Two-time survivor, current patient talk about cancer experiences

While most people will relate 2020 with COVID-19, Kelly Harrell will remember it for an entirely different disease.

Harrell, 31, was diagnosed in March with breast cancer.

“During spring break a change in my right breast was really bothering me,” she said.

She didn’t think it was anything serious enough to see the doctor for, but her husband and mother insisted. So, she called her OB/GYN.

“She saw me the next day and that same day she wanted me to get a mammogram,” Harrell said.

She said she could tell by the small talk the technician made that something was wrong.

“I knew something was there when the ultrasound tech asked me if cancer runs in my family,” she said.

Three days later she had a biopsy and that confirmed two spots in her breast and a third in the lymph nodes under her arm. It was an invasive ductal carcinoma, a kind that can spread rapidly.

“It was scary at first,” she said.

On April 6 she had her first oncology appointment at The University of Texas MD Anderson Cancer Treatment Center. By April 13 was beginning her first round of chemotherapy treatments – a 20-week process. She was given Adriamycin, also known as Red Devil medicine. It made her sick and her hair fell out.

Although the treatment was rough, it worked.

“They were very pleased that it was shrinking,” she said.

For her second round of chemo, Harrell was given Taxol. They had to stop it a short time later when she developed neuropathy in her feet.

“They moved my surgery up to Sept. 4. I had a double mastectomy,” she said.

On Oct. 12 Harrell underwent the knife again.

“They took some stomach fat and reconstructed my breasts … and I got a tummy tuck,” she said by phone while recovering in her room at MD Anderson.

There are several types of breast cancer and they affect women (and some men) differently.

Noah Hankins of San Felipe has battled it twice. She was first diagnosed in 2005 while she was working as a teacher’s aide at O’Bryant Intermediate School in Bellville. She had surgery and six months of chemo, all while continuing to work. She had the dreaded Red Devil medication and went bald.

“I never wore a wig. I didn’t feel comfortable wearing a wig,” she said.

Hankins was cancer free for 13 years.

“On Good Friday in 2018 I found a lump. I had cancer again, this time in the opposite breast,” she said.

This time she underwent six weeks of radiation treatment.

“Radiation was very tough on me,” she said.

She had surgery again. This time they removed the other breast, five lymph nodes, and the implant she had from her first bout with cancer.

“They took the implant out because it had an infection in it,” she said.

This time she opted not to have new implants or reconstructive surgery.

“I’m cancer free and I’m feeling good,” she said.

She isn’t the only one in her family to be a double cancer survivor. Her husband Terry had hairy cell leukemia in 1999 and in 2010 had prostate cancer. He said it was harder helping his wife go through her cancers than his own.

“It was a rough road, very trying at times,” he said.

Hankins had her treatment at Houston Methodist West Hospital in Katy. She praised her doctors and everyone who helped her through it.

“You just put your faith in the Lord and he helped us through it, made us stronger,” Terry Hankins said.

Noah Hankins said the toughest part for her was telling their four children about her cancer.

“It was hard to see my kids,” she said. “I’m supposed to be the strong one.”

Their children are adults now. The youngest was in college when Noah had her first bout with cancer.

One of the unfortunate side effects of her treatment was damage in her eye due to the chemo. Unknown to her at the time, she had an eye infection. As a result, she can only see half an image out of one eye.

The couple, who attend Trinity Lutheran Church, relied on their faith and the prayers and support of family and friends to get them through. Even her doctors prayed with her before surgery.

“God doesn’t give it to you, he’s just seeing how you’ll handle it and grow,” Noah Hankins said.

Faith also played a major role in Kelly Harrell’s recovery.

“My children were praying that mommy’s treatments would go well,” Harrell said.

She said a lot of people were praying for her and offering support to her family. She had help from the school where she works as well as her church, Hope City in Houston.

“There was an amazing outpouring of love that has blown me away,” she said.

Her husband Chase and children Hunter and Hailey have been her biggest supporters. He mother retired a couple months earlier than planned so she could help out at home.

Harrell is a third grade teacher at Sealy Elementary School and plans to return to the classroom in January. She said she was “super quarantined” at home during the summer but feels safe returning to the school despite the COVID-19 pandemic.

“We will have masks and face shields … I’m not worried about it,” she said.

Both Harrell and Hankins are doing what they can to help others. Hankins does breast cancer walks and often talks with women going through treatment. Harrell said she is trying to “pay it forward for other people as well.”

“Our emphasis is on the positive,” she said.

The post Women share their breast cancer journeys appeared first on MyMedicPlus.

Pharmaceutical company Allergan has issued a worldwide recall of its Biocell textured breast implants and tissue expanders after the products were linked to a rare form of cancer. The recall was based on the recommendation of the U.S. Food and Drug Administration (FDA).

“Allergan is taking this action as a precaution following notification of recently updated global safety information concerning the uncommon incidence of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) provided by the U.S. Food and Drug Administration,” the company said in a press release, before stressing that “patient safety is a priority” for Allergan.

Allergan is specifically recalling the following products:

•  Natrelle Saline-Filled breast implants
•  Natrelle Silicone-Filled breast implants
•  Natrelle Inspira Silicone-Filled breast implants
•  Natrelle 410 Highly Cohesive Anatomically Shaped Silicone-Filled breast implants
•  Natrelle 133 Plus Tissue Expander
•  Natrelle 133 Tissue Expander with Suture Tabs

Textured breast implants aren’t as common as their smoother counterparts, the FDAsays, and the represent less than 5 percent of all breast implants sold in the U.S.

What are the symptoms of BIA-ALCL?

These particular implants have been linked to breast implant-associated anaplastic large cell lymphoma, a rare form of non-Hodgkin’s lymphoma, according to the FDA. This is not a breast cancer—it’s a cancer of the immune system. In most cases, BIA-ALCL is detected in scar tissue and fluid near the implant. However, it can spread throughout a person’s body and become deadly.

The FDA released new data with the recall, noting that there have been 573 cases globally of BIA-ALCL and 33 patient deaths from the disease. “Specifically, of the 573 unique cases of BIA-ALCL, 481 are attributed to Allergan implants. Of the 33 patient deaths the FDA is reporting today, 12 of the 13 patients for which the manufacturer of the implant is known, are confirmed to have an Allergan breast implant at the time of their BIA-ALCL diagnosis,” per the FDA statement.

The FDA also says that is own analysis found that the risk of developing BIA-ALCL in patients who have Allergan Biocell textured implants is six times the risk of BIA-ALCL with textured implants from other companies that sell their implants in the U.S.

While the implants and tissue expanders have been recalled, the FDA actually doesn’t recommend that they be removed in patients who have them “due to potential risks,” the agency says.

Instead, the FDA recommends that doctors and women with the implants be aware of the symptoms of BIA-ALCL—including swelling, pain, or lumps in the breast or armpit due to excessive fluid buildup—and monitor the area around their implants for any changes. If you notice the signs of BIA-ALCL, call your doctor.

What happens next if you have these Allergan implants?

It’s understandably scary to know that your implants can cause an increased risk of cancer, which is why it’s a good idea to call your doctor to have a “discussion” if you have these implants, says Daniel Maman, MD, a board-certified plastic surgeon with 740 Park Plastic Surgery.

If you want the implants out ASAP, Dr. Maman just recommends keeping this in mind: “It is not difficult to remove or replace breast implants, but it is still a surgical procedure that comes with potential risks and downtime.”

If you opt for surgery, “the implants can be completely removed, with no replacement, or the woman can choose to replace them with new implants,” says Constance Chen, MD, a board-certified plastic surgeon and breast reconstruction specialist.

If you want the implants out without replacing them, your breasts may look deflated because the skin can get stretched out, Dr. Chen says. However, this can go away with time, although women sometimes request a breast lift or fat grafting to help with the appearance of their breasts, she says. Natural tissue breast reconstruction, which involves using skin and fat from another part of your body like your lower abdomen or inner thighs to recreate the breasts, is also an option, she says.

The post Textured Breast Implants Linked to Rare Cancer Are Being Recalled Worldwide appeared first on MyMedicPlus.

Q: What kinds of activities should be restricted after treatment for breast cancer?

A: For more than 25 years, many breast cancer survivors were given a lifelong, life-changing warning: Do not lift anything over five pounds, avoid getting manicures, taking saunas or even gardening since it might lead to a painful complication called lymphedema, which can cause irreversible swelling in the arm and often hardening of skin.

The condition is usually caused by the removal of lymph nodes, which is done during breast cancer surgery to determine if the cancer has spread. The nodes are part of the body’s lymphatic system, which protects against invaders. Lymphedema happens when a blockage, often because of scarring from surgery or radiation, causes fluid to accumulate, painfully and often irreversibly.

Doctors treating breast cancer patients long thought that infection or injury would cause inflammation, which in turn would overload the lymphatic system causing the swelling and pain of lymphedema.

But based on studies over the past decade, the old warnings of lymphedema do’s and don’ts have been dramatically relaxed.

“We continue to caution women about injury to the hand/arm that is at risk for lymphedema. Meaning, when gardening, you should wear gloves, said Katherine Kopkash, director of oncoplastic breast surgery at NorthShore University HealthSystem outside Chicago. “If receiving manicures, you should not have your cuticles cut. Be careful in saunas to limit your exposure to heat and avoid burns.”

Using light weights and very slowly increasing them is also OK.

Many of these warnings, said Simona Shaitelman, associate professor of radiation oncology at the University of Texas MD Anderson Cancer Center, were little more than “old wives’ tales,” which in recent years have been debunked based on results of a group of well-run studies.

Kathryn Schmitz, a professor of public health sciences at Penn State Cancer Institute and president of the American College of Sports Medicine, conducted those studies, which showed that a careful return to working out with weights did not increase the risk of lymphedema.

For years, breast cancer doctors used axillary lymph node dissection (removal of lymph nodes in the underarm) to see if cancer has spread beyond the tumor, often removing between 10 and 40 of the nodes, which made the chances for lymphedema fairly high. In the late 1990s, sentinel node biopsy (removing only the node closest to the tumor, to start with to see if the cancer had spread, and then looking at others only if necessary) came into use to allow fewer lymph nodes to be surgically removed.

Although this decreases the chance of developing lymphedema, it can still occur. The New England Journal of Medicine calculated the risk for women using the sentinel node technique at about 6% to 10%.

“It depends on how many nodes were removed,” Schmitz said. “Patients need to know how many.”

In addition to warnings about working out and not lifting anything heavy, women were told to wear a compression sleeve when traveling by air, to prevent air pressure causing lymph flow problems, and not to have blood pressure readings or blood draws on the affected arm.

Shaitelman, who oversees a lymph screening initiative that helps patients treat lymphedema early and is involved in ongoing research, cites a 2016 study by researchers at Harvard Medical School and Massachusetts General Hospital that investigated these warnings and found they were based on anecdotal evidence.

“Despite the prevalence and persistence of recommendations to pursue precautionary behavior after breast cancer treatment, few data exist to support these practices,” the study said.

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Women are increasingly worried about breast implants. In 2016, the American Society of Plastic Surgeons reported that 400,000 women in the United States had breast implant surgery. About 75% were for cosmetic breast augmentation; the rest were for breast reconstruction after mastectomy. While some breast implants last for decades, most are removed well beforehand. Why?

Implants are foreign bodies that incite a scar tissue barrier called a capsule. Capsules may be soft, filmy and hardly noticeable, or may become painful, hard and tight, like a shell around the implant that starts to shrink and squeeze. Capsular contracture is uncomfortable and a common reason for implant removal. Other reasons include infection, because the implant lacks a blood supply to fight bacteria; rupture, in which the saline or silicone gel filling leaks; and extrusion, in which the implant erodes out of the skin.

In addition, some women with breast implants report symptoms such as chronic fatigue, joint pains, food allergies, skin and hair problems and other issues that patients call Breast Implant Illness (BII). A 2019 M.D. Anderson Cancer Center study found that women with silicone breast implants had six to eight times the normal population rates of rare diseases like rheumatoid arthritis, scleroderma and Sjogren syndrome. A 2018 Israeli study found a 22% increase in autoimmune or rheumatic disorders in women with silicone breast implants. While a cause-effect relationship between breast implants and autoimmune issues remains unproven, the association disturbs women who believe they developed unexplained problems after getting breast implants.

Finally, in 2011, the U.S. Food and Drug Administration noticed that women with breast implants had a higher incidence of a rare immune system cancer called anaplastic large cell lymphoma (ALCL). In 2016, the World Health Organization renamed the disease Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL), a T-cell lymphoma that developed following breast implants in up to 1 in 3,800 women with breast implants. Patients with BIA-ALCL usually have retained fluid around the breast implant or a mass on the implant capsule, which can sometimes be seen on breast imaging and biopsied.

How are breast implants removed? The quickest procedure involves removing only the implant while leaving behind the entire capsule, because thin, filmy capsules may eventually be reabsorbed by the body. For thickened capsules, the surgeon can perform a capsulotomy by making incisions to break up and soften the capsule. If patients want their capsule removed, most surgeons perform a partial capsulectomy. When implants are underneath the pectoralis muscle, capsular material is fused to the chest wall or ribs, and is very close to the lungs. To save time and avoid lung injury, surgeons routinely leave the chest wall capsule. A complete capsulectomy is a lengthy procedure that removes not just the implant, but the entire capsule that surrounds it, including the portion on the chest wall. In an en bloc capsulectomy, the surgeon removes the implant and capsule in one piece.

If a woman decides to remove her implants without any other procedures, immediately after surgery her breasts will look deformed and empty. Over time, however, the breast skin will contract and any remaining breast tissue will re-expand — much like resolving indentations in the skin after wearing tight clothing. It can take weeks or even months, but the body has a remarkable ability to equilibrate, and for most women with breast tissue their breasts will look normal again without further surgery.

That said, if a woman has minimal breast tissue and proportionally large implants, she may be unhappy with the appearance of her natural breasts. Some women may want a breast lift, fat transfer, new implants or even natural tissue free flaps. Additional procedures can be performed at the same operation as the implant removal, or later on when a woman sees how her natural breasts look after they have been given a chance to heal. Extra procedures, however, such as breast lifts, can involve additional scarring and extend anesthesia time, leading to a more difficult recovery. For this reason, women may take a “wait-and-see” approach to keep their post-operative recovery as easy and simple as possible.

Women with implants for breast reconstruction lack breast tissue due to mastectomy. Thus, after implant removal, they must decide whether to “go flat” or undergo breast reconstruction again. If implant removal is to treat capsular contracture, saline implant rupture, or BII, it may be possible to undergo breast reconstruction again in the same operation. If a woman has a severe infection, ruptured silicone breast implant, or BIA-ALCL, it may be necessary to allow the tissues to heal for several months before considering other breast reconstruction options. Other options include new breast implants or natural tissue breast reconstruction, a more extensive surgery that creates living breasts. Natural tissue breast reconstruction produces soft, warm breasts that can fight infection due to its blood supply, will grow and shrink as the patient gains and loses weight, and nerves can even be reconnected to restore breast sensation.

Whatever the reason for implant removal, women should be fully educated about what to expect. Capsular contracture, infection, rupture, and BII are the most common reasons for implant removal. Women removing their breast implants should consider whether they want some, all, or none of their capsule removed. At the end of the day, a woman’s body is her own, and she should have agency over it.

The post Are You Worried About Your Breast Implants? Understanding Your Options appeared first on MyMedicPlus.

Kerry Katona has revealed she is suffering with swollen boobs following surgery to help ensure they no longer ‘drag on the floor’.

Earlier this week the former Atomic Kitten singer underwent her third procedure on her breasts, having told her fans on Instagram she had been ‘tripping over her nipples’ before.

Taking a cheeky dig at her exes, Kerry joked ahead of the op: “I have the best doctor in town!

“But let’s hope I don’t wake up with three [bleep – rhymes with ‘bits’]! I’ve only just divorced them!”

Despite admitting to “a little bit of pain” in the hours after going under the knife, the mum-of-five later revealed her relief at having the procedure as she hailed the medics who had attended to her.

She said on Instagram last night: “So as you all know I’ve had a few nip and tucks here and there over the years which I’m not ashamed about and I’m very vocal and honest about…

“I have just had an uplift with a reduction and a implant put in so that my boobies are no longer dragging on the floor!”

Kerry continued in the post’s caption: “After five kids it’s become a safety hazard am sure you can imagine how swollen I am!

“This is first time after surgery I have ever been given aftercare like this!”

Fans were quick to offer Kerry encouraging words of support.

“Happy healing gorgeous, I don’t blame you one bit, I would do exactly the same as you ,” commented one fan.

“More power to you Kerry. Thankfully in this day and age we can easily access these procedures once the swelling goes down you won’t know yourself added another.

And a third remarked: “I always admire how you say it how it is, a spade is a spade as they say. Glad it went well. You look amazing.”

Kerry announced she was going to have breast surgery in her New! magazine column in May.

She revealed: “So the cat’s out of the bra – I’m having a boob lift!

“I was at Harley Street last week to get all the final details in place and I’m so excited.”

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