We here at Comprehensive Therapy Services are wishing you a happy and healthy Thanksgiving! We’ve put together a local San Diego list of all of the Turkey Trots happening next weekend. It’s not too late to sign up.

1. Coronado 5K Turkey Trot in Coronado, CA
2. Father Joe’s Villages Thanksgiving Day 5K in San Diego, CA
3. Run for the Hungry 10K and 5K in San Diego, CA
4. Running of the Turkeys 10K Trail Run in San Diego, CA

Take your pick, and enjoy the start of this holiday season! Gobble, gobble, gobble!!

Whoa, I’m Pregnant!

April Douglas, PT, DPT, MTC, OCS

I treat pregnant women on a daily basis, teach a course with a pregnancy section and go to continuing education courses on pregnancy, so when I got pregnant, I thought I would be overly prepared (yes, my ego, I know). Here’s what I didn’t realize:

1. In your first trimester, everything’s a secret. You cannot tell anyone anything.

2. My first trimester was my personal hell. Throwing up every day just isn’t my idea of fun. Don’t forget that smiley face, so no one knows anything.

3. If you do decide to announce early, be prepared for those that are worried about jinxing a healthy pregnancy. (FYI miscarriages are common. I was willing to discuss the news if it came.)

4. Because pregnancy symptoms are so variable, there really is not an explanation for most of them except, “well, you’re pregnant”.

5. If you want to be fit and throw up every day, good luck. Working out became a fond, distant memory. Don’t worry, working out returned, but just not at the same level.

6. Your breasts are no longer breasts. They’re jugs now and may be featured on a National Geographic.

7. Your body is working overtime, meaning more heat production. Sweating profusely while indoors is awesome!

With that being said, pregnancy opened my eyes to a whole new world, good and bad. Now that I’m beyond the first trimester, I get to feel a kicks and bumps of new life. It’s a constant reminder of the future. Some people say that being pregnant is the best thing in the world and could not have felt better.

The perk is I get to work with experts in pelvic floor and pregnancy. I get to walk in to work, ask bizarre questions, and advocate with my physician to get Physical Therapy when I have the first symptom. For all of you struggling pregnant ladies, having someone to help me along in the process has been a huge asset.

For all the pregnant women in general, kudos to you. Your body is doing an amazing thing that not everyone gets to experience. Remember that on your bad days.

Chronic Pelvic Pain

Chronic Pelvic Pain

 By Jill Menefee, PT

Chronic pelvic pain is defined in a variety of ways. A useful clinical definition of chronic pelvic pain is noncyclic pain that lasts six months or more; is localized to the pelvis, the anterior abdominal wall at or below the umbilicus, or the buttocks; and is of sufficient severity to cause functional disability or require medical care. As a Women’s Health physical therapist I have quite a bit of exposure to the diagnosis of chronic pelvic pain but I was quite shocked at the numbers associated with this condition upon reading an article recently while preparing for an in-service. Two to 10% of all gynecologic office consultations are for chronic pelvic pain. Twenty percent of all laparoscopies are performed for chronic pelvic pain. It is estimated that 10 million women suffer from this condition and that 7 million do not seek help. Up to 61% of patients are found to have no explanation for their pain. The economic impact of this condition is astonishing. The annual medical cost for diagnosis and treatment of chronic pelvic pain is estimated to be about $1.2 billion annually. The cost of lost productivity in these patients is estimated to be $15 billion annually. The most commonly made diagnosis in chronic pelvic pain is endometriosis (31%). The majority are undiagnosed or improperly diagnosed. (Ref. 1)

Initially the pelvic pain perception had been based on the theory that the level of pain should be proportional to the degree of tissue damage. So if your doctor could not see or palpate any masses or abnormal tissue-then you shouldn’t be feeling any pain.  That notion in the medical community is changing. Studies show that at best only 60-70% of women undergoing laparoscopic surgery for endometriosis experience pain relief, showing that there is more to the story. (Ref. 2) More information is now showing the presence of one or more other chronic pain disorders such as interstitial cystitis, irritable bowel syndrome, TMJ disorder, migraines, pelvic congestion syndrome, ovarian remnant, vulvodynia, or fibromyalgia suggesting that pelvic pain should be treated as a disease rather than just as pathological changes.

Musculoskeletal dysfunction can be a driver for pelvic pain, either as the primary problem or a secondary reaction to pelvic pain. Issues such as overactive pelvic floor muscles or hip dysfunction can be contributors. According to a Clinical Expert Series article on chronic pelvic pain from the Journal of Obstetrics and Gynecology-  “The mainstay of treatment of muscular components of pelvic pain is physical therapy, most commonly performed by a therapist with specialized training in the treatment of female pelvic pain. This subspecialty of the field has grown enormously over the pat 15 years in obvious response to growing recognition of muscular elements to pelvic pain and in recognition that it works.” (Ref. 2)

Hopefully attitudes towards chronic pelvic pain will continue to change and the medical community will move even further away from the “I can’t see it so you shouldn’t feel it” notion. It seems that more credence is now being given to treating the whole body and giving consideration to many factors such as anatomical, musculoskeletal, bowel and bladder function, and psychological issues. The multi-disciplinarian approach appears the best way to give women the support they need in dealing with this often misunderstood condition.

References

1.      Scialli AR, Barbieri RL, Glasser MH, Olive DL, Winkel CA. Association of Professors of Gynecology and Obstetrics Educational Series on Women's Health Issues: chronic pelvic pain: an integrated approach. January 2000; 1–9

2.      Steege JF, Siedhoff MT. ACOG Clinical Expert Series, Chronic Pelvic Pain.         September 2014; 616-629.

Resources

www.bodyinmind.org

www.pelvicpain.org International Pelvic Pain Society

Fibromyalgia and Interstitial Cystitis: Healthy Updates and Resources,

Integrative Medicine, September 2014

Maureen Mason-Cover MS PT, WCS, Comprehensive Therpy Services

September is Interstitial Cystitis (IC) Awareness Month, this is Part Two in a profile on IC, Part One last week featured information on Fibromyalgia and IC

Part Two: IC

How can PT help IC? A PT must decipher your primary “driver” for your overactive bladder. Anything that increases pain input to the nervous system, especially at the level of the bladder, can lead an to incresed sense of pain, urgency, urinary retention, dysuria, and pelvic muscle spasm. A PT investigates your “soft tissues; all the layers of skin, connective tissue, muscles, and nervous system structures, as a detective looking for “triggers” that create a sense of discomfort in the area of the hips, pelvis, low back, and legs. A NIH study in 2009, throughout the US, demonstrated significant reduction in pelvic pain, or painful bladder syndrome (PBS) symptoms, from PT soft tissue work.

Surgeries can create scar tissue that can limit the mobility of the bladder, and visceral mobilization, the expert assessment and gliding tissues into restorative ranges of motion and function, can improve bladder function. PT’s working with pelvic problems use visceral and scar mobilization as part of the treatment. Tight Ceserean scars are often problematic. Men with hernia repairs, and also surgery for Low Back Pain, seem to have an increased predominance of IC.

Tailbone sprains, injuring the tip, or coccyx, and or larger bone, sacrum, can lead to pelvic pain, muscle spasm, and associated bladder symptoms. The pelvis is a ring, and

any malalignment in one area can transmit force and uneven muscle and fascial tension across ligaments, causing pelvic pain.Montlhy cycles, childbirth, and menopause can also contribute to Pelvic alignemnt problems, causing pain and spasm, and feeding into IC.

Hormone imbalances that disrupt the estrogenation of tissues can cause thinning of support tissue around the urethra, and the development of urethral pain, feeding into IC.

A PT may recognize muscle thinning and recommend you discuss hormone levels with your MD. Non-restorative sleep, and chronic stress, can both affect hormone levels so that metabolic growth and repair do not take place.

 The pelvic muscles, also called Kegels, or PC muscles, can develop tender points and trigger points that sustain a sense of bladder urgency and frequency, by continuously activating the nervous system at the bladder level. Home trigger point relase can involve the use of vaginal dilators, wands, or vibrators, selected for the need of each client for pain relief. (Specialty training is needed for most individuals to use safely and effectively, and it is releiving for most, but potentially aggravating for some people).Myofascial pain sites, such as the urethral sphincter,and obturator internus, can be palpated and identified as holding extra tension, leading to a diagnosis of overactive pelvic floor. Also the larger associated muscles such as the hamstrings, adductors, quadriceps, hip flexors, and abdominals can have tender and trigger points that contribute to pain syndromes.All these areas are accessable to conservative treatment with PT.

Vulvar pain may develop after a bladder infection, or associated with hormone changes or scarring as above. Multifacted treatment for female vulvar pain, or male pelvic-or prostate related pain, can involve PT. Vulvar or male pelvic pain can exacerbate bladder symptoms.

Postural problems, neck and back pain, and pelvic organ prolapse are some other conditions that can aggravate IC. I often have clients who sit slumped and compress their pelvic organs with prolonged or frequent bearing down-from straning with voiding, defecation, power lifting, occupational heavy lifting strains, and /or child care. The bladder can signal a false sense of fullness and urgency, when it is in a position of prolapse, as our brain poorly localizes senations from the pelvic area .Pelvic organ prolapse, when mild, can be helped by PT specialists.

Thoracic or Lumbar or spinal cord problems can mimic a painful bladder; Thoracic nerves 11 and 12 wrap around the front of the pelvis, and if irritated in the back, may cause pain in the front regions near the bladder. Also surface nerves to the skin can become entrapped or compresesed after trauma or surgery; the Iliohypogastric, genitofemoral, and ilioinguinal nerve can all cause aching near the bladder and genital area, leading to a false sense of urgency and frequency.

Specific to deep in the pelvis, pudendal nerve symptoms may need exploration and treatment for a comprehensive approach. IC may be associated with a compression of the pudendal nerve. This nerve wraps between 2 ligaments in the buttocks and if compressed, can cause urethral and other discomfort. The pudendal nerve has branches to the anus, vaginal or scrotal area, urethra, and clitorus and / or penile shaft. Aching, pressure, sharp fleeting pains, senses of itching or cramping in these areas can all come from pudendal compression. Soft tissue mobilization, posture, and exercises may help reduce pudendal copression.

Bladder histories are essentail to understanding urinary patterns. Children that are humiliated in front of an elementary school class for wetting their pants, or adults that experience medium to large leaks, may lead to a fear/anxiety reaction with bladder filling. A partially full bladder may eventually trigger a sense of anxiety and panic to avoid a leak, leading to an  increased frequency of progressively smaller voids.

Inflammation, and a tendency to a greator sensitivity to PH of foods, environmental allergens, and emotional triggers of stress reactions are also items that can increase IC symptoms. This requires investiogation of food/beverage triggers, environmental allergens, and emotional stressors. Any factor that increases a sense of fear, anxiety, or worry can increase the “dangometer” processing in the brain and allow nerve flow to areas so that pain signals are magnified. Stress can increase pain. Any factor that causes peace and contentment, or relaxation and comfortable body sensations, can dial down the “dangometer” to the brain, and reduce pain signal perception. Therefore it is critical with IC that individuals perform self care with nutrition, healthy homes and work sites, and stress management.

Soaps, detergents, and tight clothing can irritate genital tissues. Hypoallergenic soaps,

And loose fitting clothing is imperitive in reducing skin inflammation and irritation.

Vaginal douches can disrupt the PH of the genital area, and are to be avoided.

Finally, breathing exercises can be accessable and developed to a skill level to calm and restore nervous system balance and health. As hormone imbalances can be an underlying component of FMS, and IC, living in a high stress “fight or flight” state can involve hormone imbalances and increased muscel tension and pain. Cortisol is released in response to stress, and it alters hormone levels and nervous system actitivity such that increased pain may be perceived The pelvic muscels should relax when we inhale, and this is opposite to how most have been trained to “take a breath”. We erroneously puff out our upper chest and tense the pelvic muscels, which may increase baldder urgency . We can develop the ability to recruit upper, mid, or lower rib cage motions, as well as to allow the diaphragm to desend fully with inhalation. We can learn to relax, and sense the pelvic muscles.This use of brathing exercises to relax the pelvic muscles can take PT training, as well as spine, rib, and visceral mobilization. Breathing exercises, combined with stress management, prayer, or meditation, can promote health and wellness, and for IC sufferers, lead to a path of improved function in life.

In summary, PT specialty tratment can help IC and may involve soft tissue, visceral, postural, body mechanics, modalities, and stress management training, in conjunction with fluid and fiber and medication management with a medical team.

IC

1. http://www.auanet.org/content/guidelines-and-quality- care/clinical-guidelines.cfm?sub=ic-bps

2.Interstital Cystitis, Diagnosis and Treatment, An Overview, Jane M Meijlink, International Painful bladder foundation, www.painful-bladder.org

3. http://www.guideline.gov/content.aspx?id=32489&search=painful+bladder+syndrome+and+physical+therapy+studies

4.http://www,pubmed/Rev Urol. 2004; 6(Suppl 5): S2–S10. Female Pelvic Floor Anatomy

Manual Therapy

1.Barral, Jean Pierre, Visceral Manipulation, Eastwood press, Seattle, 1988

2. Travel, Janet, Myofascial Pain and Dysfunction, The Trigger Point Manual, Volume 2, The Pelvic Floor, Williams and Wilkins

3. National Institute of Diabetes and Digestive and Kidney Diseases, 2010

Urological Pelvic Pain Collaborative Research Network

Interstitial Cystitis Collaborative Research Network, Clinical notes with Rhonda Katarinos, PT

            “A Single-Blinded Randomized Multi-Center Trial to Evaluate the Efficacy and Durability of   Myofascial Tissue Manipulation in Women with Interstitial Cystitis/Painful Bladder Syndrome”

( Maureen Mason-Cover MS PT and Cindy Furey PT were research therapists with UCSD on the San Diego arm of this study).

Relaxation, Mind Body Therapies

1.Kraftsow, Gary, Yoga for Transformation, Penguin Compass, 2002

2. Franklin, Eric, Pelvic Power, Mind/body exercises for strength, flexibility, posture and balance, Elysian 2003

Fibromyalgia and Interstitial Cystitis: Healthy Updates and Resources,

Integrative Medicine Sept 2014

Maureen Mason-Cover MS PT ,WCS, Comprehensive Therapy Services

September is Interstitial Cystitis Awareness Month!

If you have a diagnosis of IC, you may also have associated symptoms in other areas,

and you may have a diagnosis of Fibrymyalgia Syndrome, FMS. Conditions that aggravate your IC would potentially aggravate other symptoms that you have as well, symptoms that are part of your FMS. This is because the entire immune system, nervous system, muscular system, and metabolism are interconnected. In Part I, I will explain FMS in more detail, and then in Part II next week, how Interstitial Cystitis, IC, and it’s profile of problems, can be treated with physical therapy (PT).

Part One: FMS

FMS is a chronic pain disorder, with multiple areas of dysfunction throughout the body. Typical problems include symptoms such as sleep disturbances, widespread pain, fatigue, and possible associated headaches, digestion problems such as ulcers and irritable bowel disease (IBS), bowel and bladder disorders, numbness and tingling in arms and legs, and other ailments. The key musculoskeletal signs are the presence of pain and tender points in 11 of 18 regions throughout the body. (Reference 1). The American College of Rheumatology established the “tender/painful point” criteria for diagnosing FMS in 1990. Recently researchers have identified vascular and sensory changes in the hands of patients with FMS, and you can view the links at the end of this article for more information. If you have FMS, you may have felt overwhelmed at the diagnosis, and felt your future was bleak. Read on!

Medically, health practitioners have to investigate the causes of symptoms, and a combination of physical trauma (strains, sprains, falls, car accidents), hormone imbalances (hypothyroidism, endometriosis), stress, and nutritional deficiencies can all contribute to FMS. Emotional trauma can trigger FMS, as well as infections such as Mononucleosis, and Lyme disease. Cases I have seen have had an onset after military deployment, a car accident, pelvic surgery for endometriosis, and thyroid cancer treatment. Most cases have a few triggers from the preceding list, so that the illness can seem to come up with no real cause for the individual suffering with symptoms.The bodies systems for recharge and energy production can dwindle, with a decline in work performance and mood. Ultimately, an individual with FMS may end up feeling weak, not sleeping, and losing function for basic activities of daily living (ADL’s) such as stair climbing, lifting groceries, and general fitness decline. Due to the myriad of causes for FMS, a multifaceted treatment approach can help reduce pain and increase function and quality of life. Whereas individuals with FMS have been “written off” as simply “depressed” in the past, now there are clinics and programs that offer resources and solutions for healing.

Your MD can screen hormones and blood values, and nutritional deficiencies such as anemia, low vitamin D, and thyroid imbalances can be addressed. SLEEP DISORDERS must be addressed, and a program for “restorative sleep” created, so that an individual with FMS “charges their battery” during sleep. You cannot work, and work out with fitness, if your own personal energy level is like a battery without a charge.Medications, stress and relationship management with counseling, and changing nighttime routines (reduce TV, warm bath, earlier bed time, block light at night) can all help improve restorative sleep.

Conservative treatment of bowel, bladder, and musculoskeletal pain problems is offered by Physical Therapists for FMS. Elimination of dietary irritants, healthy food choices with nutritional class support, and honoring posture and optimal body mechanics can reduce symptoms. Manual therapy, massage, and visceral (organ, fascial and muscular) treatments can help you to rebalance and lighten your physical pain. Hypnosis, counseling, acupuncture and massage therapy are often helpful as well, and can be part of your FMS therapeutic tools. A local military MD tells her patients they have to “have fun” regularly, so play time with art class or similar relaxing adventures can create good moods and alter your outlook and enjoyment of life.

Medical studies have been performed with analysis of the benefits of strength exercise and aerobic exercise for FMS, and it is a fact that these treatments can help reduce pain and improve function. The key is to gradually increase health exercise performance and to stay with it so it becomes a part of your healthy lifestyle.

What is the best type of aerobic exercise? That which you perform consistently that suits your lifestyle, such as bicycling, treadmill or outdoor walking or running, elliptical trainer, or hiking. Pool fitness, including aerobic activities, is also recommended. Ottawa panel guidelines (reference 2) identified positive benefits of aerobic exercise programs from two times up to three times a week, from 20 to 60 minutes, for 8 weeks, up to 24 weeks. Participant benefits ranged from pain relief, improved psychological well-being, reduced depression and anxiety, improved quality of life and sense of self-efficacy, improved sleep, muscle strength, cardio respiratory fitness, balance, coordination, and mobility.

What about strength exercises? Can individuals with FMS lift weights and reduce, rather than aggravate, their FMS symptoms? The Ottawa Panel of researchers performed a comprehensive analysis of the studies on strength training with FMS, and they universally recommended weight lifting for helping FMS patients (reference 3).

The exercise ideally should be individually tailored to each person, be provided near the persons home, and include feedback and social encouragement. Intensity can be moderate to strong resistance without aggravation of the FMS, depending on the individual. Expected improvements from strength training can be found in an improved quality of life, decreased sense of depression and of course increased strength. A PT or restorative-fitness professional can train you in progressive fitness as part of functional training, so you can walk, climb, lift, push and pull with more power. The BenchFit strength training DVD and Book (Mason Home Fitness) are 20 minute workkouts and contain progressive fitness protocols that can be performed at home, and are joint and spine-safety oriented as designed by this author for healthy fitness for beginning to intermediate level exercises (Reference 4). Key ingredients for a fitness recipe for you include assessment of interests, measurements of starting aerobic and strength levels, goal setting, and creating an action plan with weekly and monthly adjustments.

As you look for resources to help your FMS, please recognize that each person FMS is unique, and avoid anyone selling a “#1 cure” product, as success comes a multifaceted approach. One person’s FMS may have evolved from physical trauma and infections, another from genetics, digestive problems, and nutritional deficiencies, and your MD can help you decipher the causes of your condition. As you go through treatment, try to add one new healthy habit a week, rather than change your whole life suddenly. Consult the Web MD and National Fibromyalgia Association websites (references 1, 5). There are FMS support groups both locally and nationally, and  Janet Lawler, massage therapist, helps with a local chapter and can refer you to a local support group as needed (reference 6). You can keep a “healthy habits tracker” that you can pick use to log your progress. Keeping a written record, having specific goals, and medical and peer support are all ingredients for success.

FMS

1. www.webmd.com/fibromyalgia/guide/what-is-fibromyalgia

2. Brosseau, Wells, Tugwell et al, Ottawa Panel

Evidence-Based Clinical Practice Guidelines for Aerobic Fitness Exercises in the Management of Fibromyalgia: Part 1, Physical therapy Journal, Volume 88, Number 7, 857-871, July 2008

3.Brosseau, Wells, Tugwell et al, Ottawa Panel

Evidence-Based Clinical Practice Guidelines for Strengthening Exercises in the Management of Fibromyalgia: Part2, Physical therapy Journal, Volume 88, Number 7, 873-885, July 2008

4. Mason-Cover, Maureen, BenchFit I 20 Exercises, Book and

DVD, Mason Home Fitness, 2004, www.BenchFit.com

5. www.fmaware.org

6. janet@bodytherapies.com

7. http://www.womenshealth.gov/publications/our-publications/fact-sheet/fibromyalgia.html

8. http://www.healthline.com/health-news/aging-scientists-find-physical-cause-of-fibromyalgia-062113

Breast Cancer, Part 2: Risk Factors and Prevention

Natasha Ratajczak, PT, DPT

In the last post, I discussed the risk factors and role of genetics with breast cancer. The factors that mainstream lets us hear about include gender, age and family history. However, did you know that there are several other things that could potentially increase the risk of breast cancer? Let’s take a look at a few of these and see if there are some manageable steps to decrease personal risk of breast cancer.

1.   Being overweight: Women that have a BMI (Body Mass Index) greater than 25 are more likely to be at risk for breast cancer than women who maintain a healthier body weight, especially after menopause. The reason for this is because fat cells produce estrogen; therefore, extra fat cells in the body mean more estrogen in the body. However, this risk factor is complex because the area of where the extra fat is stored is important – extra fat around your middle section may increase risk more than having the same amount of fat around the thighs and hips. So, how can you take step to manage or prevent this? Create a healthy eating and exercise plan, after consulting with your physician. For helpful tips, please look here. For more information on healthy eating, dietary supplements, and nutrition resources, visit the Breastcancer.org Nutrition section.

2. Pregnancy history: Women who delivered before full term, or had their first child after the age of 30 have a higher incidence of breast cancer. According to breastcancer.org, “when breast cells are made in adolescence, they are immature and very active until your first full-term pregnancy. The immature breast cells respond to the hormone estrogen as well as hormone-disrupting chemicals in products. Your first full-term pregnancy makes the breast cells fully mature and grow in a more regular way. This is the main reason why pregnancy helps protect against breast cancer. Being pregnant also reduces your total number of lifetime menstrual cycles -- which may be another reason why earlier pregnancy seems to offer a protective effect.” Regardless of this fact, you can manage any increased risk by looking at lifestyle choices to keep your breast cancer risk as low as it can be: maintain a healthy weight, exercise regularly, limit alcohol, eat nutritiously, and never smoke, or quit smoking if you do so currently.

3. Going along with pregnancy histo is breastfeeding history: breastfeeding, especially for a year or more, can decrease your risk of breast cancer for several reasons. First, making milk 24/7 limits breast cells' ability to overgrow and misbehave. Also, most women have fewer menstrual cycles when they're breastfeeding (added to the 9 missed periods during pregnancy) resulting in lower estrogen levels. And of course, many women tend to eat more nutritious foods and follow healthier lifestyles (limit smoking and alcohol use) while breastfeeding. Whether or not you breastfeed, following the same lifestyle habits listed above can keep your breast cancer risk at bay.

4. Drinking alcohol: Research shows that drinking any type of alcohol excessively can increase risk by increasing estrogen and other hormones associated with hormone-receptor-positive breast cancer. Alcohol also may increase breast cancer risk by damaging DNA in cells. Minimize drinks per week to 3 or less in order to reduce the risk maximally.

5. Lack of exercise: Exercising regularly at moderate intensity (60-70% of your max heart rate) for 4-7 hours per week helps reduce breast cancer risk, according to research.

For more information on risk factors and more tips for prevention, please visit breastcancer.org/risk/factors.

Breast Cancer Prevention, Part 1

Natasha Ratajczak, PT, DPT

In the last month and a half, my mom has gone through receiving the diagnosis of stage 1 breast cancer 75% chance stemming from genetic etiology, undergoing a radical mastectomy and getting bilateral breast reconstruction, all in what feels like the blink of an eye. It all has left me amazed, incredibly grateful and completely humbled by how far technology has come and how strong and graceful my mom has handled everything thus far.

A little back story: my maternal grandmother passed on after breast cancer metastasized into her liver, lungs and bones in the mid 1990s. Several years later, my mom’s sister developed breast cancer early on in her right breast. She had a lumpectomy, then went into remission. The cancer returned in the following years so the doctors and my aunt decided to remove the breast. Unfortunately, the cancer returned in the other breast this year, so she had the second breast removed right about the same time as my mom began her journey (btw, my mom found her own lump by doing a regular monthly self-exam that she had done for years...she rocks!). Both women are currently recovering, but they are both proceeding with caution.

I am extremely grateful for and extremely proud of these strong women in my life. And because I now know how quick this type of cancer can occur and progress, I wanted to write up this blog post to give a little more background information to the men and women out there who have been affected by as well as may have breast cancer in their family DNA.

First off, breast cancer occurs like other cancer: it is an abnormal growth of cell tissue that comes from the genes that are supposed to help the tissue stay regulated and healthy. Therefore, “breast cancer” is caused by a malignant tumor that has developed from breast tissue. (Please refer here for current staging of breast cancer.)

Of course, you’ve probably noticed that breast cancer is embedded in my family history; my sister and I have discussed the potential of having inherited a genetic mutation, and are wondering the next steps to take for prevention for ourselves. Here are some interesting statistics that I found while doing my research:

1. About 5-10% of breast cancers can be linked to gene mutations (abnormal changes) inherited from one’s mother or father. Mutations of the BRCA1 and BRCA 2 genes are the most common. Women with a BRCA1 mutation have a 55-65% risk of developing breast cancer before age 70, and often at a younger age that it typically develops. For women with a BRCA2 mutation, this risk is 45%. An increased ovarian cancer risk is also associated with these genetic mutations. In men, BRCA2 mutations are associated with a lifetime breast cancer risk of about 6%; BRCA1 mutations are a less frequent cause of breast cancer in men.

2. About 85% of breast cancers occur in women who have no family history of breast cancer. These occur due to genetic mutations that happen as a result of the aging process and life in general, rather than inherited mutations. The two highest risk factors for breast cancer are gender (women >>men) and age (increased risk comes with growing older).

Given our family history, my sister and I have decided to undergo genetic testing, because after speaking with my mom’s physicians, they have told us that we each have 50% chance of having the mutation. Although you should know that there are also screening tests that can be done for early detection. These screening tests include yearly mammograms, and are usually given to those individuals who appear to be healthy and have no history of breast cancer. If an abnormality is found, then tests (usually a biopsy) are done to the abnormality to determine if the tissue is benign or malignant.

As mentioned above, there are two genetic mutations that can be tested for: BRCA1 (BReast CAncer gene 1) and BRCA2 (BReast CAncer gene 2). Mutations in these genes that are supposed to keep breast cells growing normally can lead to increased risks in malignant tumors in breast as well as ovarian tissue (or prostate tissue in men). Abnormal BRCA1 and BRCA2 genes may account for up to 10% of all breast cancers, or 1 out of every 10 cases. For more information about genetic testing please visit here.

I encourage you to please pay attention to your breast tissue. Start regular monthly self-exams to learn about your tissue enough to detect when something does not feel right. Also get your mammograms done yearly, even if you are not at risk. In my next blog posting, I will address more preventative options for all of you when contemplating breast cancer as I continue by my mom’s side on this journey.

Tune in to the next few posts for more on breast cancer prevention!

More information can be found at breastcancer.org.