breast self-check

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Johns Hopkins OB/GYN Francisco Rojas, M.D., discusses various types of breast lumps and what you can do about them.

Q: How common are lumps in the breast?
Breast lumps are common, particularly in young women in their late teens and early 20s. Women also may feel a breast lump during pregnancy or breastfeeding. Lumps in older women tend to be less common but more dangerous.

Q: What causes breast lumps?
Most breast lumps are benign or “normal;” however, breast lumps also can be caused by cancer. We cannot always explain what causes benign breast lumps.

Q: What are the different types of breast lumps?
Fibroadenomas are benign masses in the breast. They are not cancer and will not become cancer. They occur most often in younger women but also can happen in later years. Cysts are fluid-filled lumps that may cause pain and are usually benign. Other tumors are less common, can be benign or malignant and should be removed. The important thing to remember is that breast cancer also can present as a lump.

Q: What should you do if you detect a lump?
Any change in the breast should be evaluated by your physician or provider. Your provider will need to know when you noticed the lump and if it has changed in any way; also tell your provider about any changes in the skin or nipple discharge and if you notice any other lumps or changes in the breast or armpit. Tests such as an ultrasound, mammogram or MRI may be ordered.

Q: How are breast lumps treated?
Treatment is determined by the type of breast lump. Most often, a biopsy of the lump will be needed to determine the type. Fibroadenomas can be watched over time for changes. Cysts can be drained with a needle to remove fluid. Other tumors and breast cancer must be removed by a surgeon.

Q: Is there anything you can do to prevent breast lumps?
You may not be able to prevent breast lumps, but for your breast and overall health it is important to eat a healthy diet with fruits and vegetables. Do not smoke, and consume alcohol only in moderation. Exercise and maintain a healthy weight. Perform self-breast exams once a month and have breasts examined annually by a medical provider. Report any changes in your breasts to your provider as soon as you notice them.

Q: Who is at the greatest risk for developing breast lumps?
Anyone can develop a lump, but people who have a prior personal history of breast cancer or family history of breast cancer are at a higher risk of developing a malignant tumor.

Dr. Francisco Rojas is a Johns Hopkins OB/GYN.

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nutritionWe all remember that special food our parents used to feed us when we were sick as kids. As adults, it seems reasonable that those same comfort foods would help us feel better as adults, but many times that is not the case. In the new age of gluten-free, anti-inflammatory, plant-based, low GI, diets all promoting health and anti-cancer benefits however, how are we supposed to know what’s right for us when we are sick?

We all know that one of the major side-effects of chemotherapy is nausea. This can lead to loss of appetite and weight loss at a time when you need those nutrients most. A healthier diet can help with those tummy troubles. Either way you look at it, a healthier diet can lead a cancer patient down the road to a faster recovery.

Some changes will be obvious. Processed and pre-packaged foods, the red velvet cheesecake at your favorite restaurant, are almost certainly bad. Others may not be so obvious. Multiple sources list vegan diets as optimal, but this is up to the individual. Cutting back on red meat is a start as many tend to find it has a metallic taste after treatment. Non-animal proteins such as beans and nuts will be easier to digest. Vegetables are going to be the most important food group for cancer patients, specifically leafy greens. Easy to digest whole grains are also important.

With all this knowledge, there are definitely some foods you can, and should, still eat.
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Still not feeling great? Chemocare has some great advice for how to prevent nausea and continue eating when you need those nutrients the most. My personal favorite for stomach problems is eating smaller meals throughout the day instead of two or three big ones.

Aryn is an Instructor & Research Specialist at the Miller Branch and has been with HCLS for over 3 years. She has many hobbies including, but not excluded to: exercising, vegetarian living, and eating cake. Perhaps cake is neither “well” nor “wise” but it’s certainly delicious!

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nowhere hairThe title of this post is a quote attributed to Susan McHenry, from The Book of Awakening by Mark Nepo

“Cancer.” The first thought we may have when seeing someone without any hair or eyebrows.

Hair loss can be one of the greatest fears for a cancer patient. Many patients about to undergo chemotherapy shave their heads to avoid the experience of watching their hair thin and disappear. Why does this hair loss occur and why don’t all patients undergoing cancer treatment lose their hair? Medication administered to target and kill cancer cells is commonly referred to as “chemotherapy.” Many patients whose cancer treatment includes chemotherapy will lose their hair because of the mechanism of action of these medications. Some cancer patients undergo radiation treatment as well. Radiation may also result in hair loss.

Alopecia is the clinical term for loss of hair from the body. Alopecia can be in a specific area of the body, such as the scalp, or all over the body. Hair grows out of follicles and is characterized by a long growth phase, a transitional phase, and a brief resting phase, after which the hair falls out. One mechanism by which chemotherapy works is to kill off rapidly reproducing cells. Cancer cells and hair cells both divide constantly- and for this reason are targeted by many forms of chemotherapy. Chemotherapy speeds the progress of hair to the resting phase, resulting in a sudden onset of hair loss. Cancer patients receiving particular types of drugs, however, may not experience hair loss. Medications targeting specific cells or parts of cells or those that attack cancer by boosting a patient’s own immune pathways are unlikely to affect hair growth.

LEARN Cancer MEthodSince each medication has a slightly different onset of action and duration of effect, hair loss from chemotherapy may occur within a week or not until several weeks after treatment. Hair loss may be partial or total. Hair will usually return several weeks after treatment is completed. New hair growth may be a different color or texture from what it was prior to treatment, but the change is rarely permanent. Radiation therapy also destroys rapidly growing cells, so hair follicles in the area targeted by radiation may be destroyed. Hair loss in these areas can be permanent. If hair does return, any alteration in texture or color may be permanent because the goal of radiation is to alter and remove treated cells to prevent their regeneration. Radiation may target every cell in its path, while chemotherapy’s long-term effect is to permanently destroy only cancer cells.

Every cancer patient is different. Each person’s experience of hair loss is highly personal. One close friend might have a response you expect, another might surprise you. Be open and forthright and your friend or family member will appreciate your support. When one of my friends had hair loss during chemotherapy, she welcomed the hand-me-down hats from another friend whose sister had gone through chemo. A different person may not have wanted these hats. Sensitivity and empathy goes a long way. Years later, my friend and I still laugh about the wonderful experiences we had because she was bald and wearing a bold hat. It seemed we always got the best table in the restaurant and the most attentive service. Once, we got special attention from a rock star signing CDs after a concert. We’re convinced it was the crazy hat.

Websites for organizations such as the American Cancer SocietyJohns Hopkins Medicine and the National Cancer Institute offer useful information about coping with chemotherapy-induced hair loss. The comedian Jay London has said, “I was going to buy a book on hair loss, but the pages kept falling out.” Nonetheless, there are many helpful text references including Cancer Caregiving A to Z: An At-Home Guide for Patients and Families and Learn to Live Through Cancer: What You Need to Know and Do.

Cherise Tasker is an Instructor & Research Specialist at the Central Branch and has a background in health information. Most evenings, Cherise can be found reading a book, attending a book club meeting, or coordinating a book group.

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When you get a cancer diagnosis, it is natural to panic, get depressed, and feel angry. But, as Dr. Agus says in A Short Guide to a Long Life, take it not as a death sentence, but as a wake-up call and an opportunity to take control of the health of your own body by learning all you can, studying your options, and going forth with the best treatment that you and your doctor have decided on, all with the best positive attitude you can muster. But don’t become so micro-focused on this one area of your health that you let other areas of your life get pushed aside or forgotten, such as the simple joys of playing with an animal friend or eating a delicious meal.

You know your health is all wrapped up like a rubber band ball with your emotions, your lifestyle, and your attitude. More than anything, eating can be the most important and healthy thing that you can do to guarantee your body receives the raw materials to fight the growth of cancerous cells and to keep the rest of your body humming along in fine shape.

I am going to list a few of my favorite cookbooks from Howard County Library System for those who want to have some new recipes for themselves, a family member, or a friend who may be living with cancer and going through radiation and/or chemotherapy treatments. They may need some help with preparing a nourishing meal, especially if they have a decreased appetite and not much energy. Don‘t forget, drinking lots of fluids is super important, so check out the great drinks and smoothie recipes too–they are great for throwing in healthy ingredients!

The most beautifully illustrated book of clean, green, and fresh recipes is No. 4, but my favorite is No. 1 because it is written as if there is a helper there with you as you plan to make a tasty recipes with notes of interest on how certain ingredients are beneficial or may help with treatment side-effects. For instance, one note says that metal, as in silverware, can often have a bad taste or feel in your mouth when you are getting cancer treatments. So, the suggestion is to go get some pretty plastic ware so that your eating implements are not an impediment to having some yummy healing food.

My son, who underwent two radical craniotomies for brain cancer, said that it was the preparation of the food and often the smell of the cooking, and even sometimes the energy to do the chewing, that really didn’t make eating appealing. Things that could be prepared quickly were helpful. What he appreciated the most was cold things like yogurt, ice cream, fresh fruit shakes, and smoothies. Simple things like crackers and dips or hummus, omelets, cereal or even ramen noodles were preferred as well.

What helped my son the most? Someone who was there providing love and support as well as a full pantry and refrigerator with lots of good-for-you ingredients for wholesome recipe options, especially as he felt better and began to want to experiment with more foods and flavors as his health, energy, and well-being improved. You will find a treasure-trove of great recipes in these books to complement any lifestyle or condition, and remember healthy eating is for all of us always –and thanks for reading my story.

Susan Cooke has worked in Howard County Library System for 20 years. She loves golden retrievers, fresh veggies, and (of course) reading good books. She is proud to have her daughter Sarah Cooke working for HCLS alongside her!

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Prostate-specific antigen or “PSA” is a blood test that screens for the level of a protein in the blood that can indicate prostate cancer. For many years, it has been the only screening tool for prostate cancer. According to the Centers for Disease Control, approximately 30 million PSA screenings are done every year, and about 1.5 million of the screenings are found to be abnormal. Of the one million men who undergo a biopsy due to an abnormal PSA test, 250,000 are diagnosed with prostate cancer. This means that three out of four men with an increased PSA are found to be negative for cancer after having a biopsy.

The American Urology Association (AUA) released its new clinical guidelines on prostate cancer screening in 2013, creating a stir of questions by patients. The panel decided that, from a public health perspective, the current strategy of PSA-based screening that measures the level of enzyme in the prostate provided high rates of over-diagnosis, needless biopsies and over-treatment.

“We still believe the PSA test is the standard,” said Dr. Alan Partin, M.D., Ph.D., chairman, professor and urologist-in-chief of the Department of Urology and the James Buchanan Brady Urological Institute at The Johns Hopkins Hospital. “However, in the past, when an elevated PSA was found and the biopsy was negative, we would routinely biopsy again. Today, due in part to research Johns Hopkins participated in, we can offer two new tests: the Prostate Health Index (PHI) blood test and PCA3 urine test. As these tests become more widely available, urologists will be able to follow those 750,000 men each year and avoid performing some additional biopsies.”

Marc Applestein, M.D., a urologist on staff at HCGH, notes, “These new tests will offer men new options. PHI testing will be more widely available soon and, at present, neither the PHI nor the PCA3 tests are covered by insurance. There is still debate and a lack of consensus about recommendations for men about screening. Men should discuss their family history and when to start PSA testing as well as what new testing options are available with their urologist.”


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1CarePackageIt’s natural to want to show someone you care for and have been thinking about them, but it can sometimes be hard to come up with what to do or say. Do you send someone with cancer a get well soon card? Take them out to dinner? Send flowers? Just give them a hug? (Probably advisable, unless you’re sick -in which case stay away!) One good option is to give them a care package – it will show that you’re thinking about them and that you care how they’re doing, even when you can’t find the right words.

So, what do you put in a care package for someone who’s dealing with cancer (or other serious illness)? The following are just a few of the things I would pack for a friend going through treatment.

  • Something that’s cute or nice to look at; a little thing that will make them smile. I added  a small vase of flowers and a happy bumble bee knot-wrap containing a bath bomb and some sweet soap – just to help them relax in the bath and smile a little.
  • Soothing ginger and mint teas – to help an upset stomach or lessen nausea
  • Tea ball (a robot!)
  • Tea scoop
  • Travel mug
  • Lotion to soothe irritated and dry skin, the stronger and more intensive care, the better.
  • Lip balm
  • Hand sanitizer (unscented if possible)
  • Some treats, just for fun! A little bit of chocolate can make anyone feel a little bit better sometimes.
  • Streaming video service subscription – great for those days when you’re too exhausted and run down to go out for entertainment.
  • Easy to make chicken noodle soup
  • Home-made lap blanket
  • Travel water bottle – though a whole case of bottled water for the trunk of their car can be a big help after chemo sessions
  • The theme of my care package is "comfortable self-care." I thought about the things that would make me feel better and the things I would like to have on hand. The beauty of care packages is personalizing them. Some people need skull caps or soft hats when their hair starts to thin or magazines to flip through while sitting in a chemo chair. These are only a few of my ideas, what would you put into a care package?
  • Something that’s cute or nice to look at; a little thing that will make your care package recipient smile. I added a small vase of flowers and a happy bumble bee knot-wrap containing a bath bomb and some sweet soap – just to help them relax in the bath and smile a little.
  • Soothing ginger and mint teas – to help an upset stomach or lessen nausea. Tea ball (a robot!), tea scoop, and Travel mug.
  • Lotion to soothe irritated and dry skin, the stronger and more intensive care, the better. Think about lip balms and unscented hand sanitizer too.
  • Some treats, just for fun! A little bit of chocolate can make anyone feel a little bit better sometimes. If they don't eat them now, they'll still be there waiting. It can be nice to have a treat to look forward to.
  • Streaming video service subscription – great for those days when you’re too exhausted and run down to go out for entertainment. The library is a great resource for streaming and digital content, be it e-books, digital audio books, magazines, and even some movies. A home-made lap blanket (or any exceptionally soft blanket) along with some easy-to-make chicken noodle soup can bring real comfort.
  • Finally, something that your care package recipient will take with them everywhere: a travel water bottle. Though, a whole case of bottled water for the trunk of their car can be a big help after chemo sessions. Extra points if you have a cooler to spare.

Jessica Seipel is an Instructor & Research Specialist at the Savage Branch. She has worked for the Howard County Library System, in various positions, for a decade.

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