Whenever a stranger is lurking around us or our children, our instincts go on high alert, and we instantly go into our hyper-vigilant protection mode, right? Well my sistahs, breast cancer is a VERY dangerous stranger lurking around our community, and it's taking up residence in too many of our homes.

According to the National Cancer Institute (NCI), "Breast cancer is the most commonly diagnosed cancer among African American women. An estimated 19,540 new cases of breast cancer are expected to occur among African American women in 2009."

Sadly, the NCI  further estimates that "6,020 deaths from breast cancer are expected to occur among African American women in 2009. It is the second most common cause of cancer death among African American women, surpassed only by lung cancer."

Just stop for a moment and take that in. Nearly 20,000 of us and our grandmothers, mothers, aunts, sisters, daughters, nieces and other loved ones will be stricken. More than 6,000 voices silenced. More than 6,000 families shattered. More than 6,000 funerals conducted.

We can no longer sit quietly, thinking this ominous "stranger" won't come our way. It can happen to any of us!  It already is!

Know the risks

One of the most important steps in subduing breast cancer among African American women is to know the changeable risk factors:

• Obesity. According to the American Cancer Society, being overweight or obese is one of the most carcinogenic (cancer causing) risk factors for breast and cervical cancer. (See WHOLE for more details about obesity.)
  
• Poor eating habits. Diets high in fat, sugar, and sodium, aside from causing excessive weight gain, can suppress the immune system and make you more vulnerable to cancers
  
• Sedentary lifestyle. Lack of even moderate exercise can inhibit your body's ability to excrete harmful toxins
  
• Drinking alcohol. Even drinking just one glass of alcohol each day can increase your risk. Is it really worth it?
  

Do any of these behaviors sound familiar? You might be at risk! Please be sure to read ALL the articles in this issue of WHOLE and follow the links we've provided for ideas about making health-affirming changes in your lifestyle.

Young sistahs are especially vulnerable

I recently heard of a ten-year-old sistah being diagnosed with breast cancer. TEN YEARS OLD!!! So often we think of breast cancer as a disease that only strikes older women. Not so.
Breast cancer is the leading cause of cancer death in women ages 15 to 54. Recent studies reveal the distressing realities about young women and breast cancer*:

• One in every 229 women between the ages of 30 and 39 will be diagnosed with breast cancer in the next 10 years
  
• When younger, premenopausal, black women get breast cancer, they are more than twice as likely as older women, black or white, to get an aggressive breast cancer subtype
• Breast cancer patients 35 years old and younger have higher rates of their cancer returning after treatment than older women patients with the same stage of cancer, and their risk of recurrence is greatly impacted by the type of treatment they received
• Many young women and their doctors are unaware that they are at risk for breast cancer.
• There is no effective breast cancer screening tool for women 40 years old and under.

One young breast cancer survivor who is sounding the alarm is Maimah Karmo.  Diagnosed when she was 32 years old, Ms. Karmo found her lump a year earlier. However, she encountered a doctor who assured her she was too young to have breast cancer. By the time of her diagnosis months later, the tumor was substantially larger.

Fortunately, the power-house native of Liberia survived, and is thriving at the helm of the Tiger Lily Foundation, an organization she founded especially to support young breast cancer survivors. From the moment of diagnosis, Tiger Lily Foundation provides online and in-person support such as comfort bags with special with skin-care products, a warm blanket to use during chemo treatments, and healthy meal resources.

A special focus of Tiger Lily Foundation is "Early Act", new proposed federal legislation on early cancer education and treatment support for young women diagnosed with breast cancer. To learn more, visit the Tiger Lily Foundation. We also recommend you visit the Young Survivors Coalition for additional information and support created specifically for young women.

An Aggressive Triple Threat

Much has been reported recently about a particularly "bad actor" called Triple Negative Breast Cancer ("TNBC"). This especially aggressive sub type of breast cancer is called Triple Negative (also known as "Basal-like") because it lacks estrogen, progesterone, and HER2 receptors. Lacking these three receptors means this form of breast cancer will not respond to hormonal therapies such as tamoxifen, nor medications that target HER2 such as Herceptin. Treatment options for TNBC are narrowed to surgery, chemotherapy, and radiation therapy.

Research over the last few years has revealed that TNBC is especially aggressive with young African American women under the age of 35. What is frustrating--as in Ms. Karmo's case--is that few doctors recognize the breast cancer risk in young women. Moreover, current best-practice protocols in breast cancer screening recommend diagnostic tools such a mammography only for women over 40 (see the American Cancer Society recommendations for more information). As a result, many young women are diagnosed at a much later stage and have a much poorer survival rate. For more information on TNBC, see our fact sheet "Triple Negative Breast Cancer," and visit the Triple Negative Breast Cancer Foundation.

Breast cancer is not just a lump

Did you know that breast cancer doesn't always show itself as a lump? Inflammatory Breast Cancer ("IBC") is another type of breast cancer that is now beginning to be understood much better. It is rare, but is known to emerge very quickly--sometimes overnight! It produces symptoms such as redness, swelling, very warm/hot to the touch, discharge, inverted nipples, discoloration of the areola (the skin around the nipple) and tenderness.

IBC is often mistaken for a mammary infection for which antibiotics are prescribed. However, if the symptoms don't abate, it is essential to follow-up with the doctor right away. For more information on IBC, see our fact sheet "Inflammatory Breast Cancer,"  and visit the Inflammatory Breast Cancer Foundation.

Be an Advocate

Early detection of breast cancer affords you the best options for treatment and survival. That is why it is incumbant upon each one of us to: know our bodies; be assertive with our doctors and insist on adequate follow up and access to advanced diagnostic screenings; maintain a healthy lifestyle (see "What You Can Do" for specific tips); and encourage sistahfriends, family, and colleagues to do the same.

Bottom line, your breast health is literally in your hands. Please take good care of your "girls!"

*Sources: National Cancer Institute, American Cancer Society, Tiger Lily Foundation, Young Survivors Coalition, BreastCancer.org,and Science Daily

When I wrote my book WHOLE: 12 Principles for Rebuilding Life after Breast Cancer, I was intent on creating specific tools for sistah survivors on how to recover their health and maintain a wellness lifestyle.

Quickly, women who purchased "WHOLE" for their loved ones realized that we ALL need to adopt the self-care practices that sustain optimal health--not only breast cancer survivors.

Here are five easy WHOLE Body Living tips:

1. Think before you bite! My grandma Ellen always said, "You are what you eat!" We all have possibly heard that saying. But this pearl of wisdom is true! Far too many of us are living on fast foods that are high in fat, sugar, salt, and empty calories. STOP! Before you drive up to the take-out window, or indulge the food craving du jour, educate yourself about Cancer Fighting Nutrition. Visit WeSpeakLoudly to learn more about healthy eating. Click on the WHOLE Newsletter Archive. Each issue features delicious, cancer-fighting recipes and food tips. Another source we love for information about cancer-fighting foods is the American Institute for Cancer Research. Check them out!
   
2. Move your body! Exercise is an effective stress-reducer and weight-loss friend. Surprisingly, you don't have to become an Olympic athlete or professional sports woman to garner the benefits of becoming more active. If you are obese or overweight, losing just 10% of your current poundage is enough to start the protective forces of lowering blood pressure and cholesterol, and helping to excrete toxins from your body. Walking is a gentle, low-impact exercise to help you get started. And now that the weather is cooling off, you can scope out warm, secure and free indoor options for exercise like your college sports facilities, and even shopping malls at off hours.
   
3. Check your Vitamin D levels. Recent research indicates that low Vitamin D levels can make a person more susceptible to cancer. This is especially true for African American women because our richly-colored skin makes it more difficult to absorb Vitamin D from the sun. Consider taking Vitamin D3 supplements--available in both pill and liquid form. Consult your doctor for proper dosage.
4. Conduct monthly Breast Self-Examination (BSE). Though in recent years (BSE) has fallen out of favor as a predictor of breast cancer, we still recommend it. BSE is still a very effective tool to help you learn about how your body feels--what's normal for you. Sensing or feeling subtle changes in breast tissue that might not be picked up on a mammogram could help catch breast cancer early. And we should teach our girls how to do BSE as they begin their menses so they can become comfortable with the practice of this healing touch. We've prepared a "How-to" fact sheet on breast self-exam that's only a click away!
5. Gather your family history. Genetics can play a large part in predicting your unique risk factors for breast cancer. Take time to contact eldest family members first and interview them about health conditions they and other kinfolk may have had. Granted they might not call an ailment by the name recognized by the medical establishment, but probe a little. For example, a family history of diabetes could have been called "Sugar." Hypertension could have been called "High Blood." Same with breast cancer. It wasn't often talked about, but with a little probing, you can find out if any female family members had mastectomies, or if people recollect a relative with swelling in their arm--a sign that lymphedema might have been present (sometimes a side effect of breast cancer surgery.) This information will be invaluable to share with your doctor when you have your annual clinical breast exam.

Want to get a copy of "WHOLE: 12 Principles for Rebuilding Life after Breast Cancer"? Come on over to our website to learn more!

What do beans, dark green leafy veggies, tomatoes, grapes, and flaxseeds have in common? They're all potent cancer-fighting foods. So are whole grains, berries, garlic, soy, and green tea. All have documented healing and disease-prevention properties that must find their way into your diet in abundance.

Now be honest. Are these foods a regular part of your diet? Mastery of cancer-fighting food preparation is much easier than you realize. It is simply adopting a diet rich with veggies, learning a few new food prep techniques, and educating yourself about what's really in the food you eat.

Chapter 8 "Renew" in WHOLE: 12 Principles for Rebuilding Life after Breast Cancer is dedicated to transforming your relationship with food, including these health-promoting steps:

• Keep a food diary to get an honest appraisal of the amounts and kinds of foods you eat. You'll be surprised by the damage you're doing to your body with each bite!
• Read food labels to learn about (and begin to avoid) the high levels of chemicals, sodium, and artificial flavoring in processed foods;
• Make veggies the star of your meals and make it colorful! This is a great way to lose weight while getting the more healthful variety of nutrients your body craves;
• Plan ahead to increase the time you'll have for making home-cooked meals--and save money, too!

Organic or Not?

To avoid pesticides, hormones, and other chemical alterations to food, organic produce, free-range meats, and wild seafoods are important alternatives to incorporate into healthier eating habits. However, access to organic foods and their substantially higher cost can put them out of reach for many African Americans. Awareness of which foods contain higher levels of pesticides will allow you to reduce your exposure to chemicals by avoiding these foods or selecting only the organically grown variety.

The Environmental Working Group (EWG), a research organization based in Washington, DC releases an annual report about the most contaminated vegetables and fruits called "The Dirty Dozen and the Clean 15."

EWG's computer analysis found that consumers could cut their pesticide exposure by almost 90 percent by avoiding the most contaminated fruits and veggies and eating the least contaminated instead. They've created the Shopper's Guide to Pesticides in Produce, available free for download. Click "Shopper's Guide" to get your copy.

Start your day the antioxidant way

Breakfast is the most important meal of the day. It sets the tone for your energy level, clears your thinking, and boosts your attitude. Yet many of us snatch a fancy coffee drink and pastry as we rush to work and school. Not good, ladies! Try this quick alternative, a raspberry smoothie! The berries and soy are two cancer-fighting foods, ready for your enjoyment in minutes!

Raspberry Soy Antioxidant Joy

Place the following ingredients in your blender:
1 1/2 cups fresh raspberries (unsweetened, whole frozen may be substituted)
1 cup unsweetened soymilk
1/4 cup vanilla soy yogurt
1 tsp honey, stevia, or agave nectar to sweeten
4 or 5 ice cubes (if you're using fresh berries)
dash nutmeg
Simply blend the berries, soymilk, yogurt, sweetner, and ice until smooth. Pour into a tall glass and dust with nutmeg. Enjoy!

Serves 1