Talking to My Tatas is on Sale!

Great news! My publisher, Rowman & Littlefield, is having an INDIE-spensable Sale, with 35% off the price of select books including Talking to My Tatas: All You Need to Know from a Breast Cancer Researcher and Survivor. The book must be purchased through the Rowman & Littlefield website to get the sale price.

Use the promo code 22JOYSALE at checkout to get the sale price now through January 6, 2023!

This is a great deal, as you’ll save over $12 on the Hardback and almost $12 on the eBook. Know someone who is going through breast cancer? This would be a helpful gift. Know someone who’s a science loving nerd? They’ll probably like it, too!

Knowledge is power, and humor is healing.

Grab a copy while the sale lasts!

Interview with Fox 13 Tampa for National Breast Cancer Awareness Month!

It’s day 26 of National Breast Cancer Awareness month! Today, I had the opportunity to appear on the Tampa Reads segment of Fox 13 in Tampa with anchor Linda Hurtado! I was able to share my breast cancer story with a bit about science, about my personal story, and a bit about Talking to My Tatas.

It was a great experience and I hope I convinced some viewers to schedule their mammograms! Shout out to Linda Hurtado, Lisa Emerson, and the rest of Fox 13 News Team!

I’m going to be on TV!!!

It’s day 23 of National Breast Cancer Awareness Month! I skipped a few days due to lack of spoons (see my previous post about spoon theory and chronic illness), but I have some extras today and am excited at the prospect of bringing my message to folks in Tampa, Florida, and beyond!

Photo Source Here.

My amazing Literary Agent, Barbara Rosenberg, put me in touch with Linda Hurtado, an award-winning news anchor by day who writes heart stopping thrillers as Linda Bond (and I totally recommend checking out her books!). Linda then invited me to appear on her live show for Breast Cancer Awareness Month! It’s scheduled for Wednesday, October 26, at 12:00 pm EST for her Tampa Bay Reads segment. I’ll be talking about breast cancer from both a patient and research perspective, talking about the book, and hopefully convincing viewers to schedule their mammograms!

This will be my first television appearance and I’m both excited and a little nervous, but I have faith in Linda and I’ll just be prepared to be poised but still be myself as I share my story and hopefully some more information about breast cancer that the public needs to know.

Super grateful for the opportunity and hope it helps me make a difference! Wish me luck!

I’ll be sure to post the link in a future blog post!

The Healing Power of Pets

It’s day 17 of National Breast Cancer Awareness Month! Today’s post is all about celebrating our pet pals and how they support and heal us when we have cancer. I’m a lifelong cat fanatic. My first pet was a ginger tomcat who chased me through the house and yard and then curled up with me for a well-earned nap. I’ve been hooked ever since. Cats are wildly entertaining goofballs that toe the line between completely endearing and completely annoying, and I’m here for it!

Enjoy these goofy cats!

I am currently owned by three cats.

Vanilla (full name Vanilla Wafter Sieders Asshole IV), my son’s 5 year old Siamese who is gorgeous, had the biggest and best purrs, likes to give love bites and has a weird foot fetish. Then there’s Kuro (Kuro I’m the Good One Sieders), my daughter’s 4 year old black beauty who is a world class snuggler, has the sweetest purr, and turns into a ninja assassin when it’s time to trim her claws. Finally, my black cat (pandemic pet) Sheila (Sheila Bad Bitch Sieders) is 2 years old, gorgeous, dumb as a bag of rocks, and wildly entertaining. She also meows loudly and nonstop.

Vanilla looking distinguished and handsome in his winter holiday bowtie collar.

Aside from their many and varied personality quirks, whenever someone in the family is sick or recovering from illness (in my case, multiple surgeries and radiation therapy), the cats are on that someone 24/7, working in shifts to provide comfort and company. Kuro takes on the brunt of the work, curled up in a lap or on a chest with soothing purrs and comforting warmth, letting us stroke her silky soft fur and relax into her calm.

Kuro sitting on my lap (covered by her favorite soft blanket) in my home office. Yes, that’s a ceramic skull on my desk. And a hand-painted ceramic mermaid. And a “Donut Give Up” plaque. Don’t worry about it.

Vanilla will then take over, making biscuits on the blanket, purring, and demanding pets. He’s not big on cuddles, but he likes to sit close and slow blink. He’s 15 pounds of fluff and squishy love.

Sheila is not best pleased to be at the vet and is trying her best to hide behind my daughter.

Then, there’s Sheila. She’s a noodle of a cat, slinky and svelte, acrobatic, energetic, and adorable with her single braincell. She’s young, very busy playing and getting into all kinds of cat shenanigans, and always makes me laugh. She’s not often cuddly, but when she is, she melts. Her purrs are soft and subtle, and her fur is as sleek as she is.

I’m a believer in the healing power of cats, but what is the scientific evidence? Turns out, the emotional support benefits of pets for cancer patients are supported by the American Cancer Society and by a recently published literature review. Click on the links for tips to stay safe and healthy with pets while undergoing cancer treatments.

As long as your healthcare provider gives you the green light and you take precautions to protect yourself and your pets during treatment, take all the fur baby love you can get!

A Brief History of Tamoxifen

It’s Day 16 of National Breast Cancer Awareness Month! Today’s topic will cover one of the oldest targeted breast cancer drugs developed that is still used in the clinic today—tamoxifen. I’ve been taking it for 3 1/2 years, and millions of other breast cancer survivors with ER+ breast cancer have taken this drug as part of their treatments to prevent recurrence. But how was it discovered? How does it work?

Image Source Here.

Like many scientific discoveries, the discovery of tamoxifen was an accident. ICI46,474, later named tamoxifen, was first synthesized in 1966 by scientists working for a company that would become AstraZeneca. The goal of the project was to find a new chemical compound that could be made into a birth control drug. Laboratory studies were promising, but they found it didn’t work as a form of contraception in humans. This could have been the end of the story for tamoxifen, but one of the members of the team thought it might work as a breast cancer drug. In 1971, tamoxifen was tested in a clinical trial conducted in the UK on “late or recurrent carcinoma of the breast.” Thankfully, it worked!

Photo Source Here.

How does it work? Since it started out as a candidate contraceptive, it makes sense that it was designed to block estrogen, a female hormone that helps prepare the uterus and uterine lining for pregnancy. It is in a class of drugs known as Selective Estrogen Receptor Modulators (SERMs), which are compounds that compete with the hormone estrogen for binding to its receptor. Normally, when estrogen binds to its receptor in the body, it triggers processes in the cell that make it divide, or produce more cells. This is called proliferation. In cancers with too many estrogen receptors (ER), estrogen in the body makes these cells grow uncontrollably. By binding to estrogen receptors in breast cancer cells, tamoxifen blocks this action and stops breast cancer cells from growing.

Around 70-80% of breast cancers are ER+, meaning that abnormal estrogen receptor activation is a key driver for growth of the breast cancer cells. Tamoxifen was a game changer for women with ER+ disease, reducing the annual breast cancer death rate by 31%. There are other drugs on the market that also block the activity of estrogen or downstream molecules in the estrogen receptor pathway, but tamoxifen remains standard of care for many cases of ER+ breast cancer.

As with any medication, tamoxifen comes with side effects that include: hot flashes, vaginal discharge, nausea, mood swings, fatigue, depression, hair thinning, constipation, loss of libido, dry skin. I experienced hot flashes, vaginal dryness and libido issues, and hair thinning, but they were not as severe as those I experienced with other estrogen blockers (aromatase inhibitors). For me, tamoxifen is a better balance between protection from recurrence and quality of life, but everyone’s physiology and experiences are different.

Be sure to talk to your healthcare providers about any side effects you experience. You don’t have to suffer in silence, and there are options to reduce side effects and improve your quality of life.

FANTASTIC Day at the Nashville Komen More Thank Pink Walk!

It’s day 15 of National Breast Cancer Awareness Month, and WHAT A DAY! There is something truly magical, beautiful, and inspiring about being surrounded by a crowd of survivors, their loved ones, and those devoted to the mission of ending breast cancer! Here are some highlights from today!

Shout out to our AMAZING volunteers who organized the event, worked the tents, and kept it going!

Beautiful people doing AMAZING work to raise dollars and awareness for breast cancer!

A GORGEOUS 10 year survivor and her bestie volunteering and supporting all the walkers!
Meet The Pink Crusader, who cheers us on and makes us smile at events! Way to Go!

The Incomparable Riley Weston, Actress, Singer, Writer, Author, Activist, and our TOP FUNDRAISER!!!!!

To all those in the thick of it with breast cancer, survivors, their caregivers and loved ones, and those who have lost loved ones too soon – we work for you!

Want to help? Here’s the Link to My Fundraiser! Or donate to your favorite survivor, team, or other nonprofit dedicated to eradicating breast cancer!

Quick Post Before Tomorrow’s More Thank Pink Walk!

It’s day 14 of National Breast Cancer Awareness Month. Whew, a blog post a day is hard, y’all! But I hope these posts have been informative, entertaining, and full of hope. We all need hope. And we all need to be inspired.

That’s what I’m aiming for tomorrow. Between the pandemic and other turmoil in the world, it’s been over 4 years since I’ve done an in-person race/walk event. I still fundraised and still kept momentum going, but there is just something about seeing a sea of supporters – people with breast cancer, survivors, caregivers, loved ones, and everyone who shows up to raise money and shine a light on this awful disease!

There’s nothing quite like it.

I’ve seen beautiful bald women and women with gorgeous scarves, women with short and long hair spray painted pink, women who’ve traded illness for the graceful bodies of athletes, women with curves for DAYS rocking it, Black, Brown, White, Asian, Indigenous, gay and all the other letters of the alphabet mafia, old, young, and men who’ve also endured this horrible disease and stand in solidarity, not to be forgotten. It’s beautiful. It’s inspiring. It gives me the will to keep going!

Please, keep going!

I walk in memory of my cousin Sherri Killian, taken from us too soon by breast cancer, my uncle Jack, who we lost to cancer, and in honor of my mother, Carol Brantley, survivor. I walk in honor of my bestie Pam Jasper, and my friends Sue Daugherty Draughn, Linda Horton, Janet Piper, Karen Pugh, Tanisha Jones, and so many others who are more private about their cancer stories. So many family members, friends, colleagues, and acquaintances have been touched by cancer. We all know someone.

Sometimes we are that someone.

I walk for you. I may not know you personally, but we are connected. I work for you. I will not rest. If I can help one person, it is worth it. We fight cancer by holding one another up, celebrating victories, and witnessing and remembering those who leave us too soon. We fight.

Familial Breast Cancer: Know Your Risk!

While most breast cancers are sporadic, meaning there’s no genetic predisposition (i.e. gene variant inherited from one or both of your parents that increases your risk of breast cancer) that caused the cancer, around 5-10% of breast cancers are thought to be familial. Knowledge is power, and knowing if you have a genetic risk for breast cancer can empower you to take charge of your health by surveillance and managing your risk.

Photo Source Here.

How do inherited gene variants increase a person’s risk for breast cancer? Everyone has two copies of genes that we inherit from our parents. These genes have many different variants in the human population, and some specific gene variants are associated with increased risk of breast cancer. For example, inherited mutations in BRCA genes that make the gene product non-functional (i.e. no longer able to repair damage to DNA) increase the risk for breast and other cancers because the loss-of-function allows other mutations to build up in affected cells, which can eventually transform them into cancer cells. If you carry BRCA variants associated with cancer, you may be at greater risk and you can also pass these risk genes to your children.

In addition to BRCA1 and 2 genes, other inherited gene variants have been identified that are associated with increased risk for breast cancer, as shown in the graphic below. Some of these genes, like TP53, PTEN, STK11, CHEK2, NF1, produce proteins that are also involved in regulating cell growth, so non-functional variants cannot put the breaks on cell growth and can cause cancer cells to grow uncontrollably. The PALB2, BARD1, ATM, and RAD51D gene products work like BRCA gene products to repair DNA damage, so loss of function increases the chance of accumulating mutations in cells, which can lead to cancer. The RAD51C gene product is involved in stopping cells with DNA damage from growing, so loss of function allows cells with mutations to divide and accumulate more mutations, which can lead to cancer.

Image Source Here. Percentages represent relative risk of breast cancer for people who have these gene variants associated with breast cancer.

Should you get genetic counseling and genetic testing? That’s a personal decision, but here are some recommendations from the CDC that might help you make your decision:

A strong family history of breast and ovarian cancer,

A moderate family health history of breast and ovarian cancer and are of Ashkenazi Jewish or Eastern European ancestry.

A personal history of breast cancer and meet certain criteria (related to age of diagnosis, type of cancer, presence of certain other cancers or cancer in both breasts, ancestry, and family health history).

A personal history of ovarian, fallopian tube, or primary peritoneal cancer.

A known BRCA1BRCA2, or other inherited mutation in your family.

Knowing your risk can help you and your healthcare providers make decisions about surveillance and possible interventions. Take care of yourself, and if you can, find out about your family history of breast cancer.

Breast Cancer and the LGBTQIA+ Community

It’s day 9 of National Breast Cancer Awareness Month! Today, let’s cover breast cancer and how it affects the LGBTQIA+ Community—Lesbian Gay Bisexual Trans Queer/Questioning Intersex Asexual Plus other gender identities outside of Cis Heterosexual (Straight). Cancer doesn’t discriminate, but people, particularly those in power, can and do. Fortunately, there are resources available to help people in these communities navigate the healthcare system, including cancer care. My focus is on breast cancer, but some of the resources provided in the list below are more general and include multiple types of cancer care.

Photo Source Deposit Photos.

LGBTQIA+ people often experience discomfort and discrimination during healthcare encounters (and in the current political climate, in their communities and at the hands of politicians who challenge their very right to exist), which may account for reduced odds of receiving annual mammography screenings among some members of the community. This is especially true for trans persons who experience difficulty finding providers who understand their unique needs and who can or will perform appropriate screenings (e.g. breast and pelvic exams for trans men, prostate exams for trans women). One glaring example from my neck of the woods is a recent attack on Vanderbilt University Medical Center’s Transgender Clinic by Republican state legislators. Early detection is key to a positive outcome when it comes to cancer, and anything that creates a barrier to seeking and receiving essential health screenings, including bigotry, can cause unnecessary pain, suffering, and death.

LGBTQ populations have the highest reported rates of tobacco and alcohol use compared to non-LGBTQ populations, which increases cancer risk and correlates with a disproportionate number of LGBTQ individuals living with cancers, including anal, breast, cervical, colorectal, endometrial, lung, and prostate (click here for reference). The intersection of identities (race/ethnicity, disability, cultural) and socioeconomic status compounds inequities in care and screening and disparities in survival and quality of care and life (click here for reference). Clearly, there is need for accessible and tailored cancer care for LGBTQIA+ populations in every location. The same issues with insurance coverage, transportation and accessibility, and availability of care that plague urban and rural communities, respectively, still apply.

What’s available now? There are several resources to help LGBTQIA+ persons with cancer screenings and cancer care. Not enough, but the ones in place are a great start:

Cancer considerations for LGBTQIA+, including checklists and guides for communicating your needs and concerns to your healthcare providers: https://www.accc-cancer.org/docs/documents/oncology-issues/articles/2019/nd19/nd19-cancer-care-considerations-for-sexual-and-gender-minority-patients.pdf?sfvrsn=d116445f_19

Resource lists curated by Cancer.Net: https://www.cancer.net/coping-with-cancer/finding-social-support-and-information/resources-lgbtq-people-with-cancer

Support provided from CancerCare.org: https://www.cancercare.org/tagged/lgbtq+

The National LGBTQ Cancer Project: https://www.lgbtcancer.org/

The National LGBT Cancer Network: https://cancer-network.org/

FORCE (Facing Our Risk of Cancer Empowered) for Hereditary Cancer: https://www.facingourrisk.org/portal/lgbtq

The National Coalition for LGBTQ Health: https://healthlgbtq.org/

Transgender Health Resources: https://www.glma.org/index.cfm?fuseaction=Page.viewPage&pageId=948&grandparentID=534&parentID=938

Transgender Patient Services from the Human Rights Campaign: https://www.thehrcfoundation.org/professional-resources/transgender-patient-services-support-resources-for-providers-and-hospital-administrators

Got any additional resources to add to my list? Please let me know! Knowledge is power, and everyone has the right to equitable and just healthcare!

Male Breast Cancer

It’s day 8 of National Breast Cancer Awareness Month! Breast cancer is widely considered to be a disease of biological females (e.g. cis women, intersex people), though cis men, trans men who forgo top surgery and trans women can develop breast cancer, as can non-binary, gender fluid, and literally any human being. That’s because we all are born with a small amount of breast epithelial tissue—cells in the breast that can grow, develop, and eventually produce and deliver milk to nursing infants.

Image from Deposit Photos.

Weird quirk of biology, but that’s how it goes. We all have a little breast tissue (unless we get it removed), so we can all theoretically get breast cancer. In the figures below, you can see a schematic of how epithelial tissue appears at birth and how it grows in response to hormone signals during puberty, as well as how the network of epithelial tissue from a mouse actually looks under a microscope. For more on how the process works, see my previous post on breast anatomy, structure, and function.

**Note – mice and other mammals have mammary epithelial tissue to make milk, which is one of the defining characteristics of a mammal, and the growth and development of mouse mammary epithelium is very similar to that in humans.**

Image Source Here.
Image Source Here.

During puberty, biological female breast epithelial tissue grows in response to female hormones like estrogen and progesterone. For biological males, the epithelium doesn’t grow in response to male hormones like testosterone, leaving only a small cluster of epithelium behind. Since biological females grow more epithelium and are exposed to hormones that make these cells grow, they have a greater risk for developing breast cancer. But biological males are still at risk, since the small amount of breast epithelium left behind after puberty can become cancerous.

How does this happen? First of all, the number one risk factor for cancer in general is age. See my previous blog posts, Intro to Cancer and Cancer 101, for how normal cells become cancer. CNN version – it involves random mutations in DNA that alter genes that tell cells to grow and/or in a small percentage of cases inherited gene variants like BRCA1 and BRCA2 (see previous post on how BRCA genes work). If enough of these mutations accumulate over time in a breast epithelial cell, that cell can transform into cancer.

While more rare in biological males, get enough mutations in a breast epithelial cells and you get male breast cancer. About 1 in every 100 breast cancer cases diagnosed in the United States is found in a man. According to the CDC, risk factors include: getting older, genetic mutations and a family history of breast cancer, previous radiation therapy in the chest area, hormone therapy treatment for prostate cancer, Klinefelter syndrome (in which a person has an extra X chromosome), some conditions that affect the testicles (like injury or removal), liver disease, being overweight, and being obese.

If you have a family history of breast cancer and ovarian cancer, consider genetic counseling and testing for BRCA1 and BRCA2 variants associated with increased risk of breast cancer. In men, mutations in these genes can increase the risk for breast cancer, prostate cancer, and pancreatic cancer (see CDC).

As with female breast cancer, early detection and diagnosis is key for a good prognosis. Pay attention to your body and any changes in your breast area, and look for symptoms including:

A lump or swelling in the breast.
Redness or flaky skin in the breast.
Irritation or dimpling of breast skin.
Nipple discharge.
Pulling in of the nipple or pain in the nipple area.

Also, don’t let stigma, shame, or toxic masculinity keep you from seeking help and advice from your healthcare provider. Since male breast cancer is rare, you may feel like you’re alone, but there are resources and survivor networks available to help, ones that are decidedly not pink and are tailored for men. Ask your healthcare provider about local and online support groups, mental health support, and other resources. For more information on male breast cancer, check out these resources: Breastcancer.org, The National Cancer Institute, The American Cancer Society, The National Breast Cancer Foundation, Susan G. Komen.