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Less Is More, or at Least Equal

By on September 2nd, 2011 Categories: Treatment & Side Effects

[Editor's Note: This post was originally published on Diana's personal blog on February 9, 2011. Breastcancer.org covered the study results she mentions here: Sentinel Node Dissection Poses No Breast Cancer Survival Hazard.]

In case you’re a day or two behind with ‘big news,’ yesterday really big news regarding standard breast cancer treatment was released indicating that there is no decrease in life expectancy in women diagnosed with breast cancer that has spread to the axillary lymph system who have only a sentinel lymph node removed versus those who have had a full lymph node dissection.

This is important information for all women to know, and thank goodness these researchers went ahead with their study to evaluate “conventional wisdom,” even though some cancer centers refused to participate, saying it was unethical. (I suggest reading the full article from the New York Times and/or JAMA for further information about the women included in this study and discuss with your own doctor how these results may or may not be applicable in any specific breast cancer case.)

I am glad science (and resulting medical care) keeps marching on and changing based on more thinking and understanding (someone asking “why not?” instead of just “why?”), in this case, changing to be less damaging to women undergoing this drastic surgery of removal of large numbers of (potentially healthy) lymph nodes, leaving them with increased risk of developing multiple physical problems. Even though I have been very fortunate to not have had to suffer with the development of lymphedema since either surgery (1984 and 1995), I know that it could still develop, and I am one of these women for whom neither right or left shoulder, arm, or hand function or sensation has ever returned to normal.

I have been left with limitation of the use of both of my arms (and I had to beg for physical therapy in 1995 to even get back as much range of motion and function as I have in that arm and shoulder). In addition, I had significant pain in my arm after my 1995 surgery for which my surgeon offered no post-op explanation, advice, let alone any sympathy. Eventually 3+ years after my surgery, I casually mentioned this pain to a massage therapist (I had gone for another reason) who worked specifically with shiatsu therapy on that pain. Even though I was pleasantly skeptical that anything would help, and almost did not go back to the second appointment because the first session initially increased the pain level in that arm, I burst into tears during the second session when I could actually feel the pain traveling down my arm, leaving my body through my fingers, never to return. I still have all the same movement and sensation limitations I had developed post-surgery, but at least I continue to be pain-free, which has been a huge quality of life improvement.

Oh my, that experience sealed the deal with me to be forthright in saying our ‘conventional medicine’ as practiced here in the US knows just the tip of the iceberg about how the body works, how the body heals, and how to prevent or treat illness with minimal ‘collateral’ damage and in a manner that takes into account a person’s humanity.

I share all this not for sympathy but to share a real-life example of why this finding is important, why the research itself was important, and to say thank you to the researchers who initially questioned the conventional standard of care and pursued the study (in spite of challenges) in order to provide data that will now allow more humane treatment for many women diagnosed with breast cancer without sacrificing long-term life-expectancy.

I have just received a copy of all the research projects being funded by The American Institute of Cancer Research (AICR) for 2011, from among which I will choose the one where money from The Diana Dyer Nutrition for Cancer Survivors’ Research Endowment at AICR (funded by proceeds from the sale of my book A Dietitian’s Cancer Story) will be focused. I have not even glanced at them yet, they are always all very interesting, but this year I think I will look at them thinking which one is asking “why not?”, i.e., which one is questioning standard of care. Of course, since for so long the lack of nutritional care during and after a cancer diagnosis has been considered the standard for cancer care, it is likely that all of these studies could fit my thinking this year!

No, no, I’m not a cynical person, in spite of how that last sentence may have sounded! I’m always looking forward with hope and action. Hopefully (hope), you or someone you know will be able to put this information to use (action), too. My endowment was founded for those two reasons.

Diana is a wife, mom, organic farmer, Registered Dietitian, and author of the book A Dietitian's Cancer Story. In between all that and more, she is a multiple-time cancer survivor. Diana's website, CancerRD.com, focuses on nutrition information for cancer survivors. She began her blog, DianaDyer.com, to share a wider scope of thoughts about life as a cancer survivor, food and nutrition, gardening, recipes, our environment, and the urgent need for developing food systems that promote health not disease, ecological sustainability, and social justice. Photo credit: Dick Dyer

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