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Shades of Pink

October 2021 Vol 7 No 5
Lillie D. Shockney, RN, BS, MAS, HON-ONN-CG
University Distinguished Service Professor of Breast Cancer,
Professor of Surgery, Johns Hopkins University School of Medicine
Co-Developer of Work Stride—Managing Cancer at Work
Johns Hopkins Healthcare Solutions

October is National Breast Cancer Awareness Month, with a special day marking Metastatic Breast Cancer Awareness on October 13. We will see seas of pink at walks and races within our communities, on the news, and globally—even the Egyptian pyramids are turned pink. As a 29+-year breast cancer survivor myself, my clothes during the 31 days of October will be various shades of pink.

This issue is filled with stories and information pertinent to this month.

Breast cancer remains the most feared disease by women, no matter their age, race, color, or ethnicity. We have, however, made great progress in the past few decades against this disease.

My own experience as a medical professional shows that gone are the days that a total radical mastectomy is done. More and more women are having lumpectomies, and those choosing to have mastectomies can in most cases undergo a skin-sparing, nipple- and areola-sparing, and even nerve-sparing mastectomy, which involves hollowing out the breast and filling it with something healthy, such as an implant or fat from the woman’s body. And we even have the ability to preserve the nipple and areola, as well as maintain sensation to their anatomic structures, which for many women are important to their sexual health.

Chemotherapy agents have vastly expanded and are used for shorter periods than before. And the new drug classes are incredibly exciting, especially drugs for triple-negative breast cancers, new hormone therapy options, CDK4/6 inhibitors, and now immunotherapies as well.

This has been made possible by major investments in lab research, followed by clinical trials participation, perhaps even by some of you. Patients with metastatic breast cancer are now living a decade or more—one of my friends is now 24 years after her initial diagnosis of stage IV breast cancer, and another friend has been living with her metastatic breast cancer for 11 years now, with scans showing “no evidence of disease”!

Ongoing research is also focused on developing vaccines for cancer prevention. I believe that my granddaughter, who turned 13 on October 4, will be the generation to receive such a vaccine, and will not have to worry whether she will face breast cancer, as her “mommom” has, twice.

I would like to give you all an assignment—please take the time to call female friends or relatives and inspire them to schedule their screening mammogram. Mammography remains our best weapon for early detection. And please make a point of calling someone you know who is dealing with metastatic breast cancer, and ask if you could pay her a visit or take her to a chick flick this month.

Patients with metastatic disease feel isolated and often misunderstood, because they may look healthy, but they are dealing with this disease 24 hours a day. Have them tell you their story, and don’t say things back to them such as, “You look fine. The cancer is all gone, right?” or, “You finished your treatment and are cured now, right?”

Take the time to learn from patients what are the issues that they are dealing with, and see how you can help support them. This is especially important for those of us who have been blessed with an earlier stage of the disease, and received treatment with curative intent, whereas patients with metastatic disease will be in treatment for the rest of their lives.

Get outside for a power walk, sign up for an outdoor breast cancer event, and know that more than 270,000 women and 1,600 men will be diagnosed with breast cancer this year, and 43,500 will die from it.

If you are in active treatment, seek out clinical trial opportunities. If you are a long-term survivor, consider participating in survivorship studies that teach us about physical and emotional issues survivors are coping with long after their treatment.

Be well. Stay safe. Inspire, and participate!

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