Science News recently reported on a new study that examined the incidence of falling in women who are breast cancer survivors.

The study, scheduled for publication in the April issue of the Archives of Physical Medicine and Rehabilitation, speaks to a higher incidence of falling among women who have survived breast cancer than their in peers who haven’t had breast cancer.

Researchers from the Oregon Health & Science University Knight Cancer Institute, Portland, asked post-menopausal breast cancer survivors whether they had fallen in the past year and then tracked their falls over a six-month study period.

“Our study is the first to consider how breast cancer treatment may increase fall risk by using a comprehensive set of objective measures of fall risk and by exploring mediators of the treatment-falls relationship,” commented Kerri M. Winters-Stone, PhD, Associate Professor and Associate Scientist, Oregon Health & Science University, School of Nursing and a member of the Knight Cancer Institute. “Our findings suggest that recently treated postmenopausal breast cancer survivors have higher rates of falling compared with population averages for community-dwelling older adults. Balance disturbances may explain how treatment could have contributed to falls in breast cancer survivors.”

Investigators found that 58% of breast cancer survivors had experienced a fall in the previous year and almost half (47%) fell within 6 months after joining the study, a rate nearly double the 25% to 30% annual fall rate reported for community-dwelling older adults over 65 years of age.

Researchers measured a comprehensive set of neuromuscular and balance characteristics known to be associated with falls in 59 study participants.  The study findings suggest that balance problems may have been related to changes in the vestibular system that were associated with chemotherapy treatment.

Professor Winters-Stone stated, “Falls in breast cancer survivors are understudied and deserve more attention, particularly in light of the increase in fractures after breast cancer treatment and the relationship of falls to fractures. Our findings add to growing evidence that fall risk is increased in breast cancer survivors and that vestibular function may underpin associations between breast cancer treatment and falls.

The following guest post comes from Heather Stempka, two-time breast cancer survivor, Founder and President of Linked By Pink.

 Linked By Pink (LBP) is an Erie, PA based nonprofit organization. While we are a resource for all breast cancer patients, we do focus on those diagnosed under the age of 45. We provide emotional and financial assistance to those who have been diagnosed with breast cancer.

As a two-time breast cancer survivor and founder of LBP, I know firsthand how a diagnosis can emotionally, physically and financial effect someone’s life. When I was diagnosed in 2007, during my second journey of breast cancer, I realized I wanted to become more involved in the battle against this disease and connect with others.

I began a search in my local area for other younger women. When I found them, we rallied together to raise funds for two local organizations and realized that we had an incredible common bond. We also realized a need in our community.

With the help of Norma Zimmer, co-founder of LBP, we created an organization that gives support to those diagnosed in our community.

We host monthly get togethers in Erie, PA that provide support and education for those who have or have had breast cancer. We are also known to have impromptu meetings for coffee if the need arises. We have women as far as 25 years out to those who are just starting the journey. We have women diagnosed from in-situ to Stage IV.

Our programs include a medical and transportation grant. This grant is for medical expenses that are related to a breast cancer diagnosis. The maximum allowance for a patient is up to $500 per year and $100 for transportation costs. Applicants need to fill out an application and meet specific criteria for grant approval.

We also provide two scholarships to graduating seniors in our community that had an immediate family member diagnosed with breast cancer. The award is a one-time, non-renewable scholarship in the amount of $500.

We also provide baskets to newly diagnosed patients and give out gift certificates to those who are recovering from a breast cancer related surgery to lighten the burden while recovering.

LBP Members

To fund the programs we have available, we host fundraisers throughout the year including an annual bowling tournament in February; a softball tournament in August, and BreastFest: A breast cancer awareness music festival featuring local bands in October. Our biggest fundraiser is our yearly calendar that features breast cancer survivors who share their incredible stories of survival.

To find out more about Linked By Pink and the programs we have available to breast cancer patients, please go to our website at www.linkedbypink.org and make sure to like us on Facebook to keep up to date with what’s happening and how you can get involved in Linked By Pink!

The Internet gives us the ability to do our own breast cancer research, which is both a blessing and a curse.

Most of us do not know much about breast cancer until we ourselves are diagnosed with the disease. Then we go to our computers and begin searching madly for answers when we are not even sure of the questions to ask.

We look to find something, anything to make us feel better; to restore some sense of control over lives. If we are lucky, we find ourselves on a reputable site that has accurate information about breast cancer explained in a way we can understand.

Unfortunately, there are a lot of Internet sites that offer incorrect, misleading and deceptive information about breast cancer, its treatment and outcomes. Landing on these sites and taking what they say as gospel can cause confusion and anxiety.

If you or a loved one are recently diagnosed with breast cancer the American Cancer Society (www.cancer.org) and the National Cancer Institute (www.nci.nih.gov), have websites on the Internet and they are good places to begin your research. These reputable sites provide information you can trust on treatment, cancer screening programs and cancer support groups.

Organizations such as Y-ME (www.y-me.org) offer 24/7-365 days a year hotline support. I can attest from personal experience that the survivor who spoke to me after my first diagnosis was a godsend. She helped me put everything in perspective.

Once diagnosed and referred to a surgeon and a treatment facility, you can do your homework and use the Internet to find websites that will give you information about the qualifications of the surgeon and the reputation of the treatment facility.

Once in treatment, you can search the Internet to  find a support group to attend in your home community.  If you are not feeling up to being physically present in a support group, there are sites that can give you information about corresponding with other survivors via email. Some organizations offer access to telephone support groups.

What makes much of the information on the Internet questionable is that there are no quality control guidelines or restraints on the health care information or advice provided online.

What does this mean for you? Unfortunately, it may mean that the burden of sorting out who is who is up you. How do you, when just diagnosed and in a state of anxiety, differentiate between legitimate health care organizations, those individuals who have sites and want to be of help but are misinformed, and groups engaged in health fraud?

Another danger resulting from no quality control of health care information on the Internet is it can lead to a person drawing conclusions that are not accurate for her type of breast cancer.

When you choose to gather breast cancer information on the Internet err on the side of caution and :

• Look for sites that are known breast cancer organizations or medical institutions.
• When you get to a site, check for facts, not opinions. It’s only natural to want to find alternative treatments to the one that have been recommended for you but remember the standard treatments are standard because they have a track record of success.
• Don’t form opinions or make decisions on your own, but review all information with a health professional. Remember that what applies to one person may not apply to you.
• Be sure to tell your doctor if you are thinking of trying other therapies. Some alternative therapies can be dangerous.

Until recently, it was considered that only women and men who had chemo as part of their treatment for breast cancer might  have cognitive issues as survivors. A new study challenges that theory, pointing to survivors who did not have chemo also experiencing cognitive problems after treatment.

An article in Science News, published in December 2011, reports a study found that breast cancer survivors may experience problems with certain cognitive abilities several years after treatment. This may occur whether they were treated with chemotherapy plus radiation or radiation only.

I found the article of particular interest as I did not have chemo, but during and after radiation I had a difficult time with recent memory retention. So much so, that I had to carry pen and paper with me and write down what I needed to remember an hour or days later. When I referred to my notes, I often had no recollection of  what I had written or why it was important to me. Frightening, to say the least. In speaking with my radiation oncologist, he kindly, but firmly dismissed it as “nerves” and not from radiation treatment.

To compare the effects of different types of cancer treatment on such cognitive abilities, Paul Jacobsen, PhD, of the Moffitt Cancer Center and Research Institute in Tampa, and his colleagues examined 62 breast cancer patients treated with chemotherapy plus radiation, 67 patients treated with radiation only, and 184 women with no history of cancer. Study participants completed neuropsychological assessments six months after completing treatment and again 36 months later, which is further out from the end of treatment than most previous studies of this type.

The investigators found that breast cancer survivors who had been treated with radiation (and not chemotherapy) often experienced cognitive problems similar to those in breast cancer survivors treated with both chemotherapy and radiation. They did not find that hormonal therapy (such as tamoxifen) caused cognitive difficulties.

“These findings suggest that the problems some breast cancer survivors have with their cognitive  abilities are not due just to the administration of chemotherapy,” said Dr. Jacobsen. “Our findings also provide a more complete picture of the impact of cancer treatment on mental abilities than studies that did not follow patients as long or look at cognitive abilities in breast cancer survivors who had not been treated with chemotherapy,” he added.

What follows is a guest blog from Pat Prijatel. Pat is the creator of the Positives About Negative blog and the author of Surviving Triple-Negative Breast Cancer (to be published in autumn 2012),  both motivated by her own journey through triple-negative breast cancer.   She is a recognized authority on the magazine industry as co-author of The Magazine from Cover to Cover, now in its third edition.

As head of the magazine sequence at Drake University, she was an award-winner teacher, the first woman to become a full professor in the School of Journalism and Mass Communication, and the E.T. Meredith Distinguished Professor.   She was also the first director of the School of Journalism and founder of the E.T. Center for Magazine Studies.

Before I was diagnosed in 2005, I thought breast cancer was a one-disaster-fits-all disease.   I believed all breast cancers were fueled by estrogen, and that, as a 60-year-old woman who had never taken hormone replacement therapy, I was not at risk of breast cancer of any flavor.

My fear and confusion were magnified when doctors started talking about the fact that I had an especially dangerous form of breast cancer. (As though I had thought there was cancer that wasn’t dangerous.)

I hit the Internet and found medical journals that helped me understand what was going on in my body.  Hormone-negative breast cancer defied my expectations of the disease.  It does not play by the rules I considered normal.  I expected it to mostly affect postmenopausal women whose estrogen supplies were depleted.  Not so. As women age, they are more likely to get the more common form, hormone-positive.  Younger women get hormone-negative.   I thought all breast cancer responded to tamoxifen, but found that hormone-negative does not.

The medical books I pored through spent little time on hormone-negative. Still, up to 20 percent of all breast cancer patients—170,000 a year worldwide—have this disease.

So I wrote a book, Surviving Triple-Negative Breast Cancer, to be published this fall by Oxford University Press.  It is a more organized offshoot of my blog, Positives About Negative.

Things have changed drastically in terms of research since my diagnosis nearly six years ago. (Six years!)  Hormone-negative, especially triple-negative—estrogen-negative, progesterone-negative, and Her2/neu-negative breast cancer—is now a major area of medical research, which is yielding new treatments and prevention strategies.   The term triple-negative breast cancer first appeared in medical literature in 2005.  Since then, it has appeared in more than 600 different publications. So, those of us with this disease are now benefiting from a great deal of new information.  We’re no longer the wallflowers at the breast cancer prom.

The process of educating myself about this disease was difficult and time-consuming. I benefited from already knowing my way around a research paper, plus I had easy access to journals through the university library.  I began writing magazine articles about breast cancer, which allowed me to interview top researchers in the field, a serious payoff to my decision 40 years ago to become a journalist. But what about all the other women without the benefits I enjoyed, who didn’t have the advantage of that research?

 In my book, I explain and describe this disease through several lenses.  First is my story, which I regurgitate early on and use sparingly throughout the rest of the book.  Second are the stories of wonderful women throughout the United States—in their 20s, 30s, 40s, 50s, and 60s— who have fought this disease.  Several have been disease-free for decades, others for only a few years.   I try to present their stories honestly, showing that this can be a harsh disease and that fighting it is no picnic.  I focus on the fact that most women survive, but acknowledge that this disease can be a serious threat.  I have dedicated the book to the women I have met who have died from triple-negative.

Third is the research.  In most cases, I rely on articles published in peer-reviewed journals, such as the Journal of the American Medical Association, New England Journal of Medicine, Journal of Clinical Oncology, Annals of Internal Medicine, and Annals of Oncology. I use footnotes throughout; I have learned through my blog that my readers appreciate being able to go back to the original research.

I do not intend this to be a book on all aspects of cancer—just one that fills the gaps other books leave in our understanding of triple-negative and other forms of hormone-negative breast cancer.  I am not a scientist nor do I pretend to be one.  I have spent five years with my nose in this disease and I am sharing what I know, what I have experienced, and what others have experienced.  All medical information has been fact-checked and verified.

When I began this project, I was thoroughly intimidated by it and often asked myself why I was writing this book and not the people who have researched this disease.   But, I realized, no book exists, so somebody has to do it.  And, as I progressed, I realized that I had a unique and valuable perspective, as a woman who has dealt with this disease and as a journalist and educator.  I can infuse the book with the voices of this disease; I can show the who as well as the what of hormone-negative. I can look at it from all angles, the way a patient does. I know when clarification and expansion are necessary and when words such as aggressive and deadly need interpretation so they explain rather than frighten.  I can give readers a sense of control in addition to information.

My goal is to inform, educate, calm, encourage.  Through women’s stories I show that this disease can be beaten. Through research I show how.