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Breast Cancer

Many businesses in the Village of Port Jefferson and Port Jefferson Station will be ‘dressed in pink’ throughout the month of October.

Pink pumpkins, chocolate nights and yoga classes will be part of this year’s Paint Port Pink, Mather Hospital’s month-long October breast cancer awareness community outreach in Port Jefferson and Port Jefferson Station. The event was created in 2015 to raise awareness about the disease, share information and education and foster solidarity in the community.

Employees at Mather Hospital will celebrate Wear Pink Day on Oct. 9.

New this year are Pink Your Pumpkin and Pink Your Windows contests and chocolate-making classes. It Takes a Village Wellness will offer yoga classes with a portion of the registration fees going to the Fortunato Breast Health Center’s Fund for Uninsured and Underinsured. 

Paint Port Pink begins on Oct. 1 with Turn Your Pink Lights On!, when local merchants and residents will be asked to light up Port Jefferson and Port Jefferson Station. On Wear Pink Day, Oct. 9, Mather employees and community residents will be encouraged to dress in pink and to post their photos on Facebook and Instagram using #paintportpink. 

Local residents and merchants can Pink Their Pumpkins and Pink Their Windows in contests designed to raise awareness about breast cancer. Month-long promotions by local businesses will raise funds for the Fund for Uninsured and Underinsured. Mather has teamed up with about 120 local community partners — businesses and professional offices — to help spread the word about the importance of breast health.

Mammograms can help save lives

The American Cancer Society reports that the chance of a woman having invasive breast cancer in her life is about one in eight. That is why increased awareness, education and early detection are important parts of breast health care.

Fortunato Breast Health Center co-medical directors Dr. Michele Price and Dr. Joseph Carrucciu.

A mammogram can reveal a tumor as much as two years before you or your health care professional can feel it. Following the American College of Radiology guidelines, the Fortunato Breast Health Center recommends that you get annual mammography screening starting at age 40. In some higher risk situations, earlier mammography screening or additional breast imaging studies, such as ultrasound, may be recommended. To make an appointment, call 631-476-2771, ext. 1.

If you are uninsured or underinsured, you may be eligible for no cost or discounted screenings through the center’s Fund for Uninsured and Underinsured. If you have been diagnosed with breast cancer and need financial assistance, contact Pink Aid at www.pinkaid.org.

Women receiving their annual mammograms will now have even more accurate screenings thanks to two new state-of-the-art 3-D mammography units at the Fortunato Breast Health Center. Advances in imaging technology deliver highly detailed images that enhance a radiologist’s ability to provide accurate diagnoses. Improvements in ergonomic design allow for improved patient comfort and relaxation. The units also protect patients by delivering the lowest radiation dose of all FDA approved 3-D mammography systems.

“The mammographic images are very clear and detailed, which helps us to identify abnormalities at the smallest possible size,” says Dr. Michelle Price, co-medical director of the breast center. 

Above, one of the new 3-D mamography units at Mather Hospital

The new devices allow for improved detection rates and diagnostic accuracy over older mammography technology through the addition of tomosynthesis, also known as three-dimensional (3-D) mammography. This allows radiologists to see more than what is shown on a standard digital mammogram. “A traditional mammogram offers a top-down picture from compression of the breast tissue. With tomosynthesis, the ‘3-D’ portion of the exam, we get thin cross-sectional images so we can see what it looks like at different angles — in that respect, it is almost like a CAT scan,” said Price.

Having your mammogram done by the same center year after year allows your doctor to compare prior images and look for subtle changes or abnormalities. This can allow for early detection of breast cancer, which in turn can lead to life-saving treatment. “Being able to look back at a history of breast images and compare with prior films is critical for being able to interpret studies correctly. That’s a major advantage of coming to a place where you have established your medical records,” said Price. “It improves the accuracy of the reading.” 

Special community events

Paint Port Pink will offer several events throughout the month of October hosted by Mather’s community partners. Register for events at www.paintportpink.org.

Monday, Oct. 1: Turn Your Pink Lights On!

Thursday, Oct. 4, 6 to 8 p.m.: Chocolate Making Class, Chocolate Works, Stony Brook. Join them for some sweet fun molding and decorating your own chocolate creations! Registration is required.

Tuesday, Oct. 9, Noon: Wear Pink Day, Mather Hospital, Port Jefferson. Get dressed up in your best pink outfit, take a photo and post using #paintportpink

Wednesday, Oct. 10: Pink Sale, Mather Hospital, Port Jefferson. Come and find some pink treasures at the Mather Hospital Thrift and Gift Shop lobby sale. 

Saturday, Oct. 14, Noon & 1 p.m.: Community Reiki Circle, It Takes a Village Wellness, Port Jefferson with two chances to participate in and learn about the power of reiki. Registration is required.

Friday, Oct. 19, 6 to 7 p.m.: Meditation Session, It Takes a Village Wellness, Port Jefferson. Attend a meditation session to enhance your health and tune in to mindfulness. Registration is required. 

Friday, Oct. 19, 7 to 9 p.m.: Chocolate Making Class, Chocolate Works, Stony Brook. Join them for some sweet fun molding and decorating your own chocolate creations! Registration is required. 

Monday, Oct. 22, 6:30 to 7:30 p.m.: Yoga for Health class, Mather Hospital, Port Jefferson offered through It Takes a Village Wellness in Mather Hospital’s conference room B. Registration is required.

Friday, Oct. 26, 12 to 2 p.m.: Wellness Luncheon, Nantucket’s, Port Jefferson. Hosted by It Takes a Village Wellness, attend their “whole health” wellness luncheon and learn about staying healthy naturally. Registration is required. 

Saturday, Oct. 27, 9 a.m to 1:30 p.m.: HealthyU, Mather Hospital, Port Jefferson, a seminar series and health fair focused on physical, emotional and financial well-being. Registration is required. Call 631-686-7879.

Wednesday, Oct. 31: Winners of the Pink Your Pumpkin and Pink Your Window contests will be announced. 

* Proceeds from all events benefit the Fortunato Breast Health Center Fund for Uninsured and Underinsured.

Month-Long Promotions

Chick-fil-A, Port Jefferson Station: $1 from all milk shake sales during the month of October will benefit the Fund for Uninsured.

LI Pour House, Port Jefferson Station: Hosting Wine Down Wednesdays. Every Wednesday during the month of October a glass of wine will be $4 with 10 percent of your purchase benefiting the Fund for Uninsured.

East Main & Main, Port Jefferson: $1 from all pink donut sales during the month of October to benefit the Fund for Uninsured.

Amazing Olive, Port Jefferson: $1 from all extra virgin olive oil sales during the month of October to benefit the Fund for Uninsured.

Luck Soap, Port Jefferson: 40 percent of all Luck Soap Pink Ribbon soap sales (available for sale at Amazing Olive, Port Jefferson and Patchogue locations) during the month of October to benefit the Fund for Uninsured.

The Soap Box, Port Jefferson: 20 percent off Pink Sugar Kiss items during the month of October.

Yogo Delish, Port Jefferson: Donate $1 with your purchase during the month of October and get a $1 off coupon for your next visit.

Tapestry Salon, Mount Sinai: A portion of all pink hair extension sales during the month of October will benefit the Fund for Uninsured.

Cutting Hut, Port Jefferson Station: 10 percent of all pink hair extension sales during the month of October will benefit the Fund for Uninsured.

The Pie, Port Jefferson: Give a donation during the month of October and receive a free Pink Lemonade.

MAC Hair Salon, Mt. Sinai: Pink hair strands for $15 or $10 per pink foil during October with 50 percent of the proceeds to benefit the Fund for Uninsured.

Theatre Three, Port Jefferson: Receive a 20 percent discount on the purchase of your tickets in October when you mention Paint Port Pink.

For more information, please visit www.paintportpink.org.

All photos courtesy of John T. Mather Memorial Hospital

By Alex Petroski

Who knew walking could do so much good.

The Fortunato Breast Health Center, John T. Mather Memorial Hospital in Port Jefferson’s arm dedicated to treatment of breast cancer, played host to Families Walk for Hope, a fundraising event May 5 featuring a five-mile walk through Port Jefferson and Belle Terre villages. The event raised more than $81,000 for the center as of midday May 7. To donate to the center, visit familieswalkforhope.kintera.org.

Bras to be auctioned in March for Adelphi University's breast cancer program

A Creative Cup made by Samantha Eddy and Sandra Lundy will be among 137 auctioned off by Adelphi University to raise money for breast cancer support. Photos from Adelphi University

Two Selden college students got creative making bras to support breast cancer support programs.

Through Adelphi University’s Breast Cancer Program, Samantha Eddy and Sandra Lundy constructed works of art for the Creative Cups project, which encourages artistic expression in celebration of the lives of those living with and lost to the disease.

The bras will be auctioned to benefit the Adelphi NY Statewide Breast Cancer Hotline & Support Program. The program seeks to educate, support, empower and advocate for breast cancer patients and professionals. Those working the hotline answer questions, provide people with someone to talk to and guide them to resources to help.

To make their Creative Cups, people embellished ordinary bras to fit with stories they wanted to share.

Eddy said in 2014, when she received a position in Consumer Advocacy and Low Income Programs as an assistant coordinator, she was given the opportunity to join the Employee Outreach Council at PSEG Long Island. This group of employees has a mission to coordinate support for the specific needs of the communities served by PSEG.

“I hope it brings support to the fight against breast cancer.”

— Sandra Lundy

When October came around and breast cancer awareness fundraising was in full force, the Employee Outreach Council launched Cups for a Cure, according to Eddy.

“The entire company was invited to design a bra and donate the winners to Adelphi’s Creative Cups,” she said. “I was inspired by everyone’s enthusiasm and decided to create a bra that was influenced by my favorite place to visit: Las Vegas. Just like Vegas, this bra has glitz, glam and is over the top. I am proud to donate Bras Vegas to such a great cause.”

Lundy’s “Hunting for a Cure” will also be auctioned off.

The inspiration for her piece was not just her Aunt Diane, a breast cancer survivor, but also her husband.

“My husband and I are opposites, so I took his love for hunting and my love for art and morphed it into ‘Hunting for a Cure,’ ” she said. “This bra is a very personal piece as I feel it demonstrates our love and support for each other. I hope it brings support to the fight against breast cancer.”

“Bras Vegas,” “Hunting for a Cure” and 135 other Creative Cups will be auctioned at a gala event at Adelphi University’s ballroom in Garden City on March 16. NBC News personality Pat Battle is hosting the event. To date, major sponsors include Goldman Sachs Gives, The Leviton Foundation Inc. and Digital Graphic Imagery.

For further information about the hotline and support program, call 516-877-4320 or email breastcancerhotline@adelphi.edu. The hotline number is 1-800-877-8077.

By David Dunaief, M.D.

David Dunaief, M.D.
David Dunaief, M.D.

Many of us give thanks for our health on Thanksgiving. Well, let’s follow through with this theme. While eating healthy may be furthest from our minds during a holiday, it is so important. Instead of making Thanksgiving a holiday of regret, eating foods that cause weight gain and fatigue, as well as increase your risk for chronic diseases, you can reverse this trend while staying in the traditional theme of what it means to enjoy a festive meal.

What can we do to turn Thanksgiving into a bonanza of good health? Phytochemicals (plant nutrients) called carotenoids have antioxidant and anti-inflammatory activity and are found mostly in fruits and vegetables. Carotenoids make up a family of greater than 600 different substances, such as beta-carotene, alpha-carotene, lutein, zeaxanthin, lycopene and beta-cryptoxanthin (1).

Carotenoids help to prevent and potentially reverse diseases, such as breast cancer; amyotrophic lateral sclerosis, also known as Lou Gehrig’s disease; age-related macular degeneration; and cardiovascular disease — heart disease and stroke. Foods that contain these substances are orange, yellow and red vegetables and fruits and dark green leafy vegetables. Examples include sweet potato, acorn squash, summer squash, spaghetti squash, green beans, carrots, cooked pumpkin, spinach, kale, papayas, tangerines, tomatoes and Brussels sprouts.

Acorn squash contains carotenoids, which help to prevent breast cancer, Lou Gehrig’s disease, age-related macular degeneration and cardiovascular disease.
Acorn squash contains carotenoids, which help to prevent breast cancer, Lou Gehrig’s disease, age-related macular degeneration and cardiovascular disease.

Let’s look at the evidence.

Breast cancer effect

We know that breast cancer risk is high among women, especially on Long Island. The risk for a woman getting breast cancer is 12.4 percent in her lifetime (2). Therefore, we need to do everything within reason to reduce that risk. In a meta-analysis (a group of eight prospective or forward-looking studies), results show that women who were in the second to fifth quintile blood levels of carotenoids, such as alpha-carotene, beta-carotene and lutein and zeaxanthin, had significantly reduced risk of developing breast cancer (3). Thus, there was an inverse relationship between carotenoid levels and breast cancer risk. Even modest amounts of carotenoids potentially can have a resounding effect in preventing breast cancer.

ALS: Lou Gehrig’s disease

ALS is a disabling and feared disease. Unfortunately, there are no effective treatments for reversing it. Therefore, we need to work double-time in trying to prevent its occurrence. In a meta-analysis of five prestigious observational studies, including The Nurses’ Health Study and the Health Professionals Follow-Up Study, results showed that people with the greatest amount of carotenoids in their blood from foods such as spinach, kale and carrots had a decreased risk of developing ALS and/or delayed the onset of the disease (4). This study involved over one million people with more than 1,000 who developed ALS.

Those who were in the highest carotenoid level quintile had a 25 percent reduction in risk, compared to those in the lowest quintile. This difference was even greater for those who had high carotenoid levels and did not smoke; they achieved a 35 percent reduction. According to the authors, the beneficial effects may be due to antioxidant activity and more efficient function of the power source of the cell, the mitochondrion. This is a good way to prevent a horrible disease while improving your overall health.

Positive effects of healthy eating

Despite the knowledge that healthy eating has long-term positive effects, there are several obstacles to healthy eating. Two critical factors are presentation and perception. Presentation is glorious for traditional dishes, like turkey, gravy and stuffing with lots of butter and creamy sauces. However, vegetables are usually prepared in either an unappetizing way — steamed to the point of no return, so they cannot compete with the main course, or smothered in cheese, negating their benefits, but clearing our consciences.

Many consider Thanksgiving a time to indulge and not think about the repercussions. Plant-based foods like whole grains, leafy greens and fruits are relegated to side dishes or afterthoughts. Why is it so important to change our mind-sets? Believe it or not, there are significant short-term consequences of gorging ourselves. Not surprisingly, people tend to gain weight from Thanksgiving to New Year. This is when most gain the predominant amount of weight for the entire year.

However, people do not lose the weight they gain during this time (5). If you can fend off weight gain during the holidays, just think of the possibilities for the rest of the year. Also, if you are obese and sedentary, you may already have heart disease. Overeating at a single meal increases your risk of heart attack over the near term, according to the American Heart Association (6). However, with a little Thanksgiving planning, you can reap significant benefits.

What strategies should you employ for the best outcomes?

• Make healthy, plant-based dishes part of the main course. I am not suggesting that you forgo signature dishes, but add to tradition by making mouthwatering vegetable-based main dishes for the holiday.

• Improve the presentation of vegetable dishes. Most people don’t like grilled chicken without any seasoning. Why should vegetables be different? In my family, we make sauces for vegetables, like a peanut sauce using mostly rice vinegar and infusing a teaspoon of toasted sesame oil. Good resources for appealing dishes can be found at www.pcrm.org, EatingWell magazine, www.wholefoodsmarket.com and many other resources.

• Replace refined grains with whole grains. A study in the American Journal of Clinical Nutrition showed that replacing wheat or refined grains with whole wheat and whole grains significantly reduced central fat, or fat around the belly (7). Not only did participants lose subcutaneous fat found just below the skin but also visceral adipose tissue, the fat that lines organs and causes chronic diseases such as cancer.

• Create a healthy environment. Instead of putting out creamy dips, processed crackers and candies as snacks prior to the meal, put out whole grain brown rice crackers, baby carrots, cherry tomatoes and healthy dips like hummus and salsa. Help people choose wisely.

• Offer more healthy dessert options, like dairy-free pumpkin pudding and fruit salad. The goal should be to increase your nutrient-dense choices and decrease your empty-calorie foods. You don’t have to be perfect, but improvements during this time period have a tremendous impact — they set the tone for the new year and put you on a path to success. Why not turn this holiday into an opportunity to de-stress, rest and reverse or prevent chronic disease by consuming plenty of carotenoid-containing foods.

References: (1) Crit Rev Food Sci Nutr 2010;50(8):728–760. (2) SEER Cancer Statistics Review, 1975–2009, National Cancer Institute. (3) J Natl Cancer Inst 2012;104(24):1905-1916. (4) Ann Neurol 2013;73:236–245. (5) N Engl J Med 2000; 342:861-867. (6) www.heart.org. (7) Am J Clin Nutr 2010 Nov; 92(5):1165-1171.

Dr. Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com or consult your personal physician.

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St. Charles Hospital nurses and other staff wear pink bracelets as a sign of support for Desiree Bielski-Stoff, who is battling breast cancer. Photo from Bielski-Stoff

By Rebecca Anzel

Registered nurse at St. Charles Hospital in Port Jefferson Desiree Bielski-Stoff knows what a lump feels like — she had a small one removed from her left breast when she was 20. Since then, she performed self-examinations regularly and, coupled with her medical knowledge, thought she was “pretty good” at self-assessment.

In September, Bielski-Stoff, who is now 37, was diagnosed with breast cancer. Less than a month later, she had a double mastectomy at Memorial Sloan Kettering Cancer Center in Manhattan.

Bielski-Stoff waits to enter the operating room before her double mastectomy Oct. 4. Photo from Bielski-Stoff
Bielski-Stoff waits to enter the operating room before her double mastectomy Oct. 4. Photo from Bielski-Stoff

“I was looking for something like that mass in my left breast, something I could feel,” she said. “It wasn’t like a lighted sign going ‘Bling Bling, you have cancer — you have a mass in your breast,’ and I think that’s what we think we’re supposed to be looking for.”

October is national Breast Cancer Awareness Month, and Bielski-Stoff has been sharing her story with friends and family in the hopes they will not have to go through what she experienced. Every two minutes, a woman in the U.S. is diagnosed with breast cancer, a disease that kills more than 40,000 women each year, according to Right at Home, a senior care organization.

On average, women develop breast cancer at age 61. Bielski-Stoff’s diagnosis rattled her family, friends and coworkers. She has worked at the hospital since 2004.

“It’s eye-opening for all of us — I’m her age, you know? You never know,” Kim Audiino, an emergency room nurse at St. Charles Hospital and friend of Bielski-Stoff, said. “I think people need to open their eyes and be more alert about checking themselves.”

Bielski-Stoff was getting dressed after taking a shower in August when out of the corner of her eye, she noticed her right breast collapsed when she lifted her arm. Her first thought, she said, was that it was due to the 10 pounds she recently lost for her sister’s upcoming wedding. Bielski-Stoff conducted a brief self-exam, finding nothing out of the ordinary — nothing was swollen and she did not feel any lumps.

She showed her gynecologist that Wednesday. Bielski-Stoff said the doctor cocked her head, commented that it looked like a dimple and gave her a script for a mammogram and an ultrasound. The doctor told her it was probably nothing but she wanted to be on the safe side.

Her appointment was Sept. 7 at St. Charles with Dr. Jane Marie Testa, a doctor her coworkers recommended after Bielski-Stoff insisted she wanted to see the best. George, her husband, had asked if she wanted him to go with her, but she said no — she did not want to make it a big deal.

“I remember driving there and pulling up in the parking lot and thinking, either this is going to go in a good way or it’s not,” Bielski-Stoff said, “like, this could be the last time I feel normal.”

The tests took a few hours. When they were over, Testa came in and said she wanted to show Bielski-Stoff a few things with the ultrasound. There was a spot on her left breast the doctor wanted to take a sample of, and one on her right. Then Testa hovered over another spot on her right breast and said she was sorry — it was cancer.

There was no question about what it was, Bielski-Stoff said. It was a classic presentation of a cancerous mass. It was irregularly shaped and had vascularity and calcifications. Questions were flying through her mind about whether her life was over, if she would be in pain and if she was going to be okay, she said.

“The feeling that comes over you when somebody says cancer is just, I started crying,” Bielski-Stoff said. “I thought, ‘How do I absorb this right now. It was everything all at once — fear, a lot of fear.”

Her sister’s wedding was that weekend, so she booked the biopsies for the following Wednesday. Then she set about trying to find a surgeon.

Bielski-Stoff’s insurance company told her there was only one in network near her, so she turned to her coworkers at St. Charles for advice. With the help of her supervisor and the head of human resources, Bielski-Stoff learned the doctors at Memorial Sloan Kettering were covered.

The surgeon gave her two options: either Bielski-Stoff could get a lumpectomy with radiation or she could get a mastectomy. She opted for a double mastectomy.

“I have to live with this. This is what I can live with,” she said about her decision. “I’m young, 37. I can’t spend the rest of my life panicking that I’m getting cancer again.”

“The feeling that comes over you when somebody says cancer is just, I started crying. I thought, ‘How do I absorb this right now. It was everything all at once — fear, a lot of fear.”

— Desiree Bielski-Stoff

Her surgery was Oct. 3. Two weeks later, all the drains were out and she was sore but doing well. The support from her friends at St. Charles helped her through the experience, she said. They visited her every day, bringing her flowers and food, watching movies with her, checking her dressings, helping her bathe and delivering her medicine from the pharmacy.

“We were pretty much her nanny 24/7 while her husband was working,” Audiino said. “She was never alone, and she had more care than anyone I’ve seen because she’s so well-known and well-liked. We love her to pieces.”

Audiino and another friend, Colleen Miller, raised just about $600 selling over 150 pink bracelets around the hospital. Her Facebook page is littered with pictures of coworkers wearing their bracelets — some say Faith, others say Hope and Survivor. The funds paid for the hotel room Bielski-Stoff’s husband stayed in the night before her surgery.

St. Charles is letting employees donate their vacation time to Bielski-Stoff. She has exhausted hers between her cancer experience and working on the hospital’s negotiating team.

“All of us at St. Charles wish Desiree the best of health — I am very proud of our staff for supporting Desiree during this difficult time,” Jim O’Connor, executive vice president and chief administrative officer at St. Charles, said in an email. “Their gesture also brings awareness to this important health issue and the need for screening and early detection.”

Others have been doing what they can to show their support as well. A former patient’s family drove to her house from the North Shore to drop off supermarket gift cards, and her sister set up a GoFundMe account.

Bielski-Stoff said this experience has been traumatic because it feels like she does not just have cancer, but all her friends and family do. Her diagnosis has made the people around her aware of the importance of conducting self-examinations and going to a doctor regularly.

“It made me have a different look on life and it definitely opened my eyes to making sure that I take care of myself and my children, and that all of my friends keep up with checking for themselves,” Miller, a nursing assistant at St. Charles, said. “In the meantime, we all have to be ‘Dezzy strong,’ as I call it, and be there for her while she’s recovering.”

Bielski-Stoff found out on Halloween she’ll need four months of chemotherapy. 

“That’s going to change me as well and make the fight a little bit harder,” she said.

Bielski-Stoff’s friend Jimmy Bonacasa is hosting a fundraiser for her at the Harbor Crab in Patchogue Sunday, Nov. 13, from 4 to 8 p.m. There is a suggested donation of $20.

This version was updated Nov. 1 to include Bielski-Stoff’s treatment plan.

A diet rich in fruits, vegetables, beans, nuts and oily fish may prevent breast cancer. Stock photo

By David Dunaief, M.D.

NFL players are wearing pink shoes and other sportswear this month, making a fashion statement to highlight Breast Cancer Awareness Month. This awareness is critical since annual invasive breast cancer incidence in the U.S. is 246,000 new cases, with approximately 40,000 patients dying from this disease each year (1). The good news is that from 1997 to 2008 there was a trend toward decreased incidence by 1.8 percent (2).

We can all agree that screening has merit. The commercials during NFL games tout that women in their 30s and early 40s have discovered breast cancer with a mammogram, usually after a lump was detected. Does this mean we should be screening earlier? Screening guidelines are based on the general population that is considered “healthy,” meaning no lumps were found, nor is there a personal or family history of breast cancer.

All guidelines hinge on the belief that mammograms are important, but at what age? Here is where divergence occurs; experts can’t agree on age and frequency. The U.S. Preventive Services Task Force recommends mammograms starting at 50 years old, after which time they should be done every other year (3). The American College of Obstetricians and Gynecologists recommends mammograms start at 40 years old and be done annually (4). Your decision should be based on a discussion with your physician.

The best way to treat breast cancer — and just as important as screening — is prevention, whether it is primary, preventing the disease from occurring, or secondary, preventing recurrence. We are always looking for ways to minimize risk. What are some potential ways of doing this? These may include lifestyle modifications, such as diet, exercise, obesity treatment and normalizing cholesterol levels. Additionally, although results are mixed, it seems that bisphosphonates do not reduce the risk of breast cancer nor its recurrence. Let’s look at the evidence.

Bisphosphonates

Bisphosphonates include Fosamax (alendronate), Zometa (zoledronic acid) and Boniva (ibandronate) used to treat osteoporosis. Do they have a role in breast cancer prevention? It depends on the population, and it depends on study quality.

In a meta-analysis involving two randomized controlled trials, results showed there was no benefit from the use of bisphosphonates in reducing breast cancer risk (5). The population used in this study involved postmenopausal women who had osteoporosis, but who did not have a personal history of breast cancer. In other words, the bisphosphonates were being used for primary prevention.

The study was prompted by previous studies that have shown antitumor effects with this class of drugs. This analysis involved over 14,000 women ranging in age from 55 to 89. The two trials were FIT and HORIZON-PFT, with durations of 3.8 and 2.8 years, respectively. The FIT study involved alendronate and the HORIZON-PFT study involved zoledronic acid, with these drugs compared to placebo. The researchers concluded that the data were not evident for the use of bisphosphonates in primary prevention of invasive breast cancer.

In a previous meta-analysis of two observational studies from the Women’s Health Initiative, results showed that bisphosphonates did indeed reduce the risk of invasive breast cancer in patients by as much as 32 percent (6). These results were statistically significant. However, there was an increase in risk of ductal carcinoma in situ (precancer cases) that was not explainable. These studies included over 150,000 patients with no breast cancer history. The patient type was similar to that used in the more current trial mentioned above. According to the authors, this suggested that bisphosphonates may have an antitumor effect. But not so fast!

The disparity in the above two bisphosphonate studies has to do with trial type. Randomized controlled trials are better designed than observational trials. Therefore, it is more likely that bisphosphonates do not work in reducing breast cancer risk in patients without a history of breast cancer or, in other words, in primary prevention.

In a third study, a meta-analysis (group of 36 post-hoc analyses — after trials were previously concluded) using bisphosphonates, results showed that zoledronic acid significantly reduced mortality risk, by as much as 17 percent, in those patients with early breast cancer (7). This benefit was seen in postmenopausal women but not in premenopausal women. The difference between this study and the previous study was the population. This was a trial for secondary prevention, where patients had a personal history of cancer.

However, in a RCT, the results showed that those with early breast cancer did not benefit overall from zoledronic acid in conjunction with standard treatments for this disease (8). The moral of the story: RCTs are needed to confirm results, and they don’t always coincide with other studies.

Exercise

We know exercise is important in diseases and breast cancer is no exception. In an observational trial, exercise reduced breast cancer risk in postmenopausal women significantly (9). These women exercised moderately; they walked four hours a week. The researchers stressed that it is never too late to exercise, since the effect was seen over four years. If they exercised previously, but not recently, for instance, five to nine years ago, no benefit was seen.

To make matters worse, only about one-third of women get the recommended level of exercise every week: 30 minutes for five days a week. Once diagnosed with breast cancer, women tend to exercise less, not more. The NFL, which does an admirable job of highlighting Breast Cancer Awareness Month, should go a step further and focus on the importance of exercise to prevent breast cancer or its recurrence, much as it has done to help motivate kids to exercise with it Play 60 campaign.

Soy intake

Contrary to popular belief, soy may be beneficial in reducing breast cancer risk. In a meta-analysis (a group of eight observational studies), those who consumed more soy saw a significant reduction in breast cancer compared to those who consumed less (10). There was a dose-response curve among three groups: high intake of >20 mg per day, moderate intake of 10 mg and low intake of <5 mg.

Those in the highest group had a 29 percent reduced risk, and those in the moderate group had a 12 percent reduced risk, when compared to those who consumed the least. Why have we not seen this in U.S. trials? The level of soy used in U.S. trials is a fraction of what is used in Asian trials. The benefit from soy is thought to come from isoflavones, plant-rich nutrients.

Western vs. Mediterranean diets

A Mediterranean diet may decrease the risk of breast cancer significantly.
A Mediterranean diet may decrease the risk of breast cancer significantly.

In an observational study, results showed that, while the Western diet increases breast cancer risk by 46 percent, the Spanish Mediterranean diet has the inverse effect, decreasing risk by 44 percent (11). The effect of the Mediterranean diet was even more powerful in triple-negative tumors, which tend to be difficult to treat. The authors concluded that diets rich in fruits, vegetables, beans, nuts and oily fish were potentially beneficial.

Hooray for Breast Cancer Awareness Month stressing the importance of mammographies and breast self-exams. However, we need to give significantly more attention to prevention of breast cancer and its recurrence. Through potentially more soy intake, as well as a Mediterranean diet and modest exercise, we may be able to accelerate the trend toward a lower breast cancer incidence.

References: (1) breastcancer.org. (2) J Natl Cancer Inst. 2011;103:714-736. (3) Ann Intern Med. 2009;151:716-726. (4) Obstet Gynecol. 2011;118:372-382. (5) JAMA Inter Med online. 2014 Aug. 11. (6) J Clin Oncol. 2010;28:3582-3590. (7) 2013 SABCS: Abstract S4-07. (8) Lancet Oncol. 2014;15:997-1006. (9) Cancer Epidemiol Biomarkers Prev online. 2014 Aug. 11. (10) Br J Cancer. 2008;98:9-14. (11) Br J Cancer. 2014;111:1454-1462.

Dr. Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com or consult your personal physician.

By losing just 10 pounds, you can prevent deadly illness, alleviate daily pain and improve your quality of life. Stock photo

By David Dunaief, M.D.

Some research shows that obesity may be reaching a plateau. Is this true? It depends on how the data is analyzed. According to one study, yes; it has plateaued when looking at short, two-year periods from 2003 to 2011 (1).

However, another published study shows a picture that is not as positive (2). The study’s authors believe obesity has not plateaued; when looking over a longer period of time, statistics suggest that obesity has reached a new milestone. There are now more obese patients in the United States than there are overweight patients. And no, it is not because we have fewer overweight patients. This is based on a study that reviewed data from the National Health and Nutrition Examination Survey (NHANES). These results were in adults over the age of 20. This should be an eye-opener.

Unfortunately, according to one study, the probability is not very good for someone to go from obese to “normal” weight in terms of body mass index (3). In this observational trial, results show that an obese man has a 0.5 percent chance of achieving normal weight, while a woman has a slightly better chance, 1 percent. This study used data from the UK Clinical Practice Datalink. The data were still not great for men and women trying to achieve at least a 5 percent weight loss, but better than the prior data. Patients who were more obese actually had an easier time losing 5 percent of their body weight.

What are two major problems with being obese? One, obesity is a disease in and of itself, as noted by the American Medical Association in 2013 (4). Two, obesity is associated with — and is even potentially a significant contributor to — many chronic diseases such as cardiovascular disease (heart disease and stroke), high blood pressure, high cholesterol, atrial fibrillation, diabetes, cancer, cognitive decline and dementia. When I attended the 28th Blackburn Course in Obesity Medicine in June 2015 at Harvard Medical School, a panel of experts noted that there are over 180 chronic diseases associated with obesity.

In this article, we will focus on one significant multifaceted disease, cancer. Watch out for cancer One of the more unpredictable diseases to treat is cancer.

What are the risk factors?

Beyond family history and personal history, obesity seems to be important. In fact, obesity may be a direct contributor to 4 percent of cancer in men and 7 percent of cancer in women (5). This translates into 84,000 cases per year (6). On top of these stunning statistics, there is about a 50 percent increased risk of death associated with cancer patients who are obese compared to those with normal BMIs (7).

What about with breast cancer?

The story may be surprising and disappointing. According to an analysis of the Women’s Health Initiative, those who were obese had increased risks of invasive breast cancer and of death once the diagnosis was made (8). The severity of the breast cancer and its complications were directly related to the severity of the obesity. There was a 58 percent increased risk of advanced breast cancer in those with a BMI of >35 kg/m2 versus those with normal BMI of <25 kg/m2. And this obese group also had a strong association with estrogen-receptor-positive breast cancer.

However, those who lost weight did not reduce their risk of breast cancer during the study. There were 67,000 postmenopausal women between the ages of 50 and 79 involved in this prospective (forward-looking) study. The researchers do not know why patients who lost weight did not reduce their risk profile for cancer and suggest the need for further studies. This does not imply that lifestyle changes do not have a beneficial impact on breast cancer.

What can we do?

We find that fat is not an inert or static substance, far from it. Fat contains adipokines, cell-signaling (communicating) proteins that ultimately may release inflammatory factors in those who have excessive fat. Inflammation increases the risk of tumor development and growth (9).

There is a potentially simple step that obese cancer patients may be able to take — the addition of vitamin D. In a study in older overweight women, those who lost weight and received vitamin D supplementation were more likely to reduce inflammatory factor IL-6 than those who had weight loss without supplementation (10). This was only the case if the women were vitamin D insufficient. This means blood levels were between 10 and 32 ng/mL to receive vitamin D.

Interestingly, it has been suggested that overweight patients are more likely to have low levels of vitamin D, since it gets sequestered in the fat cells and, thus, may reduce its bioavailability. Weight loss helps reduce inflammation, but the authors also surmise that it may also help release sequestered vitamin D. The duration of this randomized controlled trial, the gold standard of studies, was one year, involving 218 postmenopausal women with a mean age of 59.

All of the women were placed on lifestyle modifications involving diet and exercise. The treatment group received 2,000 IU of vitamin D3 daily. Those women who received vitamin D3 and lost 5 to 10 percent of body weight reduced their inflammation more than those in the vitamin D group who did not lose weight.

What does medicine have to offer?

There are a host of options ranging from lifestyle modifications to medications to medical devices to bariatric surgery. In 2015, the FDA approved two medical devices that are intragastric (stomach) balloons (11). The balloons are filled with 500 mL of saline after inserting them in the stomach via upper endoscopy. They need to be removed after six months, but they give the sense of being satiated more easily and help with weight loss.

One, the ReShape Dual Balloon, is intended to go hand-in-hand with diet and exercise. It is meant for obese patients with a BMI of 30-40 kg/m2 and a comorbidity, such as diabetes, who have failed to lose weight through diet and exercise. In a randomized controlled trial involving 326 obese patients, those who received the balloon insertion lost an average of 14.3 lb in six months, compared 7.2 lb for those who underwent a sham operation.

Lifestyle modifications

In an ode to lifestyle modifications, a study of type 2 diabetes patients showed that diet helped reduce weight, while exercise helped maintain weight loss for five years. In this trial, 53 percent of patients who had initially lost 23 lb (9 percent of body weight) over 12 weeks and maintained it over one year were able to continue to maintain this weight loss and preserve muscle mass through diet and exercise over five years (12). They also benefited from a reduction in cardiovascular risk factors. In the initial 12-week period, the patients’ HbA1C was reduced from 7.5 to 6.5 percent, along with a 50 percent reduction in medications.

We know that obesity is overwhelming. It’s difficult to lose weight and even harder to reach a normal weight; however, the benefits far outweigh the risks of remaining obese. Lifestyle modifications are a must that should be discussed with your doctor. In addition, there are a range of procedures available to either help jump start the process, to accelerate progress or to help maintain your desired weight.

References: (1) JAMA 2014;311:806-814. (2) JAMA Intern Med 2015;175(8):1412-1413. (3) Am J Public Health 2015;105(9):e54-59. (4) ama-assn.org. (6) cancer.gov/cancertopics/factsheet/risk/obesity. (7) N Engl J Med 2003;348:1625-1638. (8) JAMA Oncol online June 11, 2015. (9) Clin Endocrinol 2015;83(2):147-156. (10) Cancer Prev Res 2015;8(7):1-8. (11) fda.gov. (12) ADA 2015 Abstract 58-OR.

Dr. Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com or consult your personal physician.

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Event raises money for cancer patients

Michele Pincus, a breast cancer survivor, walks in the show. Photo by Victoria Espinoza

Pink Aid Long Island hosted its second annual fashion show and luncheon to benefit victims of breast cancer at Mitchells|Marshs in Huntington on Thursday, Oct. 15.

Pink Aid is a nonprofit organization, with branches in Connecticut and Long Island and seeks to support breast cancer survivors and provide screenings to women in   financial need.

Pink Aid’s grant programs provide services like free breast cancer screenings and help cover nonmedical expenses such as wigs, recovery garments and transportation for patients undergoing treatment.

The event featured a fashion show with models wearing Mitchells fall 2015 and spring 2016 lines. There were also silent and live auctions, where items ranging from a Gucci iPad case to a two-night stay at an inn in Ireland were prizes.

Allison Mitchell, president of Pink Aid Long Island, said she was proud of how this event has grown in just one year. Last year, the event raised more than $225,000 from its 300 attendees.

She said while they can only fit a certain number of people in the store for the event, they also had the option of an online auction this year for those who didn’t have a chance to reserve a ticket.

“Pink Aid helps women that are underinsured or not insured to get through their treatment and their diagnosis,” Mitchell said. “I think it’s really important we’re giving back to women here on Long Island right in our backyard [who] are struggling with treatment and keeping their families together.”

Mitchell’s husband Chris heads the Huntington store, previously known as Marshs, which is part of an independent family chain. “We own a retail store [here] with a lot of amazing clothes,” he said. “Women love clothes and this event allows us to have women come and support other women while having a fun day that is really a celebration.”

During the Celebration of Life portion of the fashion show, breast cancer survivors walk the runway in Mitchells after the professional models. The survivors are accompanied by an escort, specifically someone who supported them during their journey, according to Diana Mitchnick, co-chair of the Celebration of Life fashion show.

“I am going to walk this year,” she said. “I am very excited and a little nervous.”

Mitchnick said the entire event is uplifting, and that the room is filled with love and support: “Everyone who has been through the breast cancer journey knows how much help you need. Many people don’t have it and they need it.”

This year’s guest speaker was Marisa Acocella Marchetto, a breast cancer survivor and award-winning cartoonist and graphic novelist. Her graphic novel, “Cancer Vixen: A True Story,” follows her journey from when she discovered she had breast cancer through to the end of her treatment.

“What a positive impact you’ve made creating real positive change,” Marchetto said to the room. “You’ve made Strong Island ever stronger.”

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The Village of Port Jefferson will be awash in pink all through October as part of John T. Mather Memorial Hospital’s breast cancer awareness and outreach called “Paint Port Pink.”

The event’s mission is to stress the importance of screening, early detection and education about breast cancer and to help raise funds for the Fortunato Breast Health Center Fund for the Uninsured at Mather. “Paint Port Pink allows Mather Hospital to build on our breast cancer outreach efforts by involving the entire community in a month-long campaign that is highly visible and offers important breast health information,” said Mather board member Judith Fortunato. Participating partners will distribute breast cancer education cards containing information on breast self-exams.

Paint Port Pink is presented by Astoria Bank with the support of North Shore Hematology Oncology Associates, Long Island Physician Associates, LI Anesthesia Physicians, the Greater Port Jefferson Chamber of Commerce, People’s United Bank, Suffolk Plastic Surgeons, The Richard and Mary Morrison Foundation, A World of Pink, Empire National Bank, Gordon L. Seaman and Harborview Medical Services.

Many activities will be held throughout the month to bring the community together. To kick off the event, a Tree Lighting Ceremony will be held at Village Hall tonight (Oct. 1) at 6:30 p.m. Mayor Margot Garant and Mather board member Judith Fortunato will flip the switch to light up the Village Hall tree in pink lights. All are invited. Local schools will provide music, and a flock of pink flamingos will make an appearance.

At the same time, merchants will be displaying pink lights in their windows. The water in the downtown fountains will be “pinked” with environmentally safe dye. Village Hall, the Village Center, the Port Jefferson Ferry Terminal and Mather  Hospital will be illuminated by pink spotlights. Theatre Three’s marquee will blink with pink lights. In addition, pink banners will adorn the light poles and some restaurants will offer special pink drinks.

Through Oct. 31, several events will raise funds to benefit the Fund for the Uninsured at the Fortunato Breast Health Center as well as breast cancer treatment services at Mather. Students at Edna Louise Spear Elementary School will launch their “Your Change Can Make a Change” promotion, collecting change using the Center’s giant hourglass while Port Jefferson Middle School students will sell and wear pink shoe laces and Frisbees.

Earl L. Vandermeulen High School cheerleaders and the Student Organization will begin their “Flamingo Flocking” fundraising campaign. The pink plastic suburban icons will be placed on the lawns of friends and supporters along with a note explaining that friends or family paid to have them “flocked” and explaining that if they make a donation, the flock will migrate to any yard they choose.

The 9th annual Pink Rock Golf Classic at the Port Jefferson Country Club will be held on Oct. 5. Registration is at 11 a.m. followed by a barbecue lunch at 11:30 am and a shot gun start at 1 p.m.

Mather Hospital’s 50th annual Gala, One Enchanted Evening, will be held on Oct. 23 at the Hyatt Regency Long Island, Hauppauge, from 7 to 11 p.m. The gala will include the presentation of the Community Service Award and Theodore Roosevelt Awards for service to the hospital and the community.

Finally, on Oct. 29, Cold Spring Harbor Laboratory Director of Research David L. Spector, Ph.D., will speak about his research on “Searching for New Ways to Halt the Progression of Breast Cancer” at a free educational seminar at Mather Hospital’s new Long Island Anesthesia Physicians Conference Center starting at 6:30 p.m. For more information or to register, call 631-686-7878.

 

‘Victory at Ojai’ by Marge Governale. Image from North Shore Art Guild
‘Victory at Ojai’ by Marge Governale. Image from North Shore Art Guild

Tales of survival and hope at North Shore Art Guild’s latest exhibit
Mather Hospital has also teamed up with the North Shore Art Guild, the Village of Port Jefferson and the Port Jefferson Conservancy to present Artists United Against Breast Cancer, a juried art show currently on view at the Port Jefferson Village Center through Oct. 31. Featuring the works of more than 70 artists, the exhibit is inspired by the personal transformation, hope, love, fear, loss and victory associated with breast cancer. Choice of mediums included oil, acrylic, digital art, digital photographs and soft sculpture.

The show’s theme is “Victors of Survival, A Celebration of the Warrior Within Each of Us.” “Victors of Survival is not just about breast cancer. It’s about personal transformation, the person you become having faced the experience,” said Mac Titmus, vice president of the Art Guild and coordinator of the show. “It’s about the emergence of the warrior within, and the struggle that brings it forth. It’s about … how [the artists] choose to transform that passion into expression.”

Many of the artists in the show have been afflicted with breast cancer or have close family members who have.

One painting in the show stands out among the crowd. A woman stands atop a mountain, her arms raised in triumph. The woman is also the artist, Marge Governale of E. Setauket, and she is celebrating not only reaching the mountain’s summit, but surviving breast cancer. “It’s a painting of me right after I finished my treatment in October 2013, when I went with my daughter on a trip to Ojai, California,” said Governale.

In the painting, Governale’s hair is short, just growing back after chemotherapy. “I had not been exercising. My daughter said ‘let’s hike,’ and I made it the top of that mountain,” she said. It felt so good that I was able to get back to some of the things I loved after my treatment. That was a victory for me.”

“I only started painting because I had breast cancer,” she said. “Good things sometimes come from bad things.”

The winners were announced on Sept. 1. The judges included Judith Fortunato, Holly Gordon, Ward Hooper and Lori Horowitz.

Best in Show went to Len Sciacchitano for “What Will He Think.” “I remember the terror in my cousin’s eyes when she first told me she had cancer and a breast had to be removed. I can only imagine how she felt when she was faced with that diagnosis, the moment she heard, “You have breast cancer,” said Sciacchitano. “I’m sure it is a moment that remained in her mind for the rest of her life. I do not know how it feels and tried to visually imagine her emotions when she realized she needed major surgery and a portion of what she had known was being taken away,” he said.

Joanna Gazzola garnered first place for “Defiant Yet Vulnerable.” “I have had two friends and one relative who had cancer and who handled their illnesses with grit, determination and courage. One has survived for almost a decade so far and does walks to raise money for cancer research every year. The other two have passed, but provided so much inspiration to me,” said Gazzola. “I can only hope that I live and die with as much grace and thoughtfulness as they had,” said Gazzola.

Second place went to Zhen Guo for “Breasts are the Essence,” soft sculpture. Said Guo, “A woman’s breasts are symbolic of her multifaceted nature in many ways. They are the source of nourishment for infants, of warmth and security for her children, of sexuality and attractiveness for her mate. When they are injured, her whole being and all the people who know her are injured, too.”

Evelyn Adams, whose painting, “Unite & Fight For A Cure” won third place, said, “My mother passed away of breast cancer in 2008 at the age of 60. I became so mad with the disease.  However, as time passed by, I began to accept the reality of the disease and now I really do support the fight for breast cancer. Showing my support, I expressed my view for a cure in a special way. I cast my hand and then incorporated clay made breast, and also placed over 100 pieces of pink ribbons around a pedestal in which represent all families who are coming together and bringing awareness to breast cancer.” She went on, “Therefore, my main idea of this piece is to encourage viewers, families who had a family member died of breast cancer and those who are fighting breast cancer of hope for a cure.”

Honorable mentions went to Bernadette De Nyse for “Mortality Realized,” Joanna Gazzola for “Conflict, Denial and Understanding,” Neil Leinwohl for “New Blooms,” Lynellen Nielsen for “Grace,” Susan Silkowitz for “Abuela” and Angela Stratton for “The Protector.”

The Port Jefferson Village Center is located at 101A. E. Broadway. An artist reception will be held on Saturday, Oct. 3, from 4 to 7 p.m. on the second level with raffles, blind auctions and art sales. All of the artists have agreed to donate 25 percent of any sales to support breast health care at the Fortunato Breast Health Center of Mather Hospital. For further information about the art show, call 631-802-2160.

Joseph Volavka, far left, stood alongside Dolan Family Health Center and Pink Aid members to celebrate the $25,000 grant. Photo from Dolan Family Health Center

Woman can receive free mammograms, sonograms and breast biopsies at Huntington Hospital’s Women’s Center and the Charles and Helen Reichert Imaging Center at Huntington with the help of a new grant.

On Friday, Aug. 7, Pink Aid, an organization that aims to help women receive and survive breast cancer treatment, gave the Dolan Family Health Center a one-year, $25,000 grant.

According to Joseph Volavka, senior administrative director of the Dolan Family Health Center, around 23 percent of the center’s patients pay out of pocket for their regular appointment. The purpose of the grant is to encourage women who may not have health insurance to receive free breast screenings, which can be costly. Most patients usually have enough money to pay for their regular appointments, so the grant gives more women the opportunity to get additional health care than they would otherwise receive due to financial limitations.

“We are very grateful for this grant, which will help so many women to get the medical care that they need, and it will also help their families.” Kathy Giffuni, RN, nurse manager of the Dolan Family Health Center, said in a press release.

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