oxygen.

The general goal is for your blood pressure to be less than 120/80. However, if you have high blood pressure, your blood pressure goal may be different. For example, if your blood pressure is normally above 140/90, your goal may be to bring your numbers down to 130/80.

It is possible for someone with hypertension to bring their numbers down to less than 120/80.

CCholesterol

Cholesterol is a waxy substance naturally produced in the liver. It is also found in animal based products, and is needed to make hormones and is used for food digestion.

There are two types of cholesterol. LDL (low-density lipoproteins) is the bad cholesterol and HDL (high-density lipoproteins) is the good cholesterol. LDL increases the risk of heart disease and plaque buildup. HDL carries cholesterol to the liver so it can be removed from the body.

Triglycerides are a type of fat that can cause a blockage in an artery if LDL levels are high and HDL levels are low. A diet that increases HDL and lowers LDL can protect your heart health.

Make sure you know your numbers and make healthy choices to prevent and manage diabetes.

Source:

American Diabetes Association. (2020). Conquer High Blood Pressure. Retrieved from https://www.diabetes.org/diabetes-risk/prevention/high-blood-pressure.

American Diabetes Association. (2017). HDL (Good), LDL (Bad) Cholesterol and Triglycerides. Retrieved from https://www.heart.org/en/health-topics/cholesterol/hdl-good-ldl-bad-cholesterol-and-triglycerides.

Hypoglycemia and The 15-15 Rule

Hyperglycemia (high blood sugar) is caused when there is a build up of glucose (sugar) in the blood. People with diabetes can experience hyperglycemia if they are unable to manage their diabetes; causing frequent urination, increased thirst, and high levels of sugar in their urine.

Hypoglycemia (low blood sugar) is another term that people, diabetics in particular, should know. Blood sugar falling below the target range (see National Diabetes Month) can lead to insulin shock or even death.

Signs and Symptoms of Hypoglycemia

  • Shakiness
  • Weak and lethargic
  • Headache
  • Nausea
  • Lightheaded or dizziness
  • Blurred vision
  • Hunger
  • Tingling or numbness
  • Racing heart
  • Confusion
  • Sleepiness

Treating hypoglycemia

The 15-15 Rule is a method used to treat hypoglycemia without spiking blood sugar. It consists of consuming 15 grams of carbohydrates then waiting 15 minutes before checking to see if your blood sugar is above 70 mg/dL.

What can you take?

  • Hard candy (read the label)
  • Tablespoon of honey
  • 4 ounces (1/2 cup) of juice
  • 4 glucose tablets
  • Gel tube
  • 4 ounces (1/2 cup) of regular (non-diet) soda
  • 8 ounces (1 cup) of milk

If your blood sugar is still below 70 mg/dL after following the 15-15 Rule, repeat again. Once your blood sugar is above 70 mg/dL, you should eat a small meal or snack.

Keep track of your blood sugar by using an App or printable tracker.

Sources:

American Diabetes Association. (2020). Hypoglycemia (low blood sugar). Retrieved from https://www.diabetes.org/diabetes/medication-management/blood-glucose-testing-and-control/hypoglycemia.

Picture by Andrea Piacquadio from Pexels

National Diabetes Month

I remember watching my maternal grandpa slowly fill up a syringe and inject medicine (insulin) into his stomach. Sometimes, I would hold the side of his stomach so that he could administer his medicine. Grandpa would do the same with each of his grandchildren, walking them through the steps of injecting insulin and taking his blood glucose readings.

Although he had diabetes, which runs in his family, Grandpa learned as much as he could and took steps to manage it. He enjoyed exercising, would go to his appointments regularly, checked his blood sugar throughout the day, and ate a balanced diet, which would include an occasional small scoop of butter pecan ice cream when he wanted to indulge.

Grandpa: Curtis Massey & Memaw: Guinevere Rice

On the other end of diabetes self-care spectrum, I remember the latter years of my paternal grandmother’s life. I remember walking into Memaw’s room at a nursing home in complete shock because both of her legs had been amputated, and there were dark boils on her body. She laid there in agony. Her complexion, which was once light, was now darker and ashen.

The same grandmother whose smile could brighten up a room was losing her battle to diabetes. Life happens to everyone, but I believe the hardships of her life overshadowed her being able to manage her diabetes. She couldn’t properly care for herself and succumbed to the disease.

Growing up, I only thought of diabetes as “the sugar disease.” I thought that if I limited how much sugar I ate; I would be okay. I had no idea that my health was at risk because diabetes runs on both sides of my family. I had no idea what insulin was, that there are different types of diabetes, or ways other than diet that could prevent me from getting it.

Thankfully, I don’t have diabetes nor am I prediabetic. Having diabetes run on both sides of my family has made pay attention to any changes in my body. It has also motivated me to keep track of all of my lab reports for over the past ten years.  It’s hard, even as a health educator, but I try my best to focus on what I have control over (i.e., nutrition, exercise, stress management, sleep hygiene, etc.) to keep my blood glucose number down. I also enjoy being able to share my personal experiences, knowing and working with people who have diabetes, to educate others.  This post is simply that, a means to provide basic diabetes education.

What is diabetes?

If someone were to ask you what diabetes is, what would you say? I can recall the responses from people in my Diabetes Mapping classes. While they had diabetes, some of them didn’t understand what it is. Let me break it down as much as possible.

Diabetes is a group of diseases that is caused by a build up of sugar in the blood stream causing hyperglycemia (high blood sugar).

Let’s say that you eat a slice of pizza. That slice of pizza is broken down into sugar when it enters your body and then the sugar enters your blood stream.  If the sugar from the food you eat builds up in your bloodstream, your nerves, blood vessels, organs, and other parts of your body can be damaged.

What causes the build up?

Insulin is a hormone produced in the pancreas; it is known as the key in diabetes terminology because it unlocks cells so that blood sugar (glucose) can enter. Some people may not make insulin or enough insulin, while some make insulin that does not work properly. If insulin does not unlock cells for blood sugar to enter, the sugar begins to build up in the blood stream.

Glucose is needed because it provides the body with energy and supports cells, muscles, and organs like the brain. But be careful, too much glucose can harm the body.

Image from Health Interactions

The three types of diabetes

There are three types of diabetes: type 1, type 2, and gestational. Prediabetes is not diabetes, but it is a diagnosis if someone has a high risk of developing diabetes because of their A1C (2-3-month blood sugar reading).

Type 1 Diabetes

Type 1 diabetes, also referred to as juvenile diabetes, occurs when a person’s immune system attacks cells in the pancreas that make insulin. Because the pancreas is attacked, it either does not make insulin OR it does not make enough.  

This type of diabetes normally occurs in childhood but anyone of any age can have it.

Type 2 Diabetes

Type 2 diabetes is the most common type of diabetes where the body does not use insulin properly leading to insulin resistance.

Image from Nuvo Vivo

Gestational Diabetes

Gestational diabetes occurs when a pregnant woman has a build up of glucose in her bloodstream. Pregnant women are normally tested for diabetes between their 24th – 28th week of pregnancy.

Having gestational diabetes can put a woman at risk for developing type 2 diabetes.

Prediabetes

Prediabetes is not diabetes. Being diagnosed with prediabetes means that you are on the verge of developing diabetes. However, weight loss, exercise, and a change in other lifestyle factors can prevent you from becoming diabetic. 

Personal Story: Someone who joined one of my 8-week health classes started off prediabetic. He joined the class because the doctor told him to lose a few pounds because of his diagnosis.  After losing 20 pounds and making major changes to his diet and exercise routine, he received news that he was no longer prediabetic!

Knowing your numbers

A person’s blood sugar reading depends on their health, if they have diabetes, their activity level, what they eat and when they eat. Have you noticed that you’re asked not to eat or drink anything besides water before a physical? That’s because of blood work that is done to check your blood sugar/A1C. Below are the blood glucose and A1C ranges. It’s important to keep your blood glucose reading within a healthy range and keep track of changes in your blood sugar results as you age.

Prevention and Management

A family history, race/ethnicity, and age are factors that we have no control over. But diabetes can be prevented and managed through:

Image by Breakingpic from Pexels
  • Weight loss – Losing 10% of your body weight can help prevent and manage diabetes.
  • Nutrition – Following a diet low in sodium, saturated and trans fats, simple carbohydrates (i.e., white grains, pasta, honey, milk) and high in vegetables, lean protein, fruit (too much fruit can be bad for a diabetic) and complex carbohydrates (i.e., whole grains) may prevent and manage diabetes.  Diabetics should “test” how their body responds do certain foods by checking their blood glucose 2 hours after eating.
  • Exercise – Exercising moves glucose into muscles, moving it from the blood stream. Diabetics should have an exercise routine that will help them manage their diabetes without causing hypoglycemia (low blood sugar – not enough blood sugar).
  • Sleep hygiene – Getting restorative sleep (all stages, specifically 3 &4) regulates blood sugar and heals the body.
  • Stress management – Practicing stress management techniques can lower blood pressure and improve blood glucose.
  • Medication management – Taking medications as prescribed is one of the most important ways to manage diabetes.
  • Glucose numbers – Knowing your blood sugar range/A1C is the first step to prevention and management of diabetes.

To learn more about diabetes, visit the American Diabetes Association website and speak with your healthcare team about your concerns.

Breast Cancer Awareness Month in Ghana

Mary and Tonja

As soon as the boarders were open, I decided to go on an overdue trip to provide health education and outreach in Ghana. While there, I met a young lady, Mary, who was excited to share with me what she recently learned at her church’s Breast Cancer Awareness Month event.

Mary and I discussed risk factors, signs and symptoms, how to do a self-breast exam, and what she learned about breast cancer in the United States. Because I wanted to learn specifically about breast cancer in Ghana, I decided to ask Mary a few questions.

Tonja: What did you learn about breast cancer here in Ghana?

Mary: Breast cancer in Ghana has increased every year.  The last two years, it has increased. But, if a woman has a lump and it is detected early, the cancer can be removed, so that she can be free from cancer.

Tonja: Do women here go to the doctor to get a breast exam every year?

Mary: You know…in Ghana, most people feel shy to go to the doctor, or maybe they don’t go because of low income.  They may be afraid that if they go to the doctors, they’ll be charged and not have the money for it.  They may think, “Why would I force myself to go to the doctors without having money,” so they don’t go.  Those who have money in big cities like Accra, Kumasi, Cape Coast, they may pay and have health exams. Those who have family that work at health facilities may also get checked.

Tonja: Do you think there is anything that can be done to make people feel less afraid or shy of getting a breast exam?

Mary: If someone has a family member that works at the doctor, and they are diagnosed, they may be afraid that the news will spread. If possible, avoid going to a doctor where you have a family member or know someone.

Tonja: Do you think the stigma of breast cancer is just as bad as having HIV?

Mary: Yes. For example, if you have breast cancer and have to have your breast removed, people may stare and talk because it is different. We don’t really see that. People will talk.

Tonja: What do you think can be done for more women to get checked and decrease stigma?

Mary: I think more breast cancer awareness. It gives women education and information about breast cancer and helps them to know they can get help. Women can also get to know that they need to have their breast checked each year.

One thing that I’ve learned about being in Ghana is how many people view food as medicine.  Mary also learned about the benefits of eating a variety of local fruits and vegetables to lower a person’s risk of developing breast cancer. 

Like many others, Mary believes in the benefits of eating a variety of fruits and vegetables to prevent some cancers.
Sour Sop, also known as “Sweet Apple,” is recommended for cancer prevention in Ghana

Fast Facts about Breast Cancer in Ghana

  • Breast cancer is the most common type of cancer in Sub-Saharan Africa
  • Breast cancer is diagnosed at early ages across Africa than on other continents
  • The highest incidence rates of breast cancer in Ghana is for women ages 40 to 46
  • Forty-seven to 57% of breast cancer cases in Ghana are women diagnosed under 50 years of age

Source: Iddrisu, M., Aziato, L. & Dedey, F. Psychological and physical effects of breast cancer diagnosis and treatment on young Ghanaian women: a qualitative study. BMC Psychiatry 20, 353 (2020). https://doi.org/10.1186/s12888-020-02760-4

Because of health observances like Breast Cancer Awareness Month, people all over the world are seeking knowledge, gaining knowledge, and making small changes; and in my opinion, combating stigma little by little.

Breast Cancer Stigma: It’s a Global Issue

During graduate school, I learned about breast cancer stigma and the role it played in breast cancer prevention, diagnosis, and treatment.  When we think of stigma in health, HIV or AIDS may come to mind; however, women and men (read Breast Cancer in Men) around the world have experienced stigma due to breast cancer.

Here are the facts:

  • Breast cancer is the most common type of cancer among women
  • In 2012, 1.7 million women around the world were diagnosed with breast cancer
  • Approximately 500,000 women die from cancer each year
  • The incidence rates vary from 27 per 100,000 in Middle Africa and Eastern Asia to 92 per 100,000 in North America1
  • Nearly 50% of breast cancer cases and 58% of deaths occur in less developed countries2

A lack of education, access to adequate healthcare, and medical bias are a few factors that may impact data; outside of family history, genetics, age, lifestyle factors, and even cultural beliefs. However, stigma may also play a role in the number of people seeking care at later stages and dying.

Why the stigma?

“I think about fear, death, and loneliness.” – Uknown3

The association between cancer and death is a major cause of stigma.4 Personally, I remember being a teenager when I found a lump on my right breast.  My first thought was cancer. Afraid to tell my mother, I waited a few days until I finally said something.  Thankfully, the lump was only an abscess that I was able to treat with antibiotics.  Others may not have the same experience.

In a recent article published by BioMed Central, Breast cancer stigma among Indonesian women case study of breast cancer patients, participants in a breast cancer study had, “negative perceptions towards breast cancer screening because of their experience of fear and shame,” and the “fear of suffering from the disease” was even greater.4 One participant did not seek care for 3 months when experiencing pain, and other participants were diagnosed with an advance stage of cancer when they sought care.4

“If you get treatment early enough, they say you should be ok…it could be the end.” – Unknown3

A cancer study conducted in South Africa found similar findings regarding stigma.5 Participants stated that a physician’s diagnosis was important, but that cancer would lead to negative perceptions from community members.5 A key finding from this study revealed that stigma resulted from the belief that HIV/AIDS and cancer were the same.  According to the study, “cancer stigma due to conflation of stereotypes of deadliness associated with HIV may contribute to negative consequences, including social isolation.”

While there continues to be stigma regarding breast cancer, the rates of survival have improved because more people are being diagnosed at an earlier stage.1

Combating stigma

What are some ways that stigma is being combated?

Education – Education is a means to combat cancer stigma by clearing misconceptions and increasing knowledge. Healthcare professionals, especially community health workers, can provide this education.

Relay for Life, 2018 – We walked in honor of our co-worker and friend who’s a survivor.

Awareness – Events like Relay for Life bring awareness to breast cancer and empowers many.

Community outreach programs – Community outreach programs can provide education in a formal or informal way.  They may also serve as a support system for survivors and those battling cancer. 

Increasing social support – One of the reasons some are afraid of getting screened for breast cancer is because they perceive they’ll receive a negative reaction from those close to them. Educating families and increasing social support between patients and their families may help with early detection and treatment.

Times are steadily changing, and we’re living in a world where education and information is within close reach for many. Nevertheless, we have more to do to combat stigma when it comes to cancer; especially when it comes to stigma related to breast cancer in men, and other types of cancer that are often overlooked and not widely spoken of.

Sources:

World Cancer Research Foundation/American Institute for Cancer Research. (2018). Retrieved from https://www.wcrf.org/sites/default/files/Breast-cancer-report.pdf.

World Health Organization. (n.d.). Breast Cancer Prevention and Control. Retrieved from https://www.who.int/cancer/detection/breastcancer/en/index1.html.

Livestrong. (n.d.). Cancer Stigma and Silence Around The World: A Livestrong Report. Retrieved from https://www.livestrong.org/sites/default/files/what-we-do/reports/lsglobalresearchreport.pdf.

Solikhah, S., Matahari, R., Utami, F.P. et al. Breast cancer stigma among Indonesian women: a case study of breast cancer patients. BMC Women’s Health 20116 (2020). https://doi.org/10.1186/s12905-020-00983-x

Oystacher, T., Blasco, D., He, E., Huang, D., Schear, R., McGoldrick, D., Link, B., & Yang, L. H. (2018). Understanding stigma as a barrier to accessing cancer treatment in South Africa: implications for public health campaigns. The Pan African medical journal29, 73. https://doi.org/10.11604/pamj.2018.29.73.14399

Breast Cancer in Men

October is recognized as Breast Cancer Awareness Month.  You may see ads of survivors and supporters lavished in pink, bringing awareness to the impact that breast cancer has made on the lives of many. However, one group may be overlooked…men.

While the percentage is low, men also get breast cancer. Male breast cancer makes up less than 1% of all breast cancer cases in the United States.1 According to the American Cancer Society, 2,620 men will be diagnosed with, and 520 men will die from, breast cancer by the end of 2020.2

A male’s breast tissue can develop cancerous cells in various parts of the breast. Although normally not functional in men, cancer can begin in the ducts that carry milk to the nipple (ductal cancers) and glands that make milk (lobular cancers). Ductal carcinoma in situ, invasive lobular carcinoma, and invasive ductal carcinoma are the most common types of breast cancer in men. 3

Risk Factors

The risk factors for breast cancer among women and men are similar in many ways. However, there are two differences. Liver disease and conditions that affect the testicles increases the risk that a man will develop breast cancer.

Picture by Tumisu from Pixabay

Source: Centers for Disease Control and Prevention, 2020  

Signs and Symptoms

Picture from the Indian Journal of Surgical Oncology, 2020

Common signs and symptoms of male breast cancer are:

  • Nipple discharge
  • Pain in the nipple area
  • Pulling in of the nipple
  • A lump or swelling in the breast
  • Redness or flaky skin around the breast
  • Irritation or dimpling of the breast

Source: Centers for Disease Control and Prevention, 2020  

Diagnosis

Clinical breast exam – Similar to a woman’s breast exam, a doctor uses their fingers to exam the breast.

Imaging tests – Men can receive an X-ray or ultrasound.

Biopsy – The most conclusive way to determine if cancer is present. Tissue is extracted from the area and examined.  

Source: Mayo Clinic, 2020

Treatment

Surgery – Removal of tumor and breast tissue

Radiation therapy – May be used after surgery to remove cancerous cells  

Hormone therapy – Tamoxifen may be used for treatment as other hormone therapy treatments used for women may not work

Chemotherapy – Chemotherapy may be administered intravenously, through a pill, or both

Source: Mayo Clinic, 2020

Prevention

Picture by Teamsmashgames from Pixabay

Though there are risk factors that put men at a greater risk of developing breast cancer, making healthy lifestyle changes, weight management, exercising, eating a healthy diet, limiting alcohol consumption, and quitting smoking may lower the risk that a man will develop most types of cancer.

As we acknowledge women impacted by breast cancer, let us remember that there are men who have survived and lost their lives to the same disease.

Resources:

The Male Breast Cancer Coalition                        

American Cancer Society

Sources:

Johns Hopkins Medicine. (n.d.). Breast Cancer in Men. Retrieved from https://www.hopkinsmedicine.org/breast_center/breast_cancers_other_conditions/breast_cancer_in_men.html.

American Cancer Society. (2020). Key Statistics for Breast Cancer in Men. Retrieved from https://www.cancer.org/cancer/breast-cancer-in-men/about/key-statistics.html.

American Cancer Society. (2018). What is Breast Cancer in Men? Retrieved from https://www.cancer.org/cancer/breast-cancer-in-men/about/what-is-breast-cancer-in-men.html.

Centers for Disease Control and Prevention. (2020). Breast Cancer in Men. Retrieved from https://www.cdc.gov/cancer/breast/men/.

Mayo Clinic. (2020). Male breast cancer. Retrieved from https://www.mayoclinic.org/diseases-conditions/male-breast-cancer/diagnosis-treatment/drc-20374745.

First Image from Comanche County Memorial Hospital

Breast Cancer Awareness Month

Breast cancer is caused by a growth of abnormal cells in the breast which may cause a tumor (lump in breast).  There are actually different types of breast cancer with ductal carcinoma in situ (DCIS) and invasive carcinoma being the most common types, while phyllodes tumors and angiosarcoma are the less common types.1

Breast Cancer Facts

  • Breast cancer is the most common type of among women around the world
  • 1 in 8 women in the United States will be diagnosed with breast cancer in her lifetime
  • There are over 3.5 million breast cancer survivors in the United States.
  • On average, every 2 minutes a woman is diagnosed with breast cancer in the United States.
  • There are over 3.5 million breast cancer survivors in the United States.
  • On average, every 2 minutes a woman is diagnosed with breast cancer in the United States.

Source: National Breast Cancer Foundation, Inc., 2020

Signs and Symptoms

  • swelling of all or part of the breast
  • skin irritation or dimpling
  • breast pain
  • nipple pain or the nipple turning inward
  • redness, scaliness, or thickening of the nipple or breast skin
  • a nipple discharge other than breast milk
  • a lump in the underarm area

Source: Breastcancer.org, 2020

Image from Know Your Lemons

Methods of Detection

Self-breast exam

While research has “not shown a clear benefit of regular physical breast exams done by either a health professional (clinical breast exams) or by women themselves (breast self-exams),” women should continue to do a self-breast exam to detect any changes in the breast.4


Images from National Breast Cancer Foundation, Inc.

Mammograms

A mammogram is an x-ray of the breast and can detect cancer years before symptoms occur.

Three-dimensional [3D] Mammography (Digital Breast Tomosynthesis) is a newer type of mammogram that finds more types of breast cancer and is beneficial for women with denser breast.

What are the mammogram recommendations?

Age RangeAnnuallyEvery Two Years
Women ages 40-44XN/A
Women ages 45-54XN/A
Women 55 and olderAnnually OR Every Two Years

Risk Factors

Like other chronic diseases, there are factors that increases a person’s susceptibility of developing breast cancer. Those factors include:

  • Family history
  • Age
  • Genetic mutations
  • Reproductive history (starting menstrual cycle before 12 and beginning menopause after 55)
  • History of breast cancer
  • Previous use of radiation
  • Being inactive
  • Being overweight
  • Over consumption of alcohol
  • Diet

Source: Centers for Disease Control and Prevention, 2018

Prevention


Picture by BreakingPic from Pexels

There are risk factors that you do have control over that may lower your risk of developing cancer.

Exercise

Being overweight increases your chances of developing cancer. Regularly exercising and being physically active may reduce your risk of developing cancer.

Diet

Eating a balanced diet rich in fruits and vegetables may lower your risk of cancer.  However, more research is needed to determine which foods provide the most benefits.

Avoid Alcohol

There is a link between alcohol consumption and breast cancer. For women who do drink, they should not have more than 1 alcoholic drink per day.6

In honor of all those who have died from breast cancer, and all the survivors, let’s do our part by educating ourselves and those around us about cancer prevention and early detection.

Resources:

American Cancer Society

National Breast Cancer Foundation, Inc.

Sources:

American Cancer Society. (2019). What is breast cancer? Retrieved from https://www.cancer.org/cancer/breast-cancer/about/what-is-breast-cancer.html.           

National Breast Cancer Foundation, Inc. (2020). Breast Cancer Facts. Retrieved from https://www.nationalbreastcancer.org/breast-cancer-facts#:~:text=Breast%20cancer%20is%20the%20most,survivors%20in%20the%20United%20States..

Breastcancer.org. (2020). Signs and Symptoms. Retrieved from https://www.breastcancer.org/symptoms.

American Cancer Society. (2020). American Cancer Society Recommendations for the Early Detection of Breast Cancer. Retrieved from https://www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.html.

American Cancer Society. (2020). Mammogram Basics. Retrieved from https://www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/mammograms/mammogram-basics.html.

American Cancer Society. (2020). Can I Lower My Risk of Breast Cancer? Retrieved from https://www.cancer.org/cancer/breast-cancer/risk-and-prevention/can-i-lower-my-risk.html.

Medication Management

What is medication management and why is it important? Medication management is simply a method used to safely take medication as prescribed. One of the benefits of medication management is that it can prevent medication errors which can lead to hospitalization, disability, and even death.

You can practice medication management by:

  • Speaking with a doctor and/or pharmacist about your medications
  • Read prescription bottles
  • Ask your doctor and/or pharmacist questions
  • Keeping track of all prescribed and over-the-counter medications
  • Keep a medication list in your wallet
  • Keep a medication list in a safe, but visible place in your home
  • Know what each medication is for
  • Know what each medication looks like
  • Refill prescriptions before your run out
  • Use a pill organizer if taking multiple medications
  • Make sure your caregiver knows about your medications
  • Continue to take medication unless you have an allergic reaction such as rash, itchiness, swelling, or trouble breathing
  • Keep medications away from children
  • Do not share medication(s)

Practicing medication management is vital in preventing medication errors and managing your health.

Picture by Laurynas Mereckas from Unsplash