Well the honeymoon also known as Thanksgiving is over and the apartment is really quiite and lonely. Yep I do miss my girls. Their visit was great although I am bit rusty with diaper changing now since it has been several months since I changed a number 2 diaper. Fortunately I only had to do one number 2 diaper as I rode out my LC (lung cancer) card for much of visit when my daughter needed changing (I will have to make that up to my wife with something from Blue Nile soon).
Got my chemo on Monday it was a quick infusion the whole thing only took about an hour total. I haven't noticed any major side effects yet other than being tired alot and having to use the restroom often. Also it seems like my legs are fatigued; the kind of tired you get from hard track workout and doing a heavy leg workout in the same day.
It has been a long year, this time last year I had pneumonia (my diagnosis at the time) had just been promoted at work, was weeks away from the birth of our second daughter, a year away from completing my third masters degree. With all that I have been through I just wish my former primary care physician would have just owned up to the fact that they possibly should have done more test instead of quickly writing a prescription so they could get to the next patient.
Wednesday, November 29, 2006
Monday, November 27, 2006
No more Turkey Day
Well the honeymoon is over it is the end of Thanksgiving, I am no back to living as a bachelor since my family is on the plane back to TX and I am down stairs at the hospital wait my rat poison (aka chemo therapy). I don't know what to expect and am not worried if I am anything I am mad as heck dealing with this stuff after awhile makes you keep a chip on your shoulder (I have big shoulders thus a very big chip.) Oh well more to come later upstairs I go.
Wednesday, November 22, 2006
Back on the Sauce
My recent visit with the cancer docs. revealed that the current chemo might not be working so well so I am going back on the sauce (liquid chemo starting Monday). I hope this doesn't have the side effects that the first sauce provided me. There is a bright spot associated with this chemo as I will get the cream from BALCO (joke) I will be getting some kind of steroid with this sauce. I think these steroids will decrease my workout time as I will now be able to do all the cybex stations at once instead of going from station to station (gym talk); I BETTER not have any shrinkage (muscle shrinkage that is :-) )
Sunday, November 19, 2006
Age Not An Exclusion Criterion for Breast Reconstruction
Breast Reconstruction in Older Women: Should Age Be an Exclusion Criterion?
Plastic & Reconstructive Surgery. 118(1):16-22, July 2006.
Bowman, Cameron C. M.D.; Lennox, Peter A. M.D.; Clugston, Patricia A. M.D. +; Courtemanche, Douglas J. M.D., M.S.
Abstract:
Background: At present, breast reconstruction is undertaken by fewer than 10 percent of breast cancer patients undergoing mastectomy. Even though the benefits are numerous, this finding is even more notable among older women. Traditionally, women older than the age of 60 have been offered implant reconstruction or no reconstruction at all in hopes of minimizing potential morbidity. This practice may be due to a number of factors including a lack of patient education and information, as well as physician/surgeon bias regarding the safety or relevance of breast reconstruction in older women.
Methods: The authors undertook a retrospective study in which they surveyed 75 women (age range, 60 to 77 years) from two surgeons' practices who underwent various forms of breast reconstruction over the past 8 years. Type of reconstruction, recovery time, and complication rate were correlated with patient satisfaction, general health, and quality of life.
Results: An 81 percent response rate was obtained, yielding an average age of 66.6 years over a 3.8-year period. The overall rate of complications requiring operative intervention was 20.5 percent. When asked whether age should be a determining factor for breast reconstruction, more than 90 percent felt that it should not be. Only 16.1 percent of patients who had a delayed reconstruction stated that the option of breast reconstruction was presented to them at the time of their diagnosis, although 100 percent felt that it should have been. A significantly poorer physical health score was found among patients who experienced a complication, and lower mental health scores correlated with women who were less satisfied with their outcome.
Conclusions: The authors believe that all types of reconstruction should be an option for women older than 60 years of age and that age as an isolated factor should not deter physicians from offering these women the option of breast reconstruction.
******
Dr Chrysopoulo is board certified in Plastic and Reconstructive Surgery and specializes in breast reconstruction surgery after mastectomy for breast cancer. He and his partners perform hundreds of microsurgical breast reconstructions with perforator flaps each year including the DIEP flap procedure. PRMA Plastic Surgery, San Antonio, Texas. Toll Free: (800) 692-5565. Keep up to date with the latest breast reconstruction news by following Dr Chrysopoulo's Breast Reconstruction Blog.
******
Plastic & Reconstructive Surgery. 118(1):16-22, July 2006.
Bowman, Cameron C. M.D.; Lennox, Peter A. M.D.; Clugston, Patricia A. M.D. +; Courtemanche, Douglas J. M.D., M.S.
Abstract:
Background: At present, breast reconstruction is undertaken by fewer than 10 percent of breast cancer patients undergoing mastectomy. Even though the benefits are numerous, this finding is even more notable among older women. Traditionally, women older than the age of 60 have been offered implant reconstruction or no reconstruction at all in hopes of minimizing potential morbidity. This practice may be due to a number of factors including a lack of patient education and information, as well as physician/surgeon bias regarding the safety or relevance of breast reconstruction in older women.
Methods: The authors undertook a retrospective study in which they surveyed 75 women (age range, 60 to 77 years) from two surgeons' practices who underwent various forms of breast reconstruction over the past 8 years. Type of reconstruction, recovery time, and complication rate were correlated with patient satisfaction, general health, and quality of life.
Results: An 81 percent response rate was obtained, yielding an average age of 66.6 years over a 3.8-year period. The overall rate of complications requiring operative intervention was 20.5 percent. When asked whether age should be a determining factor for breast reconstruction, more than 90 percent felt that it should not be. Only 16.1 percent of patients who had a delayed reconstruction stated that the option of breast reconstruction was presented to them at the time of their diagnosis, although 100 percent felt that it should have been. A significantly poorer physical health score was found among patients who experienced a complication, and lower mental health scores correlated with women who were less satisfied with their outcome.
Conclusions: The authors believe that all types of reconstruction should be an option for women older than 60 years of age and that age as an isolated factor should not deter physicians from offering these women the option of breast reconstruction.
******
Dr Chrysopoulo is board certified in Plastic and Reconstructive Surgery and specializes in breast reconstruction surgery after mastectomy for breast cancer. He and his partners perform hundreds of microsurgical breast reconstructions with perforator flaps each year including the DIEP flap procedure. PRMA Plastic Surgery, San Antonio, Texas. Toll Free: (800) 692-5565. Keep up to date with the latest breast reconstruction news by following Dr Chrysopoulo's Breast Reconstruction Blog.
******
Saturday, November 18, 2006
One-Third of Breast Cancer Patients Unhappy with Outcome of Lumpectomy
Women with breast cancer often undergo a lumpectomy and radiation to save their breasts and avoid the need for additional reconstructive surgery. However, approximately one-third of all patients are unhappy with how their breasts look after undergoing breast conservation therapy and many would consider reconstruction, according to a study presented today at the American Society of Plastic Surgeons (ASPS) Plastic Surgery 2006 conference in San Francisco.
“I have patients walking into my office saying lumpectomy was supposed to save their breast but what’s left doesn’t look like a breast to them,” said Howard Wang, ASPS Member Surgeon and co-author of the study. “Conservation is believed to be an acceptable way of saving a woman’s breast. But many of these women are coming to plastic surgeons for help, saying it isn’t so.”
In the study, 28 percent of the breast cancer patients stated they were dissatisfied with the cosmetic result of their lumpectomy. Of those patients, 46 percent stated their physical appearance was worse or much worse after the surgery and were considering reconstruction. Only nine percent of patients who were satisfied with the outcome, however, would consider reconstruction if it were offered.
Approximately 26 percent of patients were unhappy with their physical appearance after the lumpectomy but had an improved sense of body image. Plastic surgeons believe this disparity occurred because many patients felt relieved to be free of the cancer, leading them to feel better about their bodies even though they were not happy with how their breasts looked.
According to the American Cancer Society, almost 213,000 women will be diagnosed with breast cancer this year. Almost 58,000 women underwent breast reconstruction surgery in 2005, according to ASPS.
“Patients should know their options and understand that just because they undergo a lumpectomy to save their breast does not mean they will be happy with the cosmetic outcome,” said Dr. Wang. “Oncologists need to work with patients to help them understand the potential physical outcomes and refer them to a board-certified plastic surgeon to consider all of their choices.”
For referrals to ASPS Member Surgeons certified by the American Board of Plastic Surgery, call 888-4-PLASTIC (475-2784) or visit www.plasticsurgery.org where you can also learn more about cosmetic and reconstructive plastic surgery.
The American Society of Plastic Surgeons is the largest organization of board-certified plastic surgeons in the world. With more than 6,000 members, the society is recognized as a leading authority and information source on cosmetic and reconstructive plastic surgery. ASPS comprises 94 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada.
******
Dr Chrysopoulo is board certified in Plastic and Reconstructive Surgery and specializes in breast reconstruction surgery after mastectomy for breast cancer. He and his partners perform hundreds of microsurgical breast reconstructions with perforator flaps each year including the DIEP flap procedure. PRMA Plastic Surgery, San Antonio, Texas. Toll Free: (800) 692-5565. Keep up to date with the latest breast reconstruction news by following Dr Chrysopoulo's Breast Reconstruction Blog.
******
“I have patients walking into my office saying lumpectomy was supposed to save their breast but what’s left doesn’t look like a breast to them,” said Howard Wang, ASPS Member Surgeon and co-author of the study. “Conservation is believed to be an acceptable way of saving a woman’s breast. But many of these women are coming to plastic surgeons for help, saying it isn’t so.”
In the study, 28 percent of the breast cancer patients stated they were dissatisfied with the cosmetic result of their lumpectomy. Of those patients, 46 percent stated their physical appearance was worse or much worse after the surgery and were considering reconstruction. Only nine percent of patients who were satisfied with the outcome, however, would consider reconstruction if it were offered.
Approximately 26 percent of patients were unhappy with their physical appearance after the lumpectomy but had an improved sense of body image. Plastic surgeons believe this disparity occurred because many patients felt relieved to be free of the cancer, leading them to feel better about their bodies even though they were not happy with how their breasts looked.
According to the American Cancer Society, almost 213,000 women will be diagnosed with breast cancer this year. Almost 58,000 women underwent breast reconstruction surgery in 2005, according to ASPS.
“Patients should know their options and understand that just because they undergo a lumpectomy to save their breast does not mean they will be happy with the cosmetic outcome,” said Dr. Wang. “Oncologists need to work with patients to help them understand the potential physical outcomes and refer them to a board-certified plastic surgeon to consider all of their choices.”
For referrals to ASPS Member Surgeons certified by the American Board of Plastic Surgery, call 888-4-PLASTIC (475-2784) or visit www.plasticsurgery.org where you can also learn more about cosmetic and reconstructive plastic surgery.
The American Society of Plastic Surgeons is the largest organization of board-certified plastic surgeons in the world. With more than 6,000 members, the society is recognized as a leading authority and information source on cosmetic and reconstructive plastic surgery. ASPS comprises 94 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada.
******
Dr Chrysopoulo is board certified in Plastic and Reconstructive Surgery and specializes in breast reconstruction surgery after mastectomy for breast cancer. He and his partners perform hundreds of microsurgical breast reconstructions with perforator flaps each year including the DIEP flap procedure. PRMA Plastic Surgery, San Antonio, Texas. Toll Free: (800) 692-5565. Keep up to date with the latest breast reconstruction news by following Dr Chrysopoulo's Breast Reconstruction Blog.
******
Breast Reconstruction Not as Safe For Obese Patients
Significantly obese women may wish to consider delaying breast reconstruction following mastectomy until they achieve a healthier body weight. According to findings presented today at the American Society of Plastic Surgeons (ASPS) Plastic Surgery 2006 conference in San Francisco, women who are significantly obese are at higher risk for complications and have a lower satisfaction rate than do normal and overweight patients.
“Just because someone is overweight doesn’t mean they should not be entitled to undergo breast reconstruction after mastectomy,” said Elisabeth Beahm, MD, ASPS Member Surgeon, author of the study, and associate professor at M. D. Anderson Cancer Center. “Feeling ‘whole’ can be an integral part of recovery from cancer, yet significant concerns have been
raised about the wisdom of doing breast reconstruction in very obese patients due to a high complication rate.”
The current retrospective study found that patients with a BMI greater than 35 demonstrated significantly increased complication rates for all types of breast reconstruction, from implants to flaps. The complication rate approached 100 percent for morbidly obese patients with a BMI over 40.
“We investigated whether plastic surgeons can safely perform breast reconstruction for these patients or if we would be depriving them reconstruction simply because of empiric concerns for their weight,” said Dr. Beahm. “We found that significantly obese patients, those having a BMI of 35 or higher, had a higher risk for complications. Our experience suggests that in many cases it may be more prudent to delay breast reconstruction until the patient has lost weight.”
The most frequent complications for obese patients were fluid collections and infection at both the reconstructive site and the flap donor site. When the flap was harvested from the abdominal area, weakness and deformity of the abdominal wall such as hernia and bulge was much more common than in normal weight patients.
“While it’s very difficult to tell a patient she needs to wait for breast reconstruction, patient safety is our primary concern,” said Dr. Beahm. “We must not compromise the oncologic imperative in breast cancer. Each case must be individualized. Morbidly obese patients need to work with their plastic surgeons and carefully assess risk factors. Patients may be best served by deferring breast reconstruction until they have achieved and maintained a lower BMI through exercise and nutrition.”
For referrals to ASPS Member Surgeons certified by the American Board of Plastic Surgery, call 888-4-PLASTIC (475-2784) or visit www.plasticsurgery.org where you can also learn more about cosmetic and reconstructive plastic surgery.
The American Society of Plastic Surgeons is the largest organization of board-certified plastic surgeons in the world. With more than 6,000 members, the Society is recognized as a leading authority and information source on cosmetic and reconstructive plastic surgery. ASPS comprises 94 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the Society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada.
******
Dr Chrysopoulo is board certified in Plastic and Reconstructive Surgery and specializes in breast reconstruction surgery after mastectomy for breast cancer. He and his partners perform hundreds of microsurgical breast reconstructions with perforator flaps each year including the DIEP flap procedure. PRMA Plastic Surgery, San Antonio, Texas. Toll Free: (800) 692-5565. Keep up to date with the latest breast reconstruction news by following Dr Chrysopoulo's Breast Reconstruction Blog.
******
“Just because someone is overweight doesn’t mean they should not be entitled to undergo breast reconstruction after mastectomy,” said Elisabeth Beahm, MD, ASPS Member Surgeon, author of the study, and associate professor at M. D. Anderson Cancer Center. “Feeling ‘whole’ can be an integral part of recovery from cancer, yet significant concerns have been
raised about the wisdom of doing breast reconstruction in very obese patients due to a high complication rate.”
The current retrospective study found that patients with a BMI greater than 35 demonstrated significantly increased complication rates for all types of breast reconstruction, from implants to flaps. The complication rate approached 100 percent for morbidly obese patients with a BMI over 40.
“We investigated whether plastic surgeons can safely perform breast reconstruction for these patients or if we would be depriving them reconstruction simply because of empiric concerns for their weight,” said Dr. Beahm. “We found that significantly obese patients, those having a BMI of 35 or higher, had a higher risk for complications. Our experience suggests that in many cases it may be more prudent to delay breast reconstruction until the patient has lost weight.”
The most frequent complications for obese patients were fluid collections and infection at both the reconstructive site and the flap donor site. When the flap was harvested from the abdominal area, weakness and deformity of the abdominal wall such as hernia and bulge was much more common than in normal weight patients.
“While it’s very difficult to tell a patient she needs to wait for breast reconstruction, patient safety is our primary concern,” said Dr. Beahm. “We must not compromise the oncologic imperative in breast cancer. Each case must be individualized. Morbidly obese patients need to work with their plastic surgeons and carefully assess risk factors. Patients may be best served by deferring breast reconstruction until they have achieved and maintained a lower BMI through exercise and nutrition.”
For referrals to ASPS Member Surgeons certified by the American Board of Plastic Surgery, call 888-4-PLASTIC (475-2784) or visit www.plasticsurgery.org where you can also learn more about cosmetic and reconstructive plastic surgery.
The American Society of Plastic Surgeons is the largest organization of board-certified plastic surgeons in the world. With more than 6,000 members, the Society is recognized as a leading authority and information source on cosmetic and reconstructive plastic surgery. ASPS comprises 94 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the Society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada.
******
Dr Chrysopoulo is board certified in Plastic and Reconstructive Surgery and specializes in breast reconstruction surgery after mastectomy for breast cancer. He and his partners perform hundreds of microsurgical breast reconstructions with perforator flaps each year including the DIEP flap procedure. PRMA Plastic Surgery, San Antonio, Texas. Toll Free: (800) 692-5565. Keep up to date with the latest breast reconstruction news by following Dr Chrysopoulo's Breast Reconstruction Blog.
******
Breast Implants Do Not Cause Breast Cancer Recurrence In Mastectomy Patients
Early Detection and Treatment Not Hindered, Says Study Presented at American Society of Plastic Surgeons Annual Meeting
Women interested in immediate breast reconstruction after mastectomy should not worry that their implants could cause, hinder detection of, or affect treatment of cancer recurrence, according to a study presented today at the American Society of Plastic Surgeons (ASPS) Plastic Surgery 2005 conference in Chicago.
“For women contemplating immediate breast reconstruction, there is a lot of information being presented to them. As plastic surgeons, we want to help our patients feel better about their bodies without risking their safety and long-term health,” said Andrea Pusic, MD, ASPS Member Surgeon and co-author of the study. “It is important for us to provide them with hard facts that show an implant does not increase the chance that their cancer could recur, delay the diagnosis of a recurrence or affect the outcome.”
In the study, 309 women who had immediate breast reconstruction with an implant were compared, on the basis of age and stage of disease, to a group of 309 women who had mastectomy without reconstruction. The incidence of local breast cancer recurrence in reconstructed patients (6.8 percent) was not significantly different from non-reconstructed patients (8.1 percent). In addition, the implants did not hinder early detection of recurrence. Ninety-five percent of recurrences were initially detected by physical examination of the breast during regular check-ups with their plastic surgeon or oncologist. Five percent of recurrences were detected through a computer-assisted tomography (CT) or bone scan.
The treatment for recurrence was not affected by the implants and did not generally require removal of the implants. In the study, only three of the 21 patients who experienced a recurrence had their implants removed after treatment, and two of those patients specifically requested their implants be removed for personal reasons.
“We are pleased to report that treating breast cancer recurrence rarely requires the removal of patients’ implants,” said Dr. Pusic. “This is reassuring information for women who choose to have implant-based breast reconstruction.”
In 2004, almost 63,000 women had breast reconstruction after mastectomy, according to ASPS statistics. The American Cancer Society estimates 211,240 new cases of invasive breast cancer will occur in 2005 among women in the United States and more than 40,000 women will die from the disease.
The American Society of Plastic Surgeons is the largest organization of board-certified plastic surgeons in the world. With more than 5,800 Member Surgeons, the society is recognized as a leading authority and information source on cosmetic and reconstructive plastic surgery. ASPS comprises 94 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada.
******
******
Dr Chrysopoulo is board certified in Plastic and Reconstructive Surgery and specializes in breast reconstruction surgery after mastectomy for breast cancer. He and his partners perform hundreds of microsurgical breast reconstructions with perforator flaps each year including DIEP flap reconstruction. PRMA Plastic Surgery, San Antonio, Texas. Toll Free: (800) 692-5565. Keep up to date with the latest breast reconstruction news by following Dr Chrysopoulo's Breast Reconstruction Blog.
******
Women interested in immediate breast reconstruction after mastectomy should not worry that their implants could cause, hinder detection of, or affect treatment of cancer recurrence, according to a study presented today at the American Society of Plastic Surgeons (ASPS) Plastic Surgery 2005 conference in Chicago.
“For women contemplating immediate breast reconstruction, there is a lot of information being presented to them. As plastic surgeons, we want to help our patients feel better about their bodies without risking their safety and long-term health,” said Andrea Pusic, MD, ASPS Member Surgeon and co-author of the study. “It is important for us to provide them with hard facts that show an implant does not increase the chance that their cancer could recur, delay the diagnosis of a recurrence or affect the outcome.”
In the study, 309 women who had immediate breast reconstruction with an implant were compared, on the basis of age and stage of disease, to a group of 309 women who had mastectomy without reconstruction. The incidence of local breast cancer recurrence in reconstructed patients (6.8 percent) was not significantly different from non-reconstructed patients (8.1 percent). In addition, the implants did not hinder early detection of recurrence. Ninety-five percent of recurrences were initially detected by physical examination of the breast during regular check-ups with their plastic surgeon or oncologist. Five percent of recurrences were detected through a computer-assisted tomography (CT) or bone scan.
The treatment for recurrence was not affected by the implants and did not generally require removal of the implants. In the study, only three of the 21 patients who experienced a recurrence had their implants removed after treatment, and two of those patients specifically requested their implants be removed for personal reasons.
“We are pleased to report that treating breast cancer recurrence rarely requires the removal of patients’ implants,” said Dr. Pusic. “This is reassuring information for women who choose to have implant-based breast reconstruction.”
In 2004, almost 63,000 women had breast reconstruction after mastectomy, according to ASPS statistics. The American Cancer Society estimates 211,240 new cases of invasive breast cancer will occur in 2005 among women in the United States and more than 40,000 women will die from the disease.
The American Society of Plastic Surgeons is the largest organization of board-certified plastic surgeons in the world. With more than 5,800 Member Surgeons, the society is recognized as a leading authority and information source on cosmetic and reconstructive plastic surgery. ASPS comprises 94 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada.
******
******
Dr Chrysopoulo is board certified in Plastic and Reconstructive Surgery and specializes in breast reconstruction surgery after mastectomy for breast cancer. He and his partners perform hundreds of microsurgical breast reconstructions with perforator flaps each year including DIEP flap reconstruction. PRMA Plastic Surgery, San Antonio, Texas. Toll Free: (800) 692-5565. Keep up to date with the latest breast reconstruction news by following Dr Chrysopoulo's Breast Reconstruction Blog.
******
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