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Insight, Summer 2009
In our summer 2009 issue of Insight, learn why treatment may cause menopause-like side effects and how to cope with hot flashes, intimacy issues and more. Get the facts on genetic counseling and testing. Find out how two best friends helped each other through their breast cancer diagnoses.
Table of Contents
Burning Hot: Menopause and Treatment
Lilia Storey, of Manhattan Beach, California, was 36 years old when she was diagnosed with breast cancer. After she began chemotherapy, she was at her job as a high school counselor when suddenly her face and ears became hot and bright red.
"At first I didn’t realize what was happening," she said. "But my doctor explained that my periods had stopped [because of the chemotherapy], and my body was going through menopause."
Some chemotherapies, hormonal therapies and gynecological surgeries can cause temporary or permanent menopause. If you are premenopausal like Lilia, you could have hot flashes and sexual problems from early onset menopause, and your period may return later. As a postmenopausal woman, you could have menopausal changes again or more intensely than before treatment if you take tamoxifen.
Coping with menopause-like side effects on top of a diagnosis of breast cancer can be difficult. If these side effects interfere with your everyday life, talking with your doctor and making lifestyle changes can help you cope.
If You Are Premenopausal
Why do treatments cause menopause-like side effects? The reasons vary depending on your menopausal status prior to treatment, says Mercedes Castiel, MD, head of the general gynecology section of the gynecology service in the department of surgery at Memorial Sloan-Kettering Cancer Center.
You may be among the small number of women who experience a permanent, surgically induced menopause if your ovaries are removed as part of your treatment. If you do not have your ovaries removed but you were premenopausal before treatment, your treatments may cause the temporary cessation of ovarian function, and you may experience short-term menopause-like side effects without actually entering menopause.
Temporary menopause-like side effects are common with chemotherapy treatment, especially the regimens of ACT (Adriamycin, Cytoxan and Taxol) and CMF (Cytoxan, Methotrexate, Fluorouracil). Chemotherapy works by killing rapidly dividing cancer cells. Follicles (egg containing cells) also divide rapidly, and they are sensitive to chemotherapy. Damage to these cells leads the ovaries to work less well and prompts associated symptoms, including disruption of the menstrual cycle, hot flashes, night sweats and other menopause-like changes.
Hormonal therapies can prompt sudden, temporary menopause-like changes. Tamoxifen causes hot flashes by blocking estrogen receptors in the brain that control body temperature. Taking medicine to suppress your ovaries also causes temporary menopause-like side effects.
Beginning menopause artificially seems abrupt because it’s not what the body expects, says Dr. Castiel. Symptoms can feel more intense than with a progressive natural menopause.
Lilia had menopause-like side effects from several medicines. She began hot flashes during chemotherapy, but they continued with tamoxifen and shots she received to suppress the function of her ovaries.
"I thought, ‘What am I supposed to do with this?’" says Lilia. "I would get so red. I was embarrassed at work if I was talking to a student, but I just tried to keep going."
In most circumstances, menopause-like symptoms are temporary, but depending on your age and the treatment, you may become permanently menopausal. Whether your periods return depends on many factors. As a perimenopausal woman, your treatment may speed the permanent transition into menopause. If you want to have children after treatment or keep your options open, talk with your treatment team and a fertility specialist before treatment begins.
If You Are Postmenopausal
Lori Flagg, 54, of Glendale, California, was as shocked as Lilia when she found out that she could experience menopause-like side effects after a diagnosis of inflammatory breast cancer. She had already coped with a surgically caused menopause after a hysterectomy at age 42, and she took hormone replacement therapy (HRT) to manage the symptoms.
When Lori stopped HRT immediately after her diagnosis, she began to have excessive hot flashes and night sweats. Now Lori is coping with vaginal dryness and problems with intimacy. A low amount of estrogen causes symptoms such as vaginal dryness because it causes the walls of the vagina to become thin and tight and less able to produce fluids.
"I was not a happy camper. I thought, ‘This isn’t fair,’" Lori says. "Going through chemotherapy, you feel awful anyway, you don’t look your best, and now all of these other internal things are going on. It takes all of your emotions and brings them right to the top.
"Sometimes you say things you don’t want to say, because you want other people to understand but you don’t want to explain to them what’s really going on. I’ll just say, ‘I’m menopausal, leave me alone.’"
Coping with Menopause
Behavioral changes can ease hot flashes and night sweats, Dr. Castiel says. Avoid spicy food, caffeine and alcohol, wear layers of light fabrics and keep a cool drink nearby. Lilia loves chocolate and caffeinated soda, but she stays away from them, along with greasy foods. Her hot flashes have decreased, and her sleeping has improved because she has fewer night sweats.
Leaving behind candy and greasy crackers and adding more whole grains, brown rice, lean protein and greens helps Lori feel better. "After about three days of focusing on my diet, I feel so much better, and my sleep pattern becomes more normal," she says.
Complementary therapies like massage or acupuncture may ease hot flashes, stress and headaches. Consider sleeping on cotton bed sheets and using fans or air conditioning to keep the bedroom temperature under 64 degrees to help with night sweats. As a last resort, Dr. Castiel suggests sleep medicines to help with menopause-induced insomnia and fatigue.
Researchers have found that low doses of antidepressants like venlafaxine (brand name: Effexor) may help you function better if you have hot flashes. These medicines also impact cognitive problems and mood changes because they decrease night sweats to help you get a better night’s sleep, improving your concentration and mood during the day.
Adding exercise is an excellent bet. Lilia does yoga, and she works out several times a week. Even though exercise helps with hot flashes, she says it’s hard to lose weight because she’s taking tamoxifen, which is associated with weight gain.
It can be traumatic when you try to lose weight and can’t, says Dr. Castiel. Weight control is part of preventive treatment, because overweight women have a higher risk of breast cancer recurrence than women of a lower weight. Protect yourself by undergoing nutritional counseling, making diet changes and exercising.
Exercise also helps maintain bone health. AIs, chemotherapy and radiation can weaken your bones, Dr. Castiel says, so talk with your doctor about taking extra calcium, vitamin D and, if needed, medicines called bisphosphonates, which help build bone.
Lori’s aromatase inhibitor (AI) treatment causes joint pain, a common side effect. She belly dances and hoop dances to keep up her strength and improve her mood. But her mood darkens when she thinks about the sexual challenges she faces, such as loss of libido, vaginal dryness and vaginal atrophy, or thinning of the vaginal tissue.
"I feel like my prime was taken away from me," she says. "Of all the things about having breast cancer, this would be the one I’m most bitter about."
Dr. Castiel suggests vaginal lubricants and moisturizers to decrease the pain during intercourse these side effects can cause. She recommends poking a hole in a vitamin E capsule and inserting it into the vagina, where it will dissolve. She also prescribes local vaginal estrogen suppositories but advises consulting your doctor before using hormonal treatments of any kind.
Using over-the-counter lubricants at the time of intercourse may ease pain during penetration. If you have vaginal atrophy, the over-the-counter lubricants that cause warming or other sensations could be painful. Varying your sexual routine to include external stimulation instead of intercourse may help.
For more information on intimacy concerns, read our summer 2008 issue of Insight.
Ongoing Treatment
Most of these methods apply if you are living with advanced (metastatic) breast cancer and dealing with menopause-like side effects constantly, for years or even decades.
Pam Stoops, 59, of Lafayette, Indiana, was diagnosed with metastatic breast cancer at age 51. After eight years and almost 20 different treatment combinations, she and her doctor are working hard to manage her constant hot flashes.
"I can just break out in excessive sweat, my face and neck get red and my nose starts running," she says. "I can be sitting very still reading the paper, or I can be cooking or doing [nothing] more laborious [than] running the sweeper.
"In the summertime, I gave up keeping outdoor flower beds, and I limit my time in the sun. Sometimes I can’t even go to church because it’s just too warm there."
Pam’s hot flashes and night sweats aren’t quite as severe now that she takes an antidepressant and a sleep aid. She bought hand fans and cloth handkerchiefs, and she dresses in comfortable, cool clothes, no matter what the weather.
Talking with Doctors
Maintaining open communication with her doctor helps Pam find ways to cope.
"All of these symptoms that women may experience and all of the options to manage them have to be part of the treatment plan, but not all doctors have expertise in those areas. That’s why it’s necessary to have a treatment team," Dr. Castiel says.
Approaching the doctor can be difficult, especially if you are reserved about discussing sexuality. Be comforted in knowing that you are not going through it alone. Try to rate your side effects on a scale of zero (none at all) to ten (the worst you have ever felt) to help your doctor understand how much they interfere with your life. Your doctor should work with you to find methods—medical, complementary or in your lifestyle—to help manage them.
Good Advice
Sometimes the best suggestions come from women who have been through menopause already.
"I talked to some friends from work," Lilia says. "I said, ‘I’ve heard you talk about this menopause thing. What do you do so that the hot flashes aren’t so bad?’"
If you have questions about menopause-like side effects or you want to talk with a woman who has been there, call our Survivors’ Helpline at (888) 753-LBBC (5222). Our trained volunteers are here to help you. We can match you with someone who shares your situation.
Editor’s note: Some antidepressants may help alleviate hot flashes, but researchers are investigating whether selective serotonin reuptake inhibitors (a type of antidepressant) may impact the metabolism of tamoxifen. Two studies presented at the 2009 meeting of the American Society of Clinical Oncology address this question.
Click on the links below to learn more.
http://www.asco.org/ASCOv2/Meetings/Abstracts?&vmview=abst_detail_view&confID=65&abstractID=31983
http://www.asco.org/ASCOv2/Meetings/Abstracts?&vmview=abst_detail_view&confID=65&abstractID=32720
Genetic Counseling and Testing for Breast Cancer
You’ve probably heard about the "breast cancer genes" and know that genetic abnormalities, or mutations, are somehow involved in causing the disease.
But how does this information affect you? When and for whom do doctors recommend genetic testing? What do you need to know?
Breast Cancer and Genetics
Breast cancer develops when abnormal genes that control cell growth prompt cells in the breast to grow out of control. The genes can be defective from birth, or they can undergo changes during your lifetime.
"Many people think that most breast cancer cases are caused by inherited
genetic mutations," says Robert Somer, MD, a hematologist/oncologist and genetics expert at Cooper University Hospital in Camden, New Jersey. "But in fact, only about 5 to 10 percent of all breast cancers are caused by defective genes inherited from one’s parents; all other breast cancers are caused by other risks which may be inherited or environmental."
Researchers have identified two genes with inherited mutations linked to an increased risk of breast cancer: BRCA1 and BRCA2 (BRCA stands for BReast CAncer).
Genetic Counseling
If you believe you may have inherited a genetic mutation, a genetic counselor can help interpret your family and personal health histories to determine whether you need genetic testing.
Your genetic counselor will ask if someone in your family had a breast cancer diagnosis at age 45 or younger; if you have multiple family members affected by breast cancer on the same side of the family; if family members have been diagnosed with ovarian, pancreatic or male breast cancer; and if your family is of Ashkenazi (Eastern European) descent. Click here to learn more about criteria genetic counselors use to determine whether you are a candidate for genetic testing.
A genetic counselor can explain the risks, benefits and limitations of genetic testing and how test results might impact prevention and treatment options. This person also can help you make a decision about whether genetic testing would be beneficial to you and your family.
Your genetic counselor may ask you to gather information about your family’s medical and cancer history, called your family "pedigree."
"I always tell people to do the best they can, because any information is better than none," says Dana Farengo Clark, MS, MS, a certified genetic counselor who works with Dr. Somer at Cooper. "I encourage people to reach out to cousins, aunts, uncles, etcetera. If their parents are still alive, sit down with them and get as much history as possible and write it down! Sometimes it helps to get medical records or death certificates of deceased relatives. Genetic counselors can help with that, too."
BRCA1 and BRCA2
If you inherited a BRCA1 or BRCA2 mutation, your lifetime risk of developing breast cancer is 60 percent to 80 percent, compared to about 13 percent in the general population.
According to Noah D. Kauff, MD, gynecologist and genetics specialist at Memorial Sloan-Kettering Cancer Center in New York City, differences between BRCA1 and BRCA2 mutations suggest that different treatment and prevention strategies may be needed for each mutation.
With a BRCA1 mutation, you have a 30 percent to 45 percent lifetime risk of developing ovarian cancer. Between 75 percent to 90 percent of these breast cancers will be estrogen receptor-negative. Prophylactic oophorectomy (ovary removal) has little effect on lowering breast cancer risk in the presence of BRCA1 mutations.
If you have a BRCA2 mutation, you have a 10 percent to 20 percent lifetime risk of developing ovarian cancer. BRCA2 mutations are more likely to cause estrogen receptor-positive cancers, about 65 percent to 80 percent of the time. Prophylactic oophorectomy lowers breast cancer risk from BRCA2 mutations by as much as 72 percent. BRCA2 mutations are associated with an increased risk for developing male breast cancer, prostate cancer, pancreatic cancer and melanoma (skin cancer).
A BRCAAnalysis® blood test or a new test called BRCAAnalysis® Rearrangement Test (BART) identify both these mutations.
Many insurers pay for BRCA testing. If insurance won’t cover your test or if you don’t want your insurance company to know you’re being tested, you may have to pay out-of-pocket. Ask your genetic counselor whether financial assistance is available from other sources.
Interpreting Test Results
The results of a genetic test usually are sent to the doctor who ordered the test within four to five weeks of the test date. Ask your doctor for the test results summary to take to your genetic counselor.
If your result is positive, you have a genetic mutation that’s known to increase breast cancer and related cancer risks.
If your result is negative, the test did not find a genetic mutation associated with breast cancer risk in your family. A negative test is only truly negative if another family member who had breast or ovarian cancer also tests negative. If you have a strong family history of breast cancer, you may still have an increased risk.
If your test shows variants of undetermined significance (VUS), a change was found on a breast cancer-related gene, but researchers have not yet proved the mutation is related to increased cancer risk.
"To make treatment and prevention decisions with a VUS result, we err on the side of caution and do what the family history tells us," Ms. Clark says.
Making Decisions
Linda Chandler, of Orange County, California, was diagnosed with breast cancer in one breast in 2001 and in the other breast this year. Yet she tested negative for BRCA mutations. Despite the test results, Linda decided to remove both breasts and is considering ovary removal because of her strong family history of breast cancer.
"Genetic testing just doesn’t give you an absolute answer or direction to take," she says. "I’m glad I got tested, but with my family history and negative results I got three different recommendations from three different doctors on what preventive surgery I should have," she says.
Amy Andersson, 49, lives in suburban Philadelphia and was diagnosed with breast cancer two years ago. She tested positive for a BRCA2 mutation. She has a personal history of melanoma, and her father had breast cancer. For Amy, ovary removal was a fairly easy decision, but she wasn’t ready for preventive mastectomy. "The emotional turmoil is more than I can handle right now," she explains.
The good news, according to Dr. Kauff, is that surveillance, or close monitoring, is an acceptable option for women like Amy. MRI screening is now standard for those at high risk of developing inherited breast cancer.
In May 2007, the American Cancer Society issued recommendations stating that women with a greater than 20 percent to 25 percent lifetime breast cancer risk should have an annual breast MRI, in addition to mammography. "The vast majority of insurance companies will cover the extra screening for women in the high-risk categories," Dr. Kauff says.
Chemoprevention, or using a medicine like tamoxifen to reduce risk, is available to reduce the risk of developing estrogen receptor-positive breast cancer. Tamoxifen can lower breast cancer risk by as much as 50 percent in the presence of BRCA mutations.
Another option is preventive (prophylactic) mastectomy, which means removing a healthy breast to lower the risk of cancer developing in the future. Studies show that prophylactic mastectomies can reduce the risk of developing BRCA-related breast cancers by more than 90 percent.
Another option is preventive salpingo oophorectomy, which means removing the ovaries and fallopian tubes. In premenopausal women with BRCA mutations, this can reduce the risk of developing ovarian cancer by more than 90 percent. This surgery also lowers the risk of BRCA2-related breast cancer significantly.
Practical and Family Matters
You might worry that genetic testing can result in discrimination by employers or insurance companies. Although reported cases of such discrimination are rare, legislators passed a new law in 2008 called GINA (Genetic Information Nondiscrimination Act), specifically prohibiting this type of discrimination. Click here to learn more about this law.
Another challenge you may face is talking with your family about testing and test results. Feelings of guilt and fear often get in the way of open discussions.
Tania Rossouw, 45, of Madison, Wisconsin, was diagnosed with breast cancer in 2006 and tested positive for a BRCA2 mutation. "I didn’t talk to my family beforehand; I just went ahead and did the testing," she says. "My parents know I tested positive, but we never discussed that it came from my dad’s side of the family. He’ll feel bad about it if we ever come out and say it, so it’s one of those unspoken things," she explains.
"My sister, who also got tested, felt very guilty when her tests came back negative. I was so happy for her, that she didn’t have the [mutation], but she felt bad about it.
"For me," Tania concludes on a positive note, "knowing is so much better than wondering."
Diana McMillon, 39, from Valparaiso, Indiana, was diagnosed with breast cancer at age 34. She tested positive for the BRCA1 mutation and chose to remove her uterus, ovaries, fallopian tubes and healthy left breast. "Having my 14-year-old daughter see that I look good, feel good and am healthy, after all the surgeries, might help her with her decisions when she’s old enough," Diana says.
The decision about whether to get genetic testing is personal, but if you have questions or you want to talk with someone who had genetic testing, call our Survivors’ Helpline at (888) 753-LBBC (5222).
Editor’s note: At the 2009 meeting of the American Society of Clinical Oncology, researchers discussed findings from a Phase II trial examining the use of the oral medication olaparib to treat advanced breast cancers in women carrying BRCA mutations. More research is needed, but the findings show promise for future research. Click here to learn more.
Five Common Misconceptions About Genetics and Breast Cancer
1. MISCONCEPTION: Most breast cancers are inherited.
Actually, only about 5 percent to 10 percent of all breast cancers are thought to be caused by an inherited genetic mutation. This means that 90 percent to 95 percent of breast cancers are caused by other risk factors during a person’s lifetime.
2. MISCONCEPTION: You can only inherit breast cancer gene mutations from your mother’s side of the family.
You have an equal chance of inheriting a mutated BRCA1 or BRCA2 gene from your father’s side of the family. A genetic counselor can explain how the genes are passed from generation to generation.
3. MISCONCEPTION: Getting a positive result on a genetic test will give you a clear prevention or treatment plan.
There are many options for preventive steps if you test positive for an inherited breast cancer gene mutation. The decisions about prevention are very personal and cannot be determined just based on your test results. Consider talking with your doctors and genetic counselors, getting second and even third opinions if you feel they might help and discussing options with your family before deciding. Support groups for women at high risk for developing breast cancer and online resources can also help.
4. MISCONCEPTION: Getting a negative result on a genetic test will give you a clear prevention or treatment plan.
As with a positive test result, negative results do not provide a final answer on whether you should take certain preventive steps. For example, if you test negative for BRCA mutations, but you have a strong family history of breast or related cancers, you might still consider prophylactic (preventive) surgery or other treatments to reduce your risk. Consider all your options and discuss them with your genetic counselor, your healthcare team, family and other women who have had similar experiences.
5. MISCONCEPTION: Testing positive for BRCA1 or BRCA2 is basically the same thing.
Actually, researchers have found some important differences between the two breast cancer genes. One of the main differences is that BRCA2 is associated with other malignancies such as melanoma, pancreatic cancer and stomach cancer in addition to breast and ovarian cancer; BRCA1 is not.
BRCA Mutation Risk Factors
Genetic testing is not recommended for most people with breast cancer. Instead, genetic testing is useful if you and your family have a health history that points to a cancer-related genetic mutation being passed from one generation to another. Your genetic counselor may ask questions to find out whether your family fulfills one or more of the following criteria:
- A premenopausal breast cancer diagnosis in the family
- A diagnosis before age 50 with a triple-negative breast cancer, meaning the cancer is estrogen receptor-negative (ER-), progesterone receptor-negative (PR-) and HER2 negative
- Multiple family members affected by breast cancer on the same side of the family
- Ovarian cancer in the family
- Pancreatic cancer in the family at a young age, in combination with family history of breast cancer
- The family is of Ashkenazi (Eastern European) Jewish descent. About 2.5 percent of Ashkenazi Jews have the genetic mutations with the strongest known link to breast cancer, which is ten to 20 times higher than the general population
- A member of the family has had both breast and ovarian cancer or multiple breast cancers
- Male breast cancer in the family
- Medullary breast cancer in the family, where the border between the cancer tissue and the normal tissues is relatively well-defined (associated with the breast cancer gene BRCA1)
Giving 101
We’re pleased to welcome Sandy Martin, our new director of development! Below, Sandy shares a clever idea for giving during these challenging economic times:
Right now we are all looking for small ways to spend less, save more and fundamentally change the way we do things. Giving gifts is something we all do in good times and bad. It is money we were already planning to spend on someone. Why not combine your gift giving with your charitable giving? How about making a donation in honor of a family member or friend’s birthday? When you donate to LBBC in honor of a friend or family member, we notify the honoree. What a great way to celebrate life and support women affected by breast cancer!
Despite current challenges, remember that LBBC’s education and support programs are critical to the women and families we serve. With your help, we can continue our mission of empowering all women affected by breast cancer to live as long as possible with the best quality of life.
Click here to make a safe, secure, online donation.
For more information about giving, please contact Sandy at (610) 645-4567 or .
Through The Years: A Story of Friendship and Giving Back
Rachel McFarland and Martha Jones, both 74, have been friends for more than 40 years. They met at Wayne Woods Garden Club in Wayne, Pennsylvania, in the late 1960s and struck up a friendship after discovering common interests. Both worked in the medical field—Martha as a clinical lab director and Rachel as a registered nurse—and had children close in age.
"Rachel had a fun personality, and she liked to laugh," Martha remembers. "She seemed very genuine."
Rachel and Martha joined a bridge club together, and their friendship deepened. They started a New Year’s Eve travel group with other friends, and every year for more than a decade they journeyed to different bed-and-breakfasts from Vermont to the Florida Keys.
"We picked places we were interested in up and down the [East] Coast," Rachel says. "It made our friendship better because we spent more time together."
Over the years, Rachel and Martha shared many life experiences, including children, weddings, grandchildren—and breast cancer.
Martha was diagnosed first, in May 1999. She and her husband had just returned from a winter stay in Arizona; prior to that, they had enjoyed an eight-month sailing trip down the Intracoastal Waterway to the Florida Keys. Martha had retired three years before, and she was looking forward to more traveling with her husband and enjoying time with her seven grandchildren.
She had had a needle biopsy the previous December to investigate a suspicious area in her breast, so she was back for a checkup. The first biopsy had not found cancer, but the suspicious area remained. A second biopsy confirmed that Martha had stage II breast cancer.
Martha underwent a mastectomy followed by chemotherapy and radiation. Throughout her treatment, Rachel called and visited regularly.
"When I started treatment, I was nauseous and in bed—I wasn’t taking the right amount of anti-nausea medicine," Martha says. "Rachel gave me orders like a nurse—she told me to get in the shower, and she sent her husband over with apricot nectar to make me feel better."
In 2001, Martha opted for breast reconstruction. Rachel again offered her support, driving Martha to additional surgery after her reconstruction.
"She was there as a friend and made me feel that I wasn’t alone, which put me in a better frame of mind," Martha says.
Martha first learned about Living Beyond Breast Cancer the day she was diagnosed. A year after she finished treatment, Martha attended her first LBBC conference.
"Even though I had finished the hands-on medical treatment, I still needed emotional support," Martha says. "Being able to share my experiences with other women was great, and it was an excellent source of information."
She began volunteering for LBBC, assisting with mailings, phone answering, administrative tasks and our annual gala.
Then, in 2005, Rachel was diagnosed with noninvasive, stage 0 breast cancer. She had a lumpectomy followed by a form of internal breast radiation called MammoSite. Martha stayed by her side through it all, making suggestions on how to deal with side effects and lending a listening ear.
"She came to my rescue like I came to hers," Rachel says. "I was frightened—I didn’t have any family history, but I had a caring husband and faith in my doctors and in God. Martha was immediately supportive and wanted to help."
Martha invited Rachel to volunteer. "Back when I worked as a nurse, I met Marisa Weiss [LBBC’s founder]—she came to the pharmaceutical company where I worked and gave a lecture," Rachel says. "I was impressed, so when Martha suggested it, I wanted to come."
Rachel began volunteering regularly in LBBC’s office. In 2008, she received the Ann Klein Volunteer Award at our annual volunteer party for her many hours of help with administrative tasks. Both Rachel and Martha continue to volunteer at the office, and they represent LBBC and distribute materials at health fairs and other Philadelphia events. They are a pleasure to work with, and we value their contributions.
Helping others learn about breast cancer has enriched Rachel’s life.
"I also feel an extra need to educate young women about breast cancer, as my daughter-in-law was diagnosed with an aggressive breast cancer several months after my treatment," she says.
Martha says she volunteers for LBBC because it is a worthwhile, quality organization. "Having been in the medical field, I know when [an organization] is offering good information."
Both women value the connections they make when helping other women affected by breast cancer.
"You have to do all you can for calming and building your spirit. Being a scientist, I had never paid much attention to my emotional side—I was more practical," Martha says. "But I’ve found this is something I’ve had to pay attention to since my diagnosis, and volunteering for an organization like LBBC helps me do that."
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