Buch lesen: «Breasts»

To the women and girls all over this wonderful world who have—or had—breasts.

Contents

Cover

About the Author

Title Page

Copyright

Praise

Dedication

Foreword by Sheryl Crow

Author’s Note

Introduction

PART 1: Breast Health Basics

Chapter 1: Breast Care ABCs

Chapter 2: Debunking Breast Cancer Myths

PART 2: Reducing Cancer Risk

Chapter 3: Eat This

Chapter 4: Don’t Eat That

Chapter 5: Beyond Food: What You Should Do

PART 3: Learn Your Personal Risk Factors and Control What You Can

Chapter 6: Uncontrollable Risk Factors: Do You Have Them?

Chapter 7: Medications and Operations to Consider

PART 4: Making Medical Choices and Living with Risk

Chapter 8: Breast Cancer Screening and Detection

Chapter 9: Cancer Happens: A Newly Diagnosed Starter Kit

Chapter 10: Now What? Life After Diagnosis and Treatment

Acknowledgments

Appendix: Acronyms and Abbreviations

Notes

Index

About the Publisher

Foreword

I’m embarrassed to say that when I first walked into my appointment with Dr. Kristi Funk, I wanted to turn around and leave. I thought, There’s no way this young woman whose beauty rivals Jessica Simpson’s can be the doctor I’ve heard so much about from my gynecologist and my internist as being someone who is widely known for her dedication and expertise to breast surgery. Boy, was I wrong! And furthermore, that appointment was one of the big blessings to come from my cancer experience. Not only was she then—and remains now—one of the finest breast surgeons a woman could have, but she also has been an inspiration and a friend to me ever since I walked into her office.

It was February 2006, and I was due to have my yearly mammogram. This one seemed to be more of a nuisance than ones in the past, because my engagement had just fallen apart five days before and I really didn’t want to be bothered with something I knew would be a waste of time. I was healthy and extremely fit, having spent the better part of the previous three years riding my bicycle up the sides of mountains—and I had no family history of breast cancer. I licked my wounds and went ahead and got it over with.

A few days after my mammogram, my gynecologist called me and suggested that I have two biopsies just to answer any questions that had shown up on the film, rather than waiting the recommended six months to view the areas again. She advised me to see Kristi Funk, who performed surgery a few days later.

I went through the painful process of a wire-localized open surgical biopsy and went home to resume the business of getting on with life. Four days later, I went in for my postoperative appointment with Dr. Funk. I will never forget the look on Kristi’s face when she told me that, although the odds of my having invasive cancer had been extremely minimal, mine was invasive, and I would need additional treatments. It was a blow of the first degree to someone who, until that point, had had complete and total control over every aspect of her life, or so I thought. And it seemed a blow to Kristi as well.

Now that I know Dr. Funk as I do, I believe each time she has had to deliver the outcome of a cancer screening that renders a malignant diagnosis, it has felt like a blow to her.

I got through my treatment uneventfully and went about rebuilding my life, personally and physically. Cancer was a game changer in the best and hardest of ways. I had to learn to put myself first, and I had to challenge what it means in a woman’s life to always nurture others but never to allow anyone to nurture her. I had to learn to say no and to be okay with not everyone liking or respecting me. I had to learn how symbolic breasts truly are and to accept that reality.

Accepting these truths seemed to be the lesson in the cancer experience for me—and from what I have heard from the countless women I have met in the most random of places who come up to me and share their cancer experiences, there is a lesson in it for everyone. Additionally, cancer changed my behavior; I had to learn about self-care and quality of living through nutrition and alleviating stress.

After some time passed, Kristi and her husband, Andy, and I met about their dream of opening a place that offered a “one-stop shop” where breast cancer screening, diagnosis, and treatment happened seamlessly and comfortably under one roof. I was all in. Their dream would eventually become Pink Lotus, including the free care they provide to underserved women via the Pink Lotus Foundation. The Pink Lotus Breast Center would offer the first contrast-enhanced digital mammograms in North America, combining Western medicine with complementary and alternative medicine, nutrition, psychology, physical therapy, genetics, and innovative technologies — and offering women holistic, whole-body view of health and wellness.

Over the years, I have learned so much about how to live a healthier life through diet and exercise and meditation. I wince every time I hear from someone I know or someone who is distantly connected that they’ve been diagnosed with breast cancer or cancer in general. The 1 out of 8 statistic seems to hold on, but we are learning more about prevention, and until there is a cure . . . well, early detection is a great help, but prevention is the greatest hope for us all.

Over a decade later, I remain grateful to Kristi for continuing to be driven to learn more about how to outsmart this insidious disease. Whether you live with or without breasts, there is so much to know and so many things one can do. Navigating it all can become confusing, especially with all the contradictory advice out there. Dr. Funk’s book is a gift to women everywhere looking for answers to breast issues and to health in general. Kristi shares what she learns in the hopes that eventually she will be out of a job as a breast cancer surgeon!

—Sheryl Crow

Author’s Note

My mom was thirty-six years old and had five children under the age of fourteen (I was two) in December 1971. She was in peak fitness as a competitive A-level tennis player who swam daily when she suffered a stroke and inexplicably fell into a coma that lasted three weeks. The UCLA doctors told my father on multiple occasions not to leave for home that night, for she would surely die by morning. A priest administered the sacrament of last rites, which I believe made heaven take notice: Oh heck no, we aren’t ready for that ornery MaryAnn; give her another fifty-plus. So she woke up! (If you ever meet me—and I hope you do—ask me how she woke up.) My mom remained in rehab for a year before returning home, relearning how to speak and how to walk, since she would never move her right side again (hemiparesis). All of my parents’ “friends” disappeared and my dad downsized the house, but his love for her never diminished; in fact, it grew. To this day, in their late eighties, he defends her fiercely and assists her tenderly. How could you not cherish a warrior who stared down death and won—without speaking a word?

That’s where I come from, and that’s what I offer you. I possess the dogged determination and tenacity of my mother, mixed with the empathy and compassion of my father. So when you fling excuses and hopelessness at me, I will whack you with a reality check. And when you come to me scared and broken, I will hug you until you’re whole again.

After my relationship with God, I only really care about two things in this life: loving family and killing cancer. You picked up this book. You’re family now, so let’s get going.

Introduction

From the age of four, I wanted to be an actress. (Ha! You thought I was going to say I always wanted to be a doctor, didn’t you?) I performed in every school play, beginning with Sleeping Beauty in the second grade and continuing all the way through college, when I starred as Oedipus in an all-female production. Yet Hollywood was never my endgame. I actually pictured myself helping children heal from illness, using drama and imaginative play to explore the feelings and fears brought on by sickness.

Cut to my sophomore year as a psychology major at Stanford University, when I experienced an epiphany that would both change my course and guide it to this day. In the midst of studying for a neuropsychology final, painstakingly trying to memorize which neurotransmitters in the brain led to which functions of the body, I experienced an unmistakable and repetitive “interrupting thought” that made my own neurotransmitters buzz. It came from God.

You’re going to be a doctor, it said. Whoa.

Okay, that was interesting. Incorrect, but interesting. You see, my female role models married young, and all I wanted was to raise a family and work as a drama therapist. I traveled to Africa a week later on a summer missionary trip that had been planned for months. When I saw firsthand the health challenges that millions of men, women, and children face, my life’s purpose snapped into shape—and not in the form of theater or therapy. I felt newly inspired to care for people in the one way that matters most to them—by helping them maintain the very vessel that carries them around all day: their bodies. Disease robs far too many people of joy, replacing hope with chronic illness and death. It isn’t right. As I sat cross-legged in a dung hut, balancing potatoes on my head to make the tribal kids laugh, I decided to do something with my life to try to stop the killer of joy: I heeded God’s voice and resolved to become a doctor.

I went to medical school, did my residency in general surgery, and then completed a surgical breast fellowship at Cedars-Sinai Medical Center. I stayed on to become the director of patient education at their breast center, where I gave a number of community and physician lectures. Most women don’t want to hear about cancer unless they have it and need to make some decisions, so rather than bore them to tears with medical jargon, I challenged my audiences by discussing attention-grabbing studies that would incite them to alter their behavior. I delved into risk reduction and discovered all sorts of lifestyle game changers. I loved the work, and patients responded like crazy. I couldn’t wait to get to the office to spend all day examining and educating women, operating with curative intent, and becoming creative when a diagnosis or cosmetic issue became challenging. Everything I did back then and continue to do today—helping women boost their health, reduce their breast cancer risk, make sense of a diagnosis, or find their way after treatment—inspired the book you’re reading now.

A MULTILAYERED PROBLEM

Whether perky or droopy, full or flat, for two organs perched front and center on half the population’s chests, it is pretty crazy that breast health remains rather mysterious to many breast owners. Most women don’t know much about their breasts, what their purposes are, and how to keep them healthy so the rest of their bodies can thrive. Everyone knows that breasts can grow cancer, which is the number-one killer of women ages twenty to fifty-nine, yet there’s never been a solid and informed conversation about how to reduce our risk factors for this disease and why certain precautions might help.

Any breast health conversation needs to focus on two problems: numbers and knowledge. First and foremost, breast cancer is a pandemic concern, and the numbers sure prove it. In the United States alone, 1 in 8 women will be diagnosed with breast cancer at some point in their lives. Every year, we identify 1.7 million new breast cancer cases worldwide, with over 300,000 in the US. Interestingly, incidence rates vary fourfold across the globe, ranging from 27 per 100,000 in Middle Africa and Eastern Asia, to 93 in the US, to 112 in Belgium, and it’s not the weather that accounts for these global disparities. If this freaks you out, you’re not alone.

Based on my experience as a board-certified breast cancer surgeon who has helped tens of thousands of women navigate breast health issues, I know for a fact that we have the power to reduce our breast cancer risk in achievable and dramatic ways. Enter our second big problem with breast cancer awareness: erroneous public perception. Most women believe that family history and genetics determine who gets breast cancer, but for most people, they don’t. Inherited mutations, like BRCA, only cause 5 to 10 percent of breast cancer; in fact, 87 percent of women diagnosed with breast cancer do not have a single first-degree relative with breast cancer.¹

I’ll give you a minute to pick your jaw up off the floor.

For the last thirty years, the medical community has not corrected the false notions held by the majority of breast cancer survivors who attribute their breast cancer entirely to family history, environmental factors, stress, or fate—all factors predominantly not under their direct control.² Yet research tells us that if, before reaching menopause, women embrace a lifestyle that prioritizes exercise, not smoking, not drinking alcohol, and a diet shifted away from meat and dairy toward whole food, plant-based eating, their odds of getting breast cancer are slashed in half. And for older women, risk drops by 80 percent.³

That’s right. You have the opportunity to impact the way you behave toward your breasts and how your breasts respond to that behavior. Rigorous science and firsthand experience in the trenches back up everything I know to be true about breast cancer risk reduction and care. The women I treat are exactly like you. They share your concerns about any new mammogram finding, pain, lump, itch, or discharge. They want to know if there’s anything new under the sun that they can do to ward off this disease. Most of the patients who heed my diet, lifestyle, and medical advice come away from our conversations feeling empowered and relieved, gaining clarity over “the right thing to do.” Depending on the changes they make, women might also notice that their fibrocystic lumps and pain disappear, their obesity or diabetes improves, or they find themselves cancer-free year after year.

I must mention here that having an unhealthy lifestyle doesn’t guarantee a future breast cancer diagnosis; similarly, we can never know with certainty that lifestyle choices caused the cancer you might have already had. Moreover, even women following an ideal lifestyle get breast cancer (although not as frequently, as we shall repeatedly see), and boy, are they upset. “I did everything right!”

That being said, the changes I’m about to suggest in this book don’t just serve your breasts well. Oh no, ladies. They also yield lower cholesterol, better triglycerides, perfect blood pressure, fewer heart attacks, a leaner body, less diabetes, painless joints, more energy, better sleep, a happier mood, an improved sex life, a sharper mind, less dementia, smoother skin, regular bowel movements, cleaner lungs, less cancer in every single organ in your body, a healthier planet, and a longer life. If you practice what I teach, you will radically reduce, if not completely prevent, many of the illnesses that ultimately lead to chronic and life-threatening diseases. You’ll feel a boost of happiness and satisfaction. You’ll implement your goals with ease—and never look back.

A PIONEERING APPROACH TO BREAST HEALTH

Since I founded the Pink Lotus Breast Center in Los Angeles in 2007 alongside my husband, Andy Funk, our mission has been to fuse state-of-the-art breast cancer screening, diagnosis, and treatment with preventive strategies and holistic, compassionate care. We’re out to save lives in a way that eliminates fear, instills confidence, and provides hope in a moment of panic. Pink Lotus aims to transform the delivery of breast health care in America and to help as many women as possible, regardless of their income or status in life. We see thousands of patients every year, with a wide range of concerns, and do our best to accept most insurances, including Medicare. For low-income uninsured or underinsured women, the Pink Lotus Foundation provides 100 percent free breast cancer screenings, diagnoses, treatment, and support to those who otherwise might not be able to receive any care at all.

I am incredibly grateful that occasionally working with prominent celebrity voices affords me the unique opportunity to get my message about breast health and risk reduction into the world. Three days after I removed Sheryl’s breast cancer, she arrived in my office with a paper in hand and revealed, “I want to go public about this. Can you please fact-check this press release?” And Angelina Jolie’s New York Times op-ed, “My Medical Choice,” led to a permanent increase in BRCA testing documented around the world.⁴ I consider it an honor and duty to continue the conversations they started.

While I’m best known as a surgeon, my ultimate mission as a physician is to get to people before they need to go under the knife. I do everything I can to teach others about breast health—I appear on television, contribute to our Pink Lotus Power Up blog, give lectures, publish articles, perform research, and sponsor campaigns. I want to empower you with facts and arm you with strategies to help you understand your breasts, reduce your cancer risk, and open your eyes to life-changing interventions and treatments if you are diagnosed with the disease.

HOW TO USE THIS BOOK

Educating yourself on breast health simply requires a commitment to living your best life. We should never die from something we can largely control. Can we control breast cancer? Admittedly, a percentage of breast cancer occurs in women who seem to have mastered all the things that promise to maintain health and wellness throughout life. Until that elusive cure or prevention vaccine shows up, our best efforts will occasionally be thwarted by uncontrollable mutations and unrecognized causes. Nevertheless, you do have significant power over this disease—let’s use it. A solid 50 percent—and perhaps as much or more than 80 percent—of all breast cancer could be eliminated from planet Earth if women understood that daily choices like food, drink, exercise, weight, toxic exposures, and mind-set create the environment inside the very cells of our breasts, which either stay healthy or turn malignant.⁵ Every single day, we make countless choices that bring us closer to cancer or move us farther away. The easiest cancer to cure is the one you never get.

Here’s what you can expect as you move through all these pages. I suggest reading the entire book to best comprehend all the important information it contains, but I certainly understand if you want to jump directly to the sections that apply to you and your interests. To that end, let me give you a little direction so you can navigate straight to the topics that intrigue you most.

In the first half of the book, I focus on boosting your breast savvy and teaching about lifestyle choices that reduce your breast cancer risk. In part 1, you’ll learn how to care for your breasts and never again mind the myths surrounding breast cancer’s causes. I have spent much of the last two decades researching the connection between lifestyle and cancer, and many of the things you’ve heard cause breast cancer are false. In part 2, we’ll discuss what else you can do besides showing up for your yearly mammogram and hoping that you don’t find a lump in the following 364 days. I’ll help you reduce your cancer risk based on food and lifestyle changes, particularly those that keep estrogen in check, since estrogen fuels 80 percent of all breast cancers. The healthiest meals are plant-based, low fat, and high fiber: an abundance of fresh fruits and vegetables (preferably organic), 100 percent whole grains like brown rice and oats, nonanimal proteins such as lentils, beans, and soy, with a cup of green tea on the side. I will also talk about choices like supplements, exercise habits, weight control, and hormones that can impact risk.

In the second half of the book, I’ll explore uncontrollable risk factors for breast cancer, plus outline your medical choices if you’re at elevated risk for, newly diagnosed with, living with, or navigating life after breast cancer. In part 3 specifically, I’ll detail the operations and medications that mitigate risk. I field a lot of questions from patients about genetics and BRCA mutations in particular, and will share the latest research on mutations and what they mean for you. The key with uncontrollable risks is to understand them and then to use them to inform controllable choices. And if you do have elevated risk, this doesn’t mean there is a one-size-fits-all protocol. Some patients choose prophylactic surgery. Others don’t want to go anywhere near the knife but take preventive medications. Still others decide to improve lifestyle factors combined with an aggressive screening regimen. If you’re struggling with medical choices, in part 4 I’ll help you find a path that leaves you feeling confident and comfortable with your decisions. I will review surgical options, explain the differences between lumpectomy and mastectomy, endocrine and immunotherapy, radiation and chemotherapy, and address specific questions I repeatedly hear at my center.