First, a confession: I’m an exercise addict. “Just do it?” Well, I’ve done it AND loved it: running, tennis, biking, skiing, yoga, Pilates, Zumba, and boot camp workouts. I cherish the memory of feeling fit and running 6 miles on a beautiful sunny morning the day before my mastectomy. It’s a goal of mine to run that far again sometime soon. We all know of the benefits of regular exercise for energy, body image, and overall health, but regular exercise has also been demonstrated to prevent both cancer and its recurrence.

A 2005 Harvard study found that just walking on a regular basis helped women diagnosed with breast cancer reduce the risk of recurrence (I love the title of the article presenting this study: “Giving cancer its walking papers”). The study followed the walking habits of 3,000 women who’d had a breast cancer diagnosis. Those who regularly walked 3 to 5 hours a week (or got comparable exercise) were 50% less likely to have a recurrence of their cancer than women who exercised less than an hour per week. Translated, that means a whole variety of potentially enjoyable activities, like gardening, hula hooping with your kids or, my favorite, salsa dancing with Bradley Cooper, count as exercise.

But some people are not motivated by a medical prescription for exercise; to start and stick with an exercise routine, it has to make them feel good, and it has to be FUN.

Here are three ideas (but there are many more) for integrating exercise into your life, all registering high on the fun meter:

Talk the Walk

Following my surgery, more moderate exercise, like walking, was recommended for me. Although I missed running, I set up walking “dates” and walked nearly every day with a friend or family member. Walking “dates” were fun: sharing neighborhood gossip, swapping funny family stories, solving the worlds’ problems, AND simultaneously getting exercise. These walking dates raised my spirits, kept me connected to family and friends, and gave me an energy boost. Were these walks exercise? Yes, but most days they doubled as therapy as well.

Dance Your Way There

Are you someone who loves to get out on the dance floor at a wedding, party, or other event with music? When you think about it, who doesn’t enjoy shaking it up with friends? That’s Zumba. Zumba is a fitness class that combines dance and aerobic elements, choreographed to popular or Latin music. It’s da bomb. The music gets turned up loud, the moves are easy to follow, and you get a complete body workout; energy fills the room, you feed off of it during the class and take it with you afterwards. And you can’t help but develop a sense of community and camaraderie with others in this crazy class. I took Zumba classes during chemo, modified them as needed, and loved laughing and dancing in the face of cancer, no gracefulness required.

Take a Joyride

Aside from walking while I was in treatment, I biked. Our area, like many others, has a number of bike trails. I love exploring new trails, no cars, smooth riding, and, most of the time, beautiful scenery. You can ride with family or friends, young or old. Biking can make you feel like a kid again, and it’s the green way to travel.

Biking can be also be a cool adventure and sometimes much more. Just after I finished chemo, I went with my husband to Arizona. A highlight of our trip was a morning of mountain biking on some trails through Sedona, Arizona, led by our guide, George. The trails we were on were filled with rocks and had some steep inclines that we had to learn to navigate both up and down. These were George’s instructions:

• Keep your eyes focused on the terrain in front of you (i.e., don’t look down, even though there are some BIG rocks underneath you); that’s the only way you’ll be able to appropriately switch gears and handle what’s ahead.

• Trust your bike; it’s designed to handle the rough terrain as long as you have faith in it.

• When going over the big rocks, stand up off the seat and work on keeping your feet and body balanced.

• Don’t forget to take in the scenery.

The mountain biking instructions were, simply stated, some of the life lessons I was trying to learn while navigating my personal journey through breast cancer: keep your eyes focused ahead, trust yourself, try to stay calm and balanced, and don’t forget to find joy in what surrounds you.

That bike ride was much more then exercise for my physical health, it enhanced my spiritual health as well – and was a laugh-out-loud good time.

Finding something you enjoy doing can make exercise fun and invigorating, connect you to others, help you meet some interesting people, see some exciting things, and might teach you a thing or two about yourself as well. Stretch your boundaries, shape YOUR exercise program to benefit both your body and spirit – and give cancer its walking papers.

Genetic counselors and some breast specialists and oncologists are trained to discuss the possible results and benefits of testing and to help you be certain that genetic testing is both medically appropriate and personally and emotionally right for you. These experts can also help you consider the possible strategies to reduce your risk should the results be positive.

Most women experience great relief if the test results are negative. But they may also have questions about why they or a loved one developed breast cancer that looked potentially high-risk. If other family members have positive test results this can lead to a range of emotions and potentially complicate family relationships. Test results can be inconclusive as well. It’s common to get a result that says “indeterminate,” which means that no known abnormality was found to explain the cases of breast and other types of cancers running in a family. This kind of report can make you continue to feel uncertain.

When the results are positive for genetic markers that are high risk for breast and ovarian cancer, intense feelings are a natural reaction. Anxiety, sadness, anger, guilt, and many other feelings may be experienced. These feelings can occur early in the process when deciding whether to test, while waiting for results, or after the results are known. These intense feelings are a normal reaction to this very stressful experience. It can be helpful to have discussed and thought through the options to minimize cancer risks before knowing these results. While there is no need to have a definite plan in place before receiving the results, thinking through the options can help you prepare for the possibility of a result indicating increased risk. Most women choose to bring along a partner or trusted friend when going to hear the results of the testing.

A positive test result for the genetic markers indicating increased risk frequently creates anxiety over family and other issues. How will family members react to learning that your test was positive and that they may be at increased risk? Think over how sisters, adult daughters, mothers, and even cousins and others may react and how you will share this difficult news. Each family situation is unique. Each individual within the family may have very different reactions and may choose different ways to deal with the same news. When you choose to tell family members who may be at risk, they will need time to process this upsetting information and to decide what they will do to assess their risk.

Mothers may feel worried and guilty about the possibility of passing their genetic mutation onto a child. Adult children and close relatives may choose to be tested themselves. Mothers frequently worry about daughters far too young to be at immediate increased risk.

Anger is also a normal reaction to finding out that you have a genetic mutation that places you, your children, and other loved ones at increased risk of developing a life-threatening illness, or anger at learning that this is why a loved one died before we knew about genetic mutations and ways to lower the risk of breast cancer.

Angelina Jolie’s courageous decision to make her choice of preventive mastectomy public is so helpful in a culture that sometimes emphasizes women’s body appearance over their health. Her announcement reaffirms that beauty and femininity do not depend on breasts. Her public statements made it clear that reconstruction worked well for her and that a supportive partner can value health and peace of mind over breasts.

Mastectomy evokes emotions beyond those of major surgery. The option of reconstruction creates additional medical choices. However, the loss of a body part with or without reconstruction may cause sadness as well as relief that a potentially deadly illness has been prevented. Powerful feelings about body image may need to be acknowledged and worked through. It can feel different when the decision is preventive rather than the removal of a known cancer. Sadness and loss, as well as relief may come all at once, or later on, after the physical healing process has occurred. Expecting a wide range of normal emotional reactions can be helpful when you are going through the whole process.

Some women choose not to test. This, too, is a valid personal choice. Choosing not to test is something you can revisit later if the need arises. Situations change and new tests are and will be developed. If you are at high risk and choose not to test, you can seek advice again in the future and decide on other medically appropriate ways to monitor your breast health.

Knowing your risk status allows you to choose to reduce your risk through medication, careful medical monitoring, preventive surgery, or some combination of interventions. Testing allows you to make a choice that is right for you with the help of a genetic counselor, breast specialist, or oncologist. Each woman’s physical and emotional needs are her own.

When anxiety, sadness, or anger continue or feel overwhelming, or ongoing difficulties with partners or family members persist, it can be helpful to seek additional counseling from a psychologist or other mental health professional with special expertise and experience in health issues.

Most women eventually work through this roller coaster of emotions and feel empowered by the information needed to make choices that will help protect their lives.

Everyone has BRCA1 and 2 genes (BReast CAncer genes one and two). The function of the BRCA genes is to repair cell damage and keep breast cells growing normally. But when these genes contain abnormalities or mutations that are passed from generation to generation, the genes don’t function normally and breast cancer risk increases. Abnormal BRCA1 and BRCA2 genes may account for up to 10% of all breast cancers, or 1 out of every 10 cases.

Myriad has held a patent on these gene sequences for over a decade. The scientists challenging the company say that you can’t hold a patent on something that occurs naturally, even if you discovered it. They say giving exclusive rights to Myriad limits others’ ability to use the BRCA sequences to develop new therapies and tests. Women with these gene mutations, as well as breast cancer advocates, are concerned that the patent is stifling research and new discoveries that could help save their lives now. They contend that any obstacle in the way of progress in research must be removed. The removal of these limitations could help patients by reducing the costs of new tests and therapies and by stimulating potentially life-saving discoveries.

Myriad says that they need the patent in order to ensure profitability, so that they can attract investors and have enough funding to surmount the enormous costs of bringing the BRCA test to market. For example, one supporter of the company said that the average cost of bringing a new drug, therapy, or test to the market is 1.2 billion dollars. Myriad and its supporters are concerned that if the business isn’t profitable, discovery and innovation simply will not happen.

But the need to make money and the need for innovation is not what’s being argued in this case. The fundamental question is whether or not the sequence of a gene is patentable. In arguments before the court, several analogies were made. Imagine that the BRCA sequence is a baseball bat. The bat is cut out of the wood and is invented and therefore patentable. No one knew the bat was there until someone came along and thought it up and cut the wood in just the right places. Another analogy likened the sequence to the ingredients for cookies: eggs, flour, etc. You could patent a certain combination of the ingredients (a new type of cookie for instance) but you cannot patent the ingredients themselves.

Personally, I believe that more competition and variety in the marketplace of ideas will yield the best results for my patients. I also acknowledge the fact that the cost of bringing a new test or therapy to the market is extremely expensive and that profitability needs to be part of the equation.

What we really need are two things. The first is smarter regulation to reduce the burdens and costs of developing drugs, tests, and therapies. We are now seeing critical shortages of generic cancer drugs; this is partly related to the fact that cancer medications are so expensive to produce and the payback is too low for doing so. Secondly, the biomedical industry needs a revolutionary advance in technology: an innovation that fundamentally changes the way drugs and tests are developed and brought to market.

Breastcancer.org will be following this case closely and will provide updates as developments occur. We welcome your comments below!

Children deserve open lines of truthful communication. Truthfulness is the best (and only!) way to establish and maintain a bond of trust with anyone, but especially with children. Discussing illness honestly and openly will teach children that parents are trustworthy and that honesty is a core family value.

As much as I wish that my experience only happened to me and that I could have shielded my husband and children from the pain, the reality is that cancer happens within the ecosystem of family, friends, and community. It just does. The Silver Lining is that there are indeed tools to help parents talk with children.

Here are some practical suggestions for how and when to talk with children:

• Talk with them at the time of the diagnosis.
• Talk frequently and briefly, letting their questions guide you.
• Base conversation on the child’s age and sense of understanding.
• Begin with the basics.
• Practice what you are going to say.
• Consider having another adult present.
• Use clear, specific words that the child can understand.
• Be honest. If you don’t know the answer, say so, but reassure them you’ll find out.
• Look for clues they may be confused, angry, sad, or withdrawn.
• Get support. Inform your child’s teachers/counselors/coaches.

When talking with children, it is helpful to become familiar with the typical beliefs that children hold about a cancer diagnosis and how to respond to these beliefs.

• Children often feel guilty (often silently) because they think they caused cancer in the family — by misbehaving, thinking angry thoughts, etc.
  • Reassure them that no one is to blame for the cancer.
• Cancer isn’t contagious, but children may think it is.
  • Let them know that this isn’t an illness like a cold or the flu, and that it is NOT contagious.
• When a parent is ill, children may feel worried about being alone and abandoned.
  • They need to know that they will always be taken care of. Identify the person who will take care of them when you are unable.
• Children may equate cancer with death, even if the prognosis is good.
  • Be honest about what you know. Do not make false promises, but stress that doctors and nurses will do everything they can to get rid of the cancer.

While we cannot protect all of the world’s children from the big and little “lumps” (pun intended) of life, the manner in which the experience is handled lays the foundation for how children will handle the inevitable future “lumps” in the road.

The Silver Lining is that children are wonderfully resilient and can survive a family’s cancer diagnosis, treatment, and recovery. My husband and I had two choices about how we were going to handle this wretched diagnosis: from a position of fear or from one of love, from a place of denial or truth. We chose love and truth. As a result, our children mirrored our words, actions, and emotions. It was emotional. It was honest. It was hard, but we were all in it together.

A potential risk factor for breast cancer is exposure to environmental estrogens. Environmental estrogens are any of a group of synthetic substances found in the environment that, when absorbed into a person’s system, function in a similar way to estrogen. Estrogen stimulates breast cell growth, and exposure to estrogen over long periods of time, without any breaks, can increase the risk of breast cancer. Whether environmental estrogens can fuel the growth of breast cancer is still being studied. But if there was a 10% chance that your plane had a significant mechanical problem, would you get on the flight?

The following are five simple ways (there are others) to avoid exposure to environmental estrogens:

• Avoid pesticides containing DDT and dieldrin (look at the labels), and advocate for your schools and community to do the same.

• Avoid cooking with nonstick cookware: the perfluorooctanoic acid (PFOA) used to make products grease- and waterproof is an environmental estrogen. When the cookware is heated, PFOA can seep into your food.

• Avoid using plastic food containers, which may contain bisphenol A. Never heat plastic containers or use plastic wraps in the microwave — heating plastic causes the leaching of the environmental estrogens into your food.

• Avoid cosmetics or personal care products containing phthalates. Because phthalates are mainly used for fragrances, and often not required to be listed on product ingredients, using fragrance-free personal products would limit exposure. Although there is no direct link of phthalates to cancer or other health issues, the European Union took the proactive step of issuing a directive banning certain phthalates in cosmetics sold in Europe in 2004.

• Recycle old electronics, including cell phones, hard drives, TVs and computer monitors, and batteries. The breakdown of the cadmium, nickel, and lead in these products form environmental estrogens that can seep into our soil and water supply.

How important is paying attention to environmental factors? A major study commissioned by Congress released in February 2013 concluded that “Primary prevention of new breast cancer cases requires identifying and reducing exposures that increase the risk of the disease, and fostering behaviors that may help to prevent it.”

The surest steps to reducing our risk of breast cancer are well established: maintain a healthy weight, exercise, eat nutritious food, avoid alcohol, and don’t smoke. Visit the Lower Your Risk section for more information on these risk-reduction steps. By making relatively simple behavior changes and avoiding environmental estrogens, we can multitask (every mother’s forte) and create a healthier planet and healthier mothers, sisters, aunts, cousins, and friends, so that future generations of mothers and children can enjoy the beauty of spring for many years to come.

The practice of yoga is intensely personal. It requires a willingness to be vulnerable – to be honest and to trust. It requires a safe place. It requires a safe place inside of yourself. You start there and you slowly begin to move out to your periphery, where things may not be so comfortable.

I teach yoga while living as an expat in Geneva, Switzerland. I see it as a way to bring people together – to form a community that is inclusive and positive, where we can move our bodies, breathe, share, and laugh together.

One of the first places I was able to feel safe during my cancer treatment 10 years ago was in yoga class. It was so much more than just a place for me to regain strength after surgery and during chemo. The intention of actually connecting to my body in a meaningful way connected me to my life and the experience I was having on a very spiritual level. I was able to find that small, vulnerable, and safe place inside of myself – and I started there. In that place I did not feel alone – and as I began to feel more connected to everyone and everything around me, so did that place begin to feel bigger and safer. Moving to a new country, I again found myself feeling vulnerable and seeking that safe place inside of myself. By creating an environment for others, I was actually mirroring what I myself needed.

Teach what you know.

There is a beautiful woman who comes to my classes. She began yoga with me shortly after her mastectomy and has traveled the journey of her chemo on her yoga mat. She just started on tamoxifen. She is a little scared. But she is also strong and passionate and positive and has the most beautiful sparkle in her eyes when she makes a joke. Every month, each week, each day has been different for her – but she keeps coming to class and in her honesty and vulnerability she is the most present person in the room. She knows exactly who she is and what she is capable of each day, and she has to sometimes accept that one week she may not be as strong or flexible as the week before. In truth, by virtue of her spirit, she is the strongest and most flexible lady in the room!

She and my other students with cancer or a chronic illness have expressed to me their deep gratitude for the yoga practice. They tell me that the asanas help them to feel more flexible after surgery; that they feel stronger and more empowered. The breath work and meditation helps them to feel calmer and more grounded. The philosophy inspires them to see deeper into their hearts and connect with their spirits. The beauty of yoga is that it invites everyone and anyone to start where they are and be present for themselves in this place.

Start where you are.

I know how to verbally guide someone through a series of movements – how to give cues, how to remind someone where they are in space – so that maybe they can connect to where they are emotionally in their body. I know how to smile and look into someone’s eyes and heart and say, “I understand. You are not alone. You are beautiful and strong and brave and amazing.”

It doesn’t matter if you have cancer, are going through a divorce, have just lost a parent, have a child struggling at school, or are trying to adjust to life in a new country. There is something about each of you and the challenges you face that opens you up and makes you vulnerable – and in that place, we make a connection. I have learned more from my cancer and more from my students than I will ever be able to share as a teacher. What has this journey through cancer taught you? How has it made you more aware of the beautiful gifts you possess to offer to the world?

Start where you are. Every day, every hour, every minute will be new – different. Embrace your life. Wrap your arms around that safe place inside of yourself and breathe.

Close your eyes. Listen to your breath. Become so quiet that you can hear your heart beating. Go into that safe place. Let it grow. Observe yourself – your thoughts, your reactions to your thoughts. Know that you are so much more than these words and emotions. Know that you are a true warrior. Know that you are an authentic teacher just by virtue of being alive and sharing this amazing human experience.

Start where you are. Teach what you know.

What if you have cancer and don’t have significant support? That’s a question that has troubled me since my diagnosis. How do you create support? How do you support yourself?

One method I used to support myself during treatment for breast cancer — and that others might find helpful too — is meditation.

Before you stop reading NOW, give me 30 seconds of your time — before learning more about meditation I would have been skeptical, too. But last year, when in the throes of treatment, and when I would have grabbed any lifeline for help, my physical therapist suggested I try meditation to deal with the stress of cancer.

Stay with me here. Close your eyes and focus on your breath for 30 seconds, observing its rhythm. If you find yourself losing focus on your breath and following your thoughts, observe where your mind went, without judging, and simply return to your breathing. Remember not to be hard on yourself if this happens. Just. Focus. On. Your. Breath.

Feel a sense of calm? It can really work. Why?

For that I leave you to an expert on meditation, Jon Kabat-Zinn. He wrote one of “the” books on the power of meditation, Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain and Illness. Kabat-Zinn has been a driving force in bringing meditation from the realm of “hippies and gurus” into mainstream medicine. His work is based on bringing calmness to the mind and body and paying attention on purpose in the present moment in a non-judgmental way. The practice of mindfulness meditation can create an inner peace and acceptance that benefit both your physical and emotional well-being. Kabat-Zinn espouses both formal mindfulness meditation and bringing mindfulness to your everyday activities.

Kabat-Zinn teaches a mindfulness meditation course at the University of Massachusetts Medical Center. In the last 30 years, Kabat-Zinn has seen countless individuals reduce or relieve pain, fatigue, high blood pressure, shortness of breath, fear, and stress through the practice of mindfulness meditation.

I will be the first to admit that in our fast-paced, 24/7-connected world, it’s hard to set aside time for silence. In my initial attempts at meditation, I found my mind wandering toward my to-do lists and other concerns. How could I sit still for 20 minutes when thoughts such as “did we give the dog his flea medication this month?” and “what other tragedy can strike Downton Abbey?” ran through my head? I discovered that guided meditations in podcasts worked for me. And you can be creative in how you practice. Yoga is meditation, as are prayer and mindful walking, which is particularly wonderful in a park, wooded area, or near water. There is no right way or wrong way to meditate. Some can be inspired to meditate by observing the simplicity of a child in the moment, so I’ve included a picture of my daughter to illustrate this blog.

What I found is that mindfulness meditation cleaned up some of my mental clutter, made me feel more positive and calm, and provided me with an energy boost. It also made me feel as if I was in control of managing some of the side effects of my treatment, which was a powerful feeling.

When meals were brought to my house and comforting messages sent, friends and family were showing me their compassion and kindness and hoping their support would promote my healing. Mindfulness meditation teaches us to connect to our bodies and our minds and treat ourselves with acceptance, compassion, and kindness. Mindfulness meditation centers us, and the more centered we are, the easier we will find connecting with other people. That connectedness, and seeing the basic goodness in ourselves, are meaningful tools in confronting cancer, edging us closer to beating the statistics. When the first step is to simply breathe (what could be easier?), you can begin as you finish this sentence. Give yourself a present, and enjoy the soothing silence.

Five years ago today I was diagnosed with breast cancer. My life has been one big whirl-a-twirl ride, filled with roller coaster loops, turns, and rolls, ever since. There have been extreme highs and a few menacing death drops. Yes, breast cancer took me for a ride and changed my life forever; yet, I wouldn’t change a thing.

Maybe that’s exaggerating a bit. I’m pretty sure I would not have chosen to get breast cancer… nor to be infused with chemo (Sacred Juice) for a year… nor to gain weight due to steroids… have my breasts cut off and rebuilt… lose my hair… put my business on hold… on and on. But all we’ve got are the cards we’re dealt… and what we do with them is our choice. That’s where choosing joy comes in.

My gratitude for my healing overflows. I’ve written about it, talked about it, prayed over it… and will continue to do so. I am blessed in more ways than even I understand.

Through cancer I’ve met unbelievable people, gained wisdom and insight, and found purpose as I help others on their own healing journey. Cancer was an unexpected visitor that brought me blessings and gifts disguised as infusions, needles, pills, stitches, and scars.

Now, as I dance into the next phase of my life, I grab hold of family and friends and move on. I remind myself to cherish every moment, even when old patterns try to break in. I bring with me all that I’ve learned and all that I treasure.

Five years ago today, cancer took center stage and captured my life’s spotlight. Today, I shift its beam back into place… for it to shine brightly on:

MUSIC. DANCE. PASSION PROJECTS. MOUNTAINS. CHOCOLATE. FUN.

LOVE AND PASSION. TRAVELS. MOVIES. BOOKS. PLAYTIME.

LAUGHTER (the pants-splitting kind).

FIRE CEREMONIES. ANIMALS. VACATIONS. PHOTOGRAPHY.

I am still here, passionately offering support to others on their own healing journey. But it’s a new day, and Positively Pat is spreading her wings and taking in more: soaring higher and higher, spreading love, healing, peace, laughter, compassion, kindness, and joy… while at the same time, mimicking the frolicking hummingbird and sucking the sweetest nectar from this beautiful life.

And so it is.

Dance on!

I was diagnosed with hormone negative breast cancer in 2006, and I’ve been studying this disease since then, reading research papers, interviewing experts and writing about TNBC, cancer in general and other broad health topics such as nutrition and exercise.

As a health journalist, I’ve been able to talk with oncologists, psychologists, dieticians, exercise specialists and researchers on everything from chemo brain to the benefits of acai. I have learned a great deal from them.

More important, I have visited with hundreds of women with TNBC through this blog. So, I know what it is like to walk this road, and I think I understand at least some of what you are going through.

It is this last perspective, yours, that I keep foremost in my mind.

I’m not a doctor.  I’m one of you.

Now to the questions:

Q. How do I manage the stress of TNBC plus family and job strain?

Stress hits all of us at one time or another after diagnosis, during treatment and as we face life after cancer. I could talk about this all month and not get it all in.

So, I will briefly discuss three areas — juggling everyday life, finding support and managing worries.

Our lives keep going even when we get sick. The kids need to get to school, the toilets need cleaning, we need to pay the — we need to work to pay for all of this. And some of us have other family members with health issues to worry about, as well.

This is, in fact, overwhelming. So, you have to ask for help, more than once, of many different people.

Recognize that some people are as helpful as the day is long, and some simply aren’t, and most are in between. So, if somebody disappoints you, don’t think that everybody will do the same thing. Ask somebody else.

And be specific. You will get many people saying, let me know if you need help. Let them know with details. Can you pick Lily up after preschool tomorrow? I hate going to chemo alone. Would you come with me? It will give us a good chance to chat.

Find a supportive friend with whom you can cry, fret, vent and just emotionally exhale or laugh a lot, laughter is such good therapy, or discuss this disease with them and help find clarification in your own mind.

We’ve all made good friends online who can send us virtual hugs. I do it all the time, so let me know if you need one. But, it’s good to get an in person hug, as well.

Now, to worry. I believe there is stress that is specific to TNBC, and there is some research to support that. In a survey of 989 women with breast cancer, those with estrogen-negative breast cancer reported the highest level of stress, as did Black and Latino women.

But, this leads us to a chicken or egg question. Did the stress lead to the cancer or did the cancer lead to the stress?

The survey did not test for this, but the research does indicate that stress may be more specifically associated with TNBC than with other breast cancer subtypes.

And this is tied to something that bothers me every time I read about this disease in a research paper or on the news, because we often use these words lethal, deadly, especially aggressive.

TNBC-related stress then can be especially heightened by not having a plain old breast cancer but one that is characterized with doctors, researchers and writers as especially deadly — as though we thought there were other kinds.

Look at this recent post on my Facebook page in which I ranted about my frustration with journalists and researchers who use these terms and imply that the disease is automatically a killer. I got a surprising result. My TNBC women popped up immediately with responses. Women agreed that hearing those words adds to their stress.

Some typical responses:

“Every time I read those phrases, my heart skips a beat.”
“I do get very depressed and scared when I read terms such as particularly deadly.”
“Gets me every time, makes me get a lump in my throat.”

And because we are dealing with an especially mean disease, we worry that we have to do everything, everything, everything we can to combat it – become organic vegetarians, and get two hours of exercise a day, and meditate and read medical books and take every vitamin and supplement known to humankind and paint the kitchen.

Okay, I exaggerate, a little. But I have noticed that women with this disease can be extremely hard on themselves by trying to take on the world of healthy eating, living, thinking and being all at once, all fabulous goals, but you can’t ever do everything at once, especially when you have other responsibilities to manage, as we all do. So, don’t try to do and be everything.

Look for balance. 

We will talk about diet and physical activity in a minute, but in all things, go for moderation and balance. Don’t try to change your lifestyle on a dime. Go slowly and implement changes bit by bit.

Cut out some sugary goodies and processed foods like doughnuts, colas, cookies, potato chips and French fries. Those don’t do anybody any good. But, leave yourself some treats. Don’t try to become the Mother Teresa of health foods over night.

If an ice cream cone or chocolate malt gets you through the day right now, that is just fine. And you might need to get through treatment first before you go for significant lifestyle changes. One step at a time.

Another root of some of our stress, I believe, is the thought that we caused our cancer. We didn’t eat well enough, we drank too much, exercised too little, took on too much work.

Okay, that was me. But, seriously, one of our first thoughts when we are diagnosed is what did I do to cause this? That’s a decent question to ask in terms of modifying your behavior to reduce your risk of recurrence, but don’t beat yourself up for not having lived a perfect life up to this point. And don’t try to be perfect now. Phew, talk about stress.

You did not cause your cancer.

You can reduce some of your stress by getting offline. Shut down the computer and go do something else. Yes, this seems ironic coming from a person talking to you online. But, consider limiting your computer time. Set an alarm to go off in a half hour, and make that your stopping point. You can spend hours sucked into the ether of the internet, and it is just not a good use of your time, your mind or especially your soul.

Plus, it is easy to soak up other people’s stress. When I was going through treatment, I could physically feel my stress building online because I was reading about this person’s TNBC recurrence, that person’s side effects and the death of a favorite online friend. Worries that never before had occurred to me suddenly loomed as real possibilities. I shut off the computer.

Take the time you’d use online and give yourself a break. Brew a cup of tea, and find a pleasant place to drink it, outside if possible, or inside with some music. Do nothing but enjoy the tea, and take deep breaths. When the stress intrudes, push it away with a deep cleansing breath. I once posted a simple note on my blog, breathe in, breathe out, and think of something beautiful. I was astounded at the emails I got on that one. Apparently, we need to be reminded to breathe. Try it now. Breathe in, breathe out, breathe in, breathe out. Ah, doesn’t that feel good? And the thing about a tea break is it only needs to last as long as it takes you to drink the tea. So, it does not require a huge planning or a time commitment, but it gives you an important breather, literally.

Just a little activity also will help reduce stress. The activity itself calms our bodies, but going off and doing something also reboots our mind into thinking about something other than taxanes versus anthracyclines.

And research on breast cancer patients has shown that going outdoors helped clear their minds and helped them think better.

Yoga is an especially helpful stress reliever, helping us sleep better and relieving fatigue. Yoga uses deep breathing and stretching techniques that can be low impact and easy to do when you’re lacking energy. I do a 20-minute morning routine that calms me like almost nothing can, and it takes less time to do than follow a new thread on a message board.

And, finally, don’t turn to alcohol to reduce stress. Alcohol may calm us for a minute, but it causes a host of problems later on including increasing our cancer risk. It leads to poorer sleep and nervousness when the initial effects wear out. So, it can actually increase our stress.

Again, moderation. A glass of wine occasionally is a nice break. It should not, however, become a habit or a necessity. [Editor's Note: Research has consistently shown that regularly drinking alcohol increases a woman’s risk of breast cancer. Results from a new study support the connection between regularly drinking even moderate amounts of alcohol -- as little as one drink per day -- and cancer risk: New Study Adds More Support to Connection Between Risk and Regularly Drinking Any Amount of Alcohol]

Breastcancer.org will continue to post questions and answers from Pat’s (Un)Common Knowledge Transcript. You can find the complete transcript on Pat’s blog, Positives About Negative.

Art Solomon

      Ojibwe elder and spiritual leader

      For the People: Teachings on the Natural Way

Since that fateful day in 2008 when I was diagnosed with breast cancer, my community of women has expanded exponentially. Maybe it’s because I am an only child: my girlfriends have always been my sacred sisters. They’re a hoot… hilarious, revealing, nurturing, safe, and through them, I find peace and healing energy. Some of my girls have been around since grade school… others I just picked up through work and travel… even on Facebook. While there is no doubt I love men, there’s no place I’d rather be than hanging with my girls.

These days, many of the women I meet are beautiful and courageous souls on the breast cancer journey to wellness. They’re coming into my life almost daily now, sent by doctors, friends, and nurses. Even friends of friends direct the shell-shocked women in their life to me, Positively Pat, for information about oncologists, plastic surgeons, chemo, wigs, and more. I usually can’t help myself, so I also dish out encouragement, hope, and inspiration along with patient-to-patient tips and advice based on my personal experiences during treatment. In 2010, I ended up with twenty new BFFs, coming together in Miami to create the breast cancer support group Link of Hope Sistas. Women helping women. It’s where I flourish.

Yes… I’m a girlfriend’s girlfriend, which is why, in the midst of a busy, crazy schedule, I hopped on a plane to California to speak at Campowerment, a three-day/three-night sleepaway Malibu camp/retreat for grown-up women. The weekends are designed to help overworked, stressed-out women totally disconnect from life and responsibilities, while giving them time to reconnect with themselves and a sisterhood, all of whom are also juggling the demands of a ridiculously hectic life. The setting was perfect: a beautiful bluff overlooking the Pacific Ocean. I chilled in front of the campfire in my sweats and laughed till my sides hurt with 60 women, most who didn’t know each other on Thursday when we arrived. By Sunday morning, after flying off zip lines (or not) and facing fears from the top of a 35-foot telephone pole (Leap of Faith)… while doing yoga, dancing, meditating, and playing Color War games with these women… magic happened. Maybe it was because we knew our days without cell phones and computers and makeup were almost over. Maybe it was because no one was demanding our attention.  We were just taking care of ourselves and just being… taking life in… playing, chilling, and partying while roasting marshmallows and singing James Taylor songs around the campfire. We were healing, connecting, and being validated as we shared secrets, struggles, and stories with strangers who seemed to care. I connected with so many women on so many levels that weekend… women ages 20 to 70 who came to Malibu as strangers and left three days later as sisters.

I hosted interactive workshops aptly named “Joy in the Midst of Turmoil.” I shared the details of my dance with cancer, my breast cancer journey, urging these women to embrace whatever their challenge with strength, trust, peace, and joy. We have no control over the events that sometimes take over our lives, but we do have control over how we respond to them and how we live our lives moving forward.

Some asked how they could possibly find joy in the midst of the some of the awful things happening in their lives. We’re not robots. Sometimes the rock we feel like we’re pushing uphill seems bigger. Give yourself permission to feel the brutal pain, grief, and sadness for a minute or two, but don’t pitch a tent in that place. That was my advice, though I don’t always take it myself (but I try). I aim to let the emotions come up for a while and then push to move past them. Quickly. That helps me get to joy much faster. When I get to other side I remind myself to bring along the blessings, lessons, and wisdom gained during my brief visit to fear, sadness, or worry, and then… joy takes center stage.

One evening an old man told his grandson about a battle that goes on inside people.

He said, “My son, the battle is between two wolves inside us all.

“One is Evil – It is anger, envy, jealousy, sorrow, regret, greed, arrogance, self-pity, guilt, resentment, inferiority, lies, false pride, superiority, and ego.

“The other is Good – It is joy, peace, love, hope, serenity, humility, kindness, benevolence, empathy, generosity, truth, compassion, and faith.”

The grandson thought about it for a minute and then asked his grandfather: “Which wolf wins?”

The old man simply replied, “The one you feed.”

The trip reminded me why I need to feed my soul with girlfriend juju. There’s a global sisterhood that we’re all a part of… no matter who we are, where we live, what we do. We are all, at the core, the same. When we open ourselves and our hearts to connect with other women… healing happens, and life takes a more purposeful and joyful course.

I am woman. I am proud. Dance on…….