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Neighborsa publication of the Daily Commercial
SEPTEMBER 2015
» Do you know your breast density?
» What is the PALB mutation and should you be tested for it?
2 NEIGHBORS September 2015
AutoTextDate AutoPageNoPUBNAME
By Melissa EricksonMore Content Now
Intensely studied for more than a decade, the BRCA1 and 2 genes are known to be huge risk factors for develop-ing breast cancer. But what
have you heard about the newer and less well-known PALB2 gene? Is it something you should be asking your doctor about? “About 10 percent of breast cancers are felt to be heredi-tary,” passed from parent to child, and “caused by mutations in genes,” said Dr. Marleen Meyers, oncologist and director of the survivorship program at New York University’s Perlmutter Cancer Center. “The most commonly discussed genes in breast cancer are BRCA1 and BRCA2. More recently, a mutation in another gene, PALB2, that works closely with the BRCA genes to repair DNA damage in cells was found to increase breast cancer risk and has been found in up to 4 percent of families with a history of breast cancer.”
Recent discoveriesResearch from the University of
Cambridge found that mutations in the PALB2 gene predispose women to breast cancer, but the effect of the mutation on the prognosis of cancer is still being studied. The PALB2 gene was identified in 2006 and linked to breast cancer in 2007.
In 2014 a study led by University of Cambridge researchers found that the PALB2 gene increases the risk of breast cancer to 1 in 3 by age 70. Since BRCA1 and 2 were discovered, no other genes of similar importance have been found, said study author Dr. Marc Tischkow-itz, who compared PALB2 to a possible “BRCA3.”
How the gene PALB2 reacts with the
BRCA1 and 2 genes is of great interest to the medical community.
“One important study looked at people who had an abnormal PALB2 gene but normal BRCA1 and 2 genes,” Meyers said. “These women had a 14 percent risk of developing breast cancer by age 50 and a 35 percent risk of developing breast cancer by age 70.
“Looked at another way, a woman by age 70, with an abnormal PALB2 gene who had no family history of breast cancer, had a 33 percent risk of devel-oping breast cancer. And, if two or more first-degree relatives had breast cancer, the risk increased to 58 per-cent,” Meyers said.
Should I be tested?Researchers continue to study the
PALB2 gene, which makes a protein that interacts with the protein made by the BRCA2 gene, and whether it increases the risk for other forms of cancer.
“Investigators have found an associa-tion between PALB2 mutations and ovarian cancer, male breast cancer and pancreatic cancer, but the sig-nificance and lifetime risks need further assessment,” Meyers said.
If you have red flags in your medical chart — a strong family history of breast cancer with negative testing for BRCA1 and 2, you may want to consult with a doctor about PALB2, Meyers said. For most women, though, it’s not a reason to rush to the doctor for genetic testing.
Unlike BRCA mutations, there are no national guidelines for testing of PALB2 or for management of breast cancer in women who carry the PALB2 gene, Meyers said.
GENETIC RESEARCH
GENE MUTATION MAY BE A NEW CANCER INDICATOR
WIK
IPEDIA
.CO
M
“Investigators have found an association between PALB2 mutations and ovarian cancer, male breast cancer and
pancreatic cancer, but the significance and lifetime risks need further assessment.” ~ Dr. Marleen Meyers
BIG
STO
CK
.CO
M
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1/2 PAGE AD
Nancy’s storyCappello’s story is shocking. After more than a decade of routine annual
mammograms and the “happy gram” reports that showed her results as normal with no significant findings, Cappello was told she had cancer when a doctor noticed a suspicious ridge in her right breast during an annual physical exam. A subsequent mammogram revealed nothing, but an ultra-sound showed stage 3c cancer that had spread to 13 lymph nodes.
“From the size and how it metastasized, the cancer had been growing for six years,” Cappello said.
As a healthy woman and educated patient who watched her weight, exercised regularly and never missed a mammogram appointment, Cappello was bowled over to learn she had advanced breast cancer. That’s when her doctor told her about her dense breast tissue and how it can hide cancer on a mammogram.
“I asked, ‘Why wasn’t I told I have dense breast tissue?’ The response was that it’s not standard protocol to share the information with the patient,” Cappello said. She went into action, and Connecticut was the first state to pass a breast density notification law.
What does ‘dense’ mean?“Dense breast tissue is not abnormal. It’s just the way
a woman is built,” said Dr. Kathryn Evers, director of breast imaging at Fox Chase Cancer Center in Phila-delphia. About 50 percent of the population has dense breast tissue, which means that it has a high proportion of glandular or connective tissue.
“A radiologist reads a mammogram and rates it in four different catego-ries from extremely fatty to extremely dense,” said Dr. Emily F. Conant, professor and chief, Division of Breast Imaging, Department of Radiology, Hospital of the University of Pennsylvania. Ten percent of people have entirely fatty breast tissue and 10 percent have extremely dense breast tissue. The other 80 percent of the population is broken down evenly between scattered fibroglandular (fatty) tissue and heterogeneously dense.
Dense breast tissue camouflages tumors on a mammogram, Evers said. Fatty tissue shows up greyish black on a mammogram, making it stand out. Dense tissue looks white. Breast masses or tumors also appear white on a mammogram, making them hard or impossible to spot in dense breasts.
“Breast density varies by age and weight,” Conant said. As women age
their breasts become less dense. Women who are overweight or obese often have denser breasts.
Not only can dense breast tissue hide cancer on a mammogram, “there is some increased risk for breast cancer for women with dense breasts,” Evers said.
It’s not possible to tell if your breasts are dense by sight or feel. “It’s not a matter of a breast feeling firm or lumpy,” Evers said. “Breast
density can only be determined by a mammogram,” she said.
Information vs. expenseAnd that’s where a bit of controversy comes in, Conant
said. Twenty-four states have laws that require health facili-ties to notify women if they have dense breasts. Eleven other states are considering breast density notification laws, and nationwide legislation has been introduced in Congress.
A woman has a right to know and deserves to be edu-cated so she can make informed health-care choices and possibly seek additional screening methods, Cappello said. The medical establishment, though, is wary of creating panic and encouraging women to seek out costly additional screening tests, Conant said.
“Everybody needs to know their breast density,” Conant says. “But telling women causes frustration because some-times they can’t do anything about it.”
There are risks and benefits to mammograms, includ-ing the possibility of false negatives. For a woman with dense breasts, an ultrasound is a complementary screening,
Conant said: Used with mammograms, ultrasounds may be more effective in detecting breast cancer but they come with many false negatives and positives.
“An MRI is a very good tool. It finds more cancers than a mammogram and has slightly fewer false positives than a mammogram,” Conant said. But “MRIs can cost thousands, and insurance won’t cover it” in the case of a woman who has dense breasts and no other high-risk factors.
“Three-dimensional mammograms are the best screening method for breast cancer,” Conant said. “It’s what you should be having.” The benefits of 3D mammograms include the ability for the radiologist to zoom in, magnify and change the contrast of the breast image and view it in slices for more precise images, flexible plates for greater comfort and a decrease in the number of false positives.
Cancer survivor creates campaign to inform women about breast density
By Melissa EricksonMore Content Now
Is your doctor keeping a secret from you?
If you don’t know your breast density, you don’t have all the
knowledge you need to make informed decisions about your breast health, said Nancy
Cappello, a former education administrator from Woodbury, Connecticut, who started the Are You Dense campaign to educate other women.
Cappello calls breast density “a best-kept secret.” If you have a mammogram, your doctor knows your breast density, but is he sharing this critical infor-mation with you? Depending on which state you live in, the answer could be no.
BREAST DENSITY
“I asked, ‘Why wasn’t I told I
have dense breast tissue?’ The
response was that it’s not standard protocol to share the information
with the patient.”~ Nancy Cappello
Nancy Cappello
AdviceThe American Cancer Society recommends women get an annual mammogram starting at age 40, continuing as long as a woman’s in good health.“As a woman you have to have this conversa-tion with your doctor,” Cappello said. “The information should never be hidden. Find out your breast density and what impact it can have on your breast health.”Find out more about Cappello’s Are You Dense campaign at areyoudense.com.
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1/2 PAGE AD
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September 2015 NEIGHBORS 3
4 NEIGHBORS September 2015
AutoTextDate AutoPageNoPUBNAME
By Melissa EricksonMore Content Now
Intensely studied for more than a decade, the BRCA1 and 2 genes are known to be huge risk factors for develop-ing breast cancer. But what
have you heard about the newer and less well-known PALB2 gene? Is it something you should be asking your doctor about? “About 10 percent of breast cancers are felt to be heredi-tary,” passed from parent to child, and “caused by mutations in genes,” said Dr. Marleen Meyers, oncologist and director of the survivorship program at New York University’s Perlmutter Cancer Center. “The most commonly discussed genes in breast cancer are BRCA1 and BRCA2. More recently, a mutation in another gene, PALB2, that works closely with the BRCA genes to repair DNA damage in cells was found to increase breast cancer risk and has been found in up to 4 percent of families with a history of breast cancer.”
Recent discoveriesResearch from the University of
Cambridge found that mutations in the PALB2 gene predispose women to breast cancer, but the effect of the mutation on the prognosis of cancer is still being studied. The PALB2 gene was identified in 2006 and linked to breast cancer in 2007.
In 2014 a study led by University of Cambridge researchers found that the PALB2 gene increases the risk of breast cancer to 1 in 3 by age 70. Since BRCA1 and 2 were discovered, no other genes of similar importance have been found, said study author Dr. Marc Tischkow-itz, who compared PALB2 to a possible “BRCA3.”
How the gene PALB2 reacts with the
BRCA1 and 2 genes is of great interest to the medical community.
“One important study looked at people who had an abnormal PALB2 gene but normal BRCA1 and 2 genes,” Meyers said. “These women had a 14 percent risk of developing breast cancer by age 50 and a 35 percent risk of developing breast cancer by age 70.
“Looked at another way, a woman by age 70, with an abnormal PALB2 gene who had no family history of breast cancer, had a 33 percent risk of devel-oping breast cancer. And, if two or more first-degree relatives had breast cancer, the risk increased to 58 per-cent,” Meyers said.
Should I be tested?Researchers continue to study the
PALB2 gene, which makes a protein that interacts with the protein made by the BRCA2 gene, and whether it increases the risk for other forms of cancer.
“Investigators have found an associa-tion between PALB2 mutations and ovarian cancer, male breast cancer and pancreatic cancer, but the sig-nificance and lifetime risks need further assessment,” Meyers said.
If you have red flags in your medical chart — a strong family history of breast cancer with negative testing for BRCA1 and 2, you may want to consult with a doctor about PALB2, Meyers said. For most women, though, it’s not a reason to rush to the doctor for genetic testing.
Unlike BRCA mutations, there are no national guidelines for testing of PALB2 or for management of breast cancer in women who carry the PALB2 gene, Meyers said.
GENETIC RESEARCH
GENE MUTATION MAY BE A NEW CANCER INDICATOR
WIK
IPED
IA.C
OM
“Investigators have found an association between PALB2 mutations and ovarian cancer, male breast cancer and
pancreatic cancer, but the significance and lifetime risks need further assessment.” ~ Dr. Marleen Meyers
BIG
STO
CK
.CO
M
AutoPageNo AutoTextDatePUBNAME
1/2 PAGE AD
Nancy’s storyCappello’s story is shocking. After more than a decade of routine annual
mammograms and the “happy gram” reports that showed her results as normal with no significant findings, Cappello was told she had cancer when a doctor noticed a suspicious ridge in her right breast during an annual physical exam. A subsequent mammogram revealed nothing, but an ultra-sound showed stage 3c cancer that had spread to 13 lymph nodes.
“From the size and how it metastasized, the cancer had been growing for six years,” Cappello said.
As a healthy woman and educated patient who watched her weight, exercised regularly and never missed a mammogram appointment, Cappello was bowled over to learn she had advanced breast cancer. That’s when her doctor told her about her dense breast tissue and how it can hide cancer on a mammogram.
“I asked, ‘Why wasn’t I told I have dense breast tissue?’ The response was that it’s not standard protocol to share the information with the patient,” Cappello said. She went into action, and Connecticut was the first state to pass a breast density notification law.
What does ‘dense’ mean?“Dense breast tissue is not abnormal. It’s just the way
a woman is built,” said Dr. Kathryn Evers, director of breast imaging at Fox Chase Cancer Center in Phila-delphia. About 50 percent of the population has dense breast tissue, which means that it has a high proportion of glandular or connective tissue.
“A radiologist reads a mammogram and rates it in four different catego-ries from extremely fatty to extremely dense,” said Dr. Emily F. Conant, professor and chief, Division of Breast Imaging, Department of Radiology, Hospital of the University of Pennsylvania. Ten percent of people have entirely fatty breast tissue and 10 percent have extremely dense breast tissue. The other 80 percent of the population is broken down evenly between scattered fibroglandular (fatty) tissue and heterogeneously dense.
Dense breast tissue camouflages tumors on a mammogram, Evers said. Fatty tissue shows up greyish black on a mammogram, making it stand out. Dense tissue looks white. Breast masses or tumors also appear white on a mammogram, making them hard or impossible to spot in dense breasts.
“Breast density varies by age and weight,” Conant said. As women age
their breasts become less dense. Women who are overweight or obese often have denser breasts.
Not only can dense breast tissue hide cancer on a mammogram, “there is some increased risk for breast cancer for women with dense breasts,” Evers said.
It’s not possible to tell if your breasts are dense by sight or feel. “It’s not a matter of a breast feeling firm or lumpy,” Evers said. “Breast
density can only be determined by a mammogram,” she said.
Information vs. expenseAnd that’s where a bit of controversy comes in, Conant
said. Twenty-four states have laws that require health facili-ties to notify women if they have dense breasts. Eleven other states are considering breast density notification laws, and nationwide legislation has been introduced in Congress.
A woman has a right to know and deserves to be edu-cated so she can make informed health-care choices and possibly seek additional screening methods, Cappello said. The medical establishment, though, is wary of creating panic and encouraging women to seek out costly additional screening tests, Conant said.
“Everybody needs to know their breast density,” Conant says. “But telling women causes frustration because some-times they can’t do anything about it.”
There are risks and benefits to mammograms, includ-ing the possibility of false negatives. For a woman with dense breasts, an ultrasound is a complementary screening,
Conant said: Used with mammograms, ultrasounds may be more effective in detecting breast cancer but they come with many false negatives and positives.
“An MRI is a very good tool. It finds more cancers than a mammogram and has slightly fewer false positives than a mammogram,” Conant said. But “MRIs can cost thousands, and insurance won’t cover it” in the case of a woman who has dense breasts and no other high-risk factors.
“Three-dimensional mammograms are the best screening method for breast cancer,” Conant said. “It’s what you should be having.” The benefits of 3D mammograms include the ability for the radiologist to zoom in, magnify and change the contrast of the breast image and view it in slices for more precise images, flexible plates for greater comfort and a decrease in the number of false positives.
Cancer survivor creates campaign to inform women about breast density
By Melissa EricksonMore Content Now
Is your doctor keeping a secret from you?
If you don’t know your breast density, you don’t have all the
knowledge you need to make informed decisions about your breast health, said Nancy
Cappello, a former education administrator from Woodbury, Connecticut, who started the Are You Dense campaign to educate other women.
Cappello calls breast density “a best-kept secret.” If you have a mammogram, your doctor knows your breast density, but is he sharing this critical infor-mation with you? Depending on which state you live in, the answer could be no.
BREAST DENSITY
“I asked, ‘Why wasn’t I told I
have dense breast tissue?’ The
response was that it’s not standard protocol to share the information
with the patient.”~ Nancy Cappello
Nancy Cappello
AdviceThe American Cancer Society recommends women get an annual mammogram starting at age 40, continuing as long as a woman’s in good health.“As a woman you have to have this conversa-tion with your doctor,” Cappello said. “The information should never be hidden. Find out your breast density and what impact it can have on your breast health.”Find out more about Cappello’s Are You Dense campaign at areyoudense.com.
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IKIP
EDIA
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1/2 PAGE AD
September 2015 NEIGHBORS 5
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cancer treatments and medications.
Stress relieverFor women with
breast cancer undergo-ing radiation therapy, a mind-body approach to yoga offers health benefits beyond fight-ing fatigue, according to research from the University of Texas MD Anderson Cancer Center.
Women who prac-ticed yoga exercises that incorporated controlled breathing, medita-tion and relaxation techniques into their
treatment plan experienced improved ability to engage in daily activities, better general health and better regulation of the stress hormone cortisol. Women in the yoga group were also better equipped to find meaning in the illness experience, which declined over time for women in the other groups.
“The transition from active therapy back to everyday life can be very stressful as patients no longer receive the same level of medical care and attention. Teaching patients a mind-body technique like yoga as a coping skill can make the transition less difficult,” said Dr. Lorenzo Cohen, profes-sor and director of the Integrative Medicine Program at MD Anderson.
What was the important ingredient in yoga that benefits breast cancer patients and survivors?
“Because yoga has several different components — breath-ing, meditative and movement or postures — we don’t know which of those was potentially most important. We assume they were all important or that one was more important than the others,” Kiecolt-Glaser said.
Before you beginBefore starting any new workout program, women should
check with a physician. “One of the nice things about yoga, especially a restor-
ative yoga like hatha yoga training, is that it is relatively low demand in terms of physical limitation,” Kiecolt-Glaser said. Check with the teacher and ask what kind of class it is and if back or other physical issues can be addressed easily in class.
By Melissa EricksonMore Content Now
Yoga’s rejuve-nating and therapeutic effects make it
a popular exercise regime for millions of people. For breast cancer patients and survivors, yoga not only helps control physical functions like breath-ing, heart rate and blood pressure, it offers some surprising benefits, too.
“Yoga can improve the quality of life for breast cancer patients in several ways,” said Dr. Janice Kiecolt-Glaser, director, Institute for Behavioral Medicine Research, Ohio State University College of Medicine. Kiecolt-Glaser was the lead author of a recent study that found that yoga can lower fatigue and inflammation in breast cancer survivors. The women in the study were less fatigued than women not practicing yoga, and the more women in the study practiced yoga, the better their results.
“Fatigue is a really important quality of life marker for breast cancer patients because it has such a pronounced effect on daily life. The fatigue is not like being short of sleep but rather the kind of fatigue that can permeate the day and the ability to do many daily activities,” Kiecolt-Glaser said.
Fatigue fighterIt’s estimated that perhaps 30 to 40 percent of longer-term
breast cancer survivors have debilitating fatigue after treat-ment, Kiecolt-Glaser said. Women stressed with fatigue are often so tired that they’re less likely to exercise.
“The less they exercise, the more tired and the weaker they may be, so it’s a downward spiral. Yoga was a way of inter-rupting that spiral and getting women the opportunity to learn a new skill that was not too physically demanding and that helped the fatigue substantially,” she said.
Sleep issues are often commonplace in breast cancer patients and survivors “much more so than their age mates in the general population who haven’t had cancer,” said Kiecolt-Glaser. Yoga can help relieve the insomnia caused by breast
AutoPageNo AutoTextDatePUBNAME
1/2 PAGE AD
MIND AND BODY
The surprising benefits of yoga for cancer patients, survivors
The fatigue is not like
being short of sleep
but rather the kind of
fatigue that can permeate
the day and the ability to
do many daily activities”
- Dr. Janice
Kiecolt-Glaser
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AY.CO
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1/2 PAGE AD
By Melissa EricksonMore Content Now
Having trouble sleeping through the night makes it hard to func-tion during the day and is a public health epidemic, accord-ing to the Centers for Disease
Control and Prevention. Breast cancer patients are part of the estimated 50 million to 70 mil-lion people affected by sleep disorders.
Insomnia is a common side effect of medical treatments and medications aimed at saving their lives. According to BreastCancer.org, insomnia can be caused by treatments Ixempra (chemical name: ixabepilone), a chemotherapy medicine; Tykerb (chemical name: lapatinib), a targeted therapy; and hormonal therapies Arimidex (chemical name: anastrozole), Aroma-sin (chemical name: exemestane) and Faslodex (chemical name: fulvestrant). Some pain medi-cations also can cause sleeping problems.
Insomnia affects your mood and energy, leaves you feeling fatigued and makes it hard to concentrate, said sleep expert Dr. Ilene Rosen, who serves on the board of directors for the American Academy of Sleep Medicine.
“Studies show that insomnia negatively affects work performance, impairs decision-making and can damage relationships,” she said.
What is insomnia?Different than just trouble sleeping,
“insomnia occurs when you have trouble falling asleep or staying asleep even though you had the opportunity to get a full night of sleep. One night of poor sleep is not necessarily insomnia; occasionally almost everyone has trouble sleep-ing,” said Rosen, who is the program director for the University of Pennsylvania Sleep Fellowship and an associate professor of clinical medicine for the University of Pennsylvania School of Medicine in Philadelphia.
Insomnia can occur after a stressor or major life change — such as being diagnosed with breast cancer — but it’s when sleepless nights start turning into sleepless weeks that it’s time to start thinking about insomnia. There are two types, short-term and chronic. Short-term insomnia lasts less than three months — this occurs in 15 to 20 percent of individuals. Chronic insomnia, which occurs at least three times a week for at least three months, occurs in
10 percent of the population, Rosen said.If you are having trouble sleeping, the first
step is to make sure you are employing good sleep hygiene, Rosen said. Here are some of her tips for overcoming insomnia:
• Keep a regular sleep schedule, making sure to go to bed when you are sleepy and wake up at the same time every morning — even on the weekends.
• Make sure your bedroom is quiet, dark and a little bit cool — it should remind you of a cave.
• Avoid caffeine in the afternoon as this can keep you awake at night.
• No screens for at least an hour before bed-time or in the bedroom. That means no TV, no phones, no tablets. The blue light they emit can hinder melatonin production, which is what makes you sleepy.
• Feel the need for a nap? Limit yourself to no longer than 10-20 minutes in the early afternoon when you feel a natural increase in sleepiness, Rosen said. “Naps of 30 minutes or longer may cause grogginess or ‘sleep inertia,’ and it can delay the performance benefits of a nap,” she said.
“Sleep, exercise and nutrition are three pillars for a healthy lifestyle. A recent survey found that individuals reported sleeping better if they exercised regularly. Research has found that exercise before bed may be OK — however, those suffering from insomnia should avoid vig-orous activity in the hours immediately before bedtime,” Rosen said.
SLEEP
More adviceStill awake after 20 minutes? “Get out of bed. Don’t lie there tossing and turning in frustration. Sit and read quietly (but not in any bright light) and crawl back into bed when you are sleepy,” Rosen said.Avoid heavy meals, caffeinated drinks and alcohol shortly before bed.“Our daily routines – what we eat and drink, how and when we exercise, the drugs and medicines we consume, how we schedule our days – can signifi-cantly affect the amount and the quality of the sleep we get,” Rosen said.If your sleep is suffering, see a specialist at an accredited sleep center – you can find one at sleepeducation.org.
MEDS MAKING IT HARD TO
SLEEP? TRY THESE TIPS
BIG
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September 2015 NEIGHBORS 7
8 NEIGHBORS September 2015
cancer treatments and medications.
Stress relieverFor women with
breast cancer undergo-ing radiation therapy, a mind-body approach to yoga offers health benefits beyond fight-ing fatigue, according to research from the University of Texas MD Anderson Cancer Center.
Women who prac-ticed yoga exercises that incorporated controlled breathing, medita-tion and relaxation techniques into their
treatment plan experienced improved ability to engage in daily activities, better general health and better regulation of the stress hormone cortisol. Women in the yoga group were also better equipped to find meaning in the illness experience, which declined over time for women in the other groups.
“The transition from active therapy back to everyday life can be very stressful as patients no longer receive the same level of medical care and attention. Teaching patients a mind-body technique like yoga as a coping skill can make the transition less difficult,” said Dr. Lorenzo Cohen, profes-sor and director of the Integrative Medicine Program at MD Anderson.
What was the important ingredient in yoga that benefits breast cancer patients and survivors?
“Because yoga has several different components — breath-ing, meditative and movement or postures — we don’t know which of those was potentially most important. We assume they were all important or that one was more important than the others,” Kiecolt-Glaser said.
Before you beginBefore starting any new workout program, women should
check with a physician. “One of the nice things about yoga, especially a restor-
ative yoga like hatha yoga training, is that it is relatively low demand in terms of physical limitation,” Kiecolt-Glaser said. Check with the teacher and ask what kind of class it is and if back or other physical issues can be addressed easily in class.
By Melissa EricksonMore Content Now
Yoga’s rejuve-nating and therapeutic effects make it
a popular exercise regime for millions of people. For breast cancer patients and survivors, yoga not only helps control physical functions like breath-ing, heart rate and blood pressure, it offers some surprising benefits, too.
“Yoga can improve the quality of life for breast cancer patients in several ways,” said Dr. Janice Kiecolt-Glaser, director, Institute for Behavioral Medicine Research, Ohio State University College of Medicine. Kiecolt-Glaser was the lead author of a recent study that found that yoga can lower fatigue and inflammation in breast cancer survivors. The women in the study were less fatigued than women not practicing yoga, and the more women in the study practiced yoga, the better their results.
“Fatigue is a really important quality of life marker for breast cancer patients because it has such a pronounced effect on daily life. The fatigue is not like being short of sleep but rather the kind of fatigue that can permeate the day and the ability to do many daily activities,” Kiecolt-Glaser said.
Fatigue fighterIt’s estimated that perhaps 30 to 40 percent of longer-term
breast cancer survivors have debilitating fatigue after treat-ment, Kiecolt-Glaser said. Women stressed with fatigue are often so tired that they’re less likely to exercise.
“The less they exercise, the more tired and the weaker they may be, so it’s a downward spiral. Yoga was a way of inter-rupting that spiral and getting women the opportunity to learn a new skill that was not too physically demanding and that helped the fatigue substantially,” she said.
Sleep issues are often commonplace in breast cancer patients and survivors “much more so than their age mates in the general population who haven’t had cancer,” said Kiecolt-Glaser. Yoga can help relieve the insomnia caused by breast
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MIND AND BODY
The surprising benefits of yoga for cancer patients, survivors
The fatigue is not like
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- Dr. Janice
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By Melissa EricksonMore Content Now
Having trouble sleeping through the night makes it hard to func-tion during the day and is a public health epidemic, accord-ing to the Centers for Disease
Control and Prevention. Breast cancer patients are part of the estimated 50 million to 70 mil-lion people affected by sleep disorders.
Insomnia is a common side effect of medical treatments and medications aimed at saving their lives. According to BreastCancer.org, insomnia can be caused by treatments Ixempra (chemical name: ixabepilone), a chemotherapy medicine; Tykerb (chemical name: lapatinib), a targeted therapy; and hormonal therapies Arimidex (chemical name: anastrozole), Aroma-sin (chemical name: exemestane) and Faslodex (chemical name: fulvestrant). Some pain medi-cations also can cause sleeping problems.
Insomnia affects your mood and energy, leaves you feeling fatigued and makes it hard to concentrate, said sleep expert Dr. Ilene Rosen, who serves on the board of directors for the American Academy of Sleep Medicine.
“Studies show that insomnia negatively affects work performance, impairs decision-making and can damage relationships,” she said.
What is insomnia?Different than just trouble sleeping,
“insomnia occurs when you have trouble falling asleep or staying asleep even though you had the opportunity to get a full night of sleep. One night of poor sleep is not necessarily insomnia; occasionally almost everyone has trouble sleep-ing,” said Rosen, who is the program director for the University of Pennsylvania Sleep Fellowship and an associate professor of clinical medicine for the University of Pennsylvania School of Medicine in Philadelphia.
Insomnia can occur after a stressor or major life change — such as being diagnosed with breast cancer — but it’s when sleepless nights start turning into sleepless weeks that it’s time to start thinking about insomnia. There are two types, short-term and chronic. Short-term insomnia lasts less than three months — this occurs in 15 to 20 percent of individuals. Chronic insomnia, which occurs at least three times a week for at least three months, occurs in
10 percent of the population, Rosen said.If you are having trouble sleeping, the first
step is to make sure you are employing good sleep hygiene, Rosen said. Here are some of her tips for overcoming insomnia:
• Keep a regular sleep schedule, making sure to go to bed when you are sleepy and wake up at the same time every morning — even on the weekends.
• Make sure your bedroom is quiet, dark and a little bit cool — it should remind you of a cave.
• Avoid caffeine in the afternoon as this can keep you awake at night.
• No screens for at least an hour before bed-time or in the bedroom. That means no TV, no phones, no tablets. The blue light they emit can hinder melatonin production, which is what makes you sleepy.
• Feel the need for a nap? Limit yourself to no longer than 10-20 minutes in the early afternoon when you feel a natural increase in sleepiness, Rosen said. “Naps of 30 minutes or longer may cause grogginess or ‘sleep inertia,’ and it can delay the performance benefits of a nap,” she said.
“Sleep, exercise and nutrition are three pillars for a healthy lifestyle. A recent survey found that individuals reported sleeping better if they exercised regularly. Research has found that exercise before bed may be OK — however, those suffering from insomnia should avoid vig-orous activity in the hours immediately before bedtime,” Rosen said.
SLEEP
More adviceStill awake after 20 minutes? “Get out of bed. Don’t lie there tossing and turning in frustration. Sit and read quietly (but not in any bright light) and crawl back into bed when you are sleepy,” Rosen said.Avoid heavy meals, caffeinated drinks and alcohol shortly before bed.“Our daily routines – what we eat and drink, how and when we exercise, the drugs and medicines we consume, how we schedule our days – can signifi-cantly affect the amount and the quality of the sleep we get,” Rosen said.If your sleep is suffering, see a specialist at an accredited sleep center – you can find one at sleepeducation.org.
MEDS MAKING IT HARD TO
SLEEP? TRY THESE TIPS
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By Melissa EricksonMore Content Now
When you hear the words, “You’ve
got breast cancer,” you’ll most likely be overwhelmed with emo-tions. Asking the right questions will give you valuable information to get the best care.
“Following a breast cancer diagnosis, women may feel totally lost, scared or maybe even numb,” said Joni Avery, spokeswoman at Susan G. Komen, which offers a variety of topic cards with pertinent questions to discuss with your doctor. Print them out at ww5.komen.org.
“It’s universal to feel helpless, but a woman needs to be prepared.
“Go into the doctor with a list of ques-tions, take it out and refer to it. Take someone with you if possible,” said Sara Goldberger, senior director of programs for the Cancer Support Com-munity, which offers a helpline staffed by healthcare professionals from 9 a.m. to 9 p.m. Mondays through Fridays at 888-793-9355.
“Even though you’ll be scared, you need to educate yourself. It will decrease your anxiety and make you feel more in control,” Goldberger said.
Here are some questions suggested by Avery and Goldberger:
• What kind of breast cancer do I have?
“Not all breast cancers are the same,” Goldberger said. Most breast cancers start in the cells that line organs and tis-sues in the breast, most commonly in the milk ducts,
according to the American Cancer Soci-ety. Others can occur in the breast itself.
• What is the stage of my breast cancer and what does that mean?
The cancer staging system, 0-4 (IV), shows the severity of the cancer as well as the tumor’s size and rate of metastasis, Goldberger said.
• Has it spread anywhere else?The most common places for breast
cancer to spread are the lymph nodes, liver, lungs, bones and brain, according to the National Cancer Institute.
• Is it treatable?“What are the standard treatments and what are my other options?” Gold-berger says to ask. “Can I
get treatment locally or do I need to go to an aca-demic center?”
• What is my prognosis?“It’s a hard question, but
most people find it easier to cope when they know their prognosis and treatment options,” Goldberger said.
• What are the side effects?Life-saving breast cancer
medicines and treatments can cause unpleasant temporary side effects. “Depending on who you are
and how you live your life, you may choose different treatments,” Goldberger
said. A treatment that causes numbness wouldn’t be a good choice for an artist. A family caregiver who needs to work every day may choose oral chemotherapy over infusions or radiation therapy.
• Should I get a second opinion?• Are there any clinical trials
available?Treatment of breast cancer has greatly
improved over the past 30 years because of the findings from clinical trials, which test the safety and benefits of new treatments, diagnostic methods and screening tests, Avery said. Talk to your doctor to see if a clinical trial is right for you.
• Were any tests done on my tumor such as a hormone receptor status test? If so, what were the results? How do these results affect my treatment options?
• How can I get a copy of my pathology report?
• Will my lymph nodes be removed?Located under the arm, lymph nodes
are the first place breast cancer is likely to spread.
• What is a sentinel node biopsy? Will I have this done?
• What tests will I have before surgery to see if the cancer has spread to any other organs? When will the tests be done?
• What are the chances that my cancer will come back or that I will develop another type of cancer?
• Where can I find a support group?
DIAGNOSIS
WRITE THESE QUESTIONS DOWN TO ASK YOUR DOCTOR
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September 2015 NEIGHBORS 11
What do you do to guard against breast cancer?
PHOTOS BY LINDA CHARLTON / CORRESPONDENT
My philosophy is prevention — good nutrition and staying healthy so the body is healthy. — Tina Carter, Clermont
Eat well and avoid mammograms. I’ve gone a couple of times and had absolutely horrible experiences, watching the radiologist read the results and refusing to talk to me. — Barbara Thunberg, Wesley Chapel
I just get the mammograms and I do my self-check, and no smoking, no alcohol and stay active. — Danielle Gray, Clermont
In my case, I get tested once a year, and I contribute with money to the charities. — Yellymary Montalvo, Minneola
My sister is a survivor of breast cancer. She was diagnosed a year ago. She’s cancer free. I was so inspired by her. I go every year. I self check. Breast cancer does run in my family. As a small child, my mother taught me that. I’m one who does not fool around with that. — Christy Smiley, Wildwood
Mammograms are vital. Although self-exams are good, I wouldn’t depend on them. Depending on the position of the tumor or the lump, you may not be able to feel it. I would stress the importance of mammograms. I would stress the importance of moving quickly, and there’s a book I recommend for every woman: Dr. Susan Love’s Breast Book. — Micki Blackburn, Clermont
›› WORD ON THE STREET
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14 NEIGHBORS September 2015
NeighborsCommunity Calendar
MOUNT DORAOCTOBER 1
› Bra-Vo 2015 runs from 5:45 to 6:45 p.m. at the Mount Dora Center for the Arts, 138 E. 5th Ave. Bra-Vo is an art-bra event to raise funds for free and low-cost mammograms. Go to www.bra-vo.org for information or call the Mount Dora Center for the Arts at 352-383-0880.
OCTOBER 2 › Dinner with gardening ex-
pert Melinda Myers and birding expert James Currie is part of the 4th Annual Wings and Wildflow-ers Festival from 6 to 7:30 p.m. at Lakeside Inn, 100 N. Alexander St. Cost is $35. For reservations and information, call Yvonne Pow-ers at 352-742-3925, email [email protected] or go to www.wingsandwildflowers.com.
OCTOBER 3 › “Le Hot Jazz!” is part of The
Florida Lakes Symphony Orches-tra Chamber Series taking you back to the ‘Hot Club de France’ to relive the days of gypsy jazz. The event features Konstan-tin Dimitrov, Steve Luciano and David Lowery. It is at 7 p.m. at Mount Dora Community Building,
520 N. Baker St. Call the Mount Dora Area Chamber of Commerce at 352-383-2165 for informa-tion and tickets, or go to www.mountdoralive.com. Doors open at 6 p.m.
› Cub Scout Pack 19 is hold-ing a pancake breakfast from 8 to 10 a.m., at First United Meth-odist Church, 439 E. Fifth Ave. Cost is $5 for pancakes, sausage or bacon, orange juice and coffee. All funds support the Scout pro-gram. For information, call 352-383-2005 or go to www.mtdora-fumc.org.
OCTOBER 3-4 › Renningers Fall in the Field
show is from 9 a.m. to 5 p.m. at Renningers Antique Center, 20651 U.S. Highway 441. It of-fers a selection of primitives and fall decor. Pick a pumpkin from Hites Heirloom Farms Patch, pur-chase fall crafts, or get your face painted. Call 352-383-8393, or go to www.renningers.net for information.
› Mount Dora Lawn Bowl-ing Club is hosting an open house from 10 a.m. to 2 p.m. The club is located at the end of Donnelly Street near Lake Dora at 125 Edg-erton Court. For information, call 352-254-0478, or go to www.mountdoralawnbowling.com.
OCTOBER 6 › TNT Trio with Janelle per-
forms from 7 to 9 p.m. every Tuesday at The Chef’s Pantry, 322 Alexander St., playing funk, soul, blues, disco, jazz and R&B music. For information, go to www.the-bandtnt.com, call 352-383-3973.
› National Night Out with the Mount Dora Police Department is from 5:30 to 8:30 p.m. at Tar-get parking lot, 17450 U.S. High-way 441. National Night Out is a chance to cultivate relationships with local law enforcement, busi-nesses, community groups and guests, as well as to promote safety and security in the com-munity. Free food and drinks will
be available as well as activi-ties kids.
OCTOBER 9 › The 2nd Friday Art Stroll
event encourages visitors to see area galleries and working art-ist studios in the downtown area from 6 to 8 p.m. For informa-tion, call the Center for the Arts, at 352-383-0880 or go to www.mountdoracenterforthearts.org.
OCTOBER 9-11 › More than 1,000 cyclists
will take part in rides of varying lengths and skill levels. The event covers three days beginning at 6 a.m. each day. For information or to register, call the Mount Dora
Chamber of Commerce at 352-383-2165, or go to www.mount-dorabicyclefestival.com.
› The Dora Invitational at the Mount Dora Golf Club, 1100 S. Highland St., is designed for com-petitive low-handicap players and is open to everyone. Call the Pro Shop at 352-383-3954 for in-formation or go to www.mount-doragolf.com.
OCTOBER 10 › Ocklawaha Chapter of the
Daughters of the American Rev-olution will host Bruce and Ja-net Smith, who, in period dress, will present “The True Story of
September 2015 NEIGHBORS 15
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SEE EVENTS, 16
April 19, 1775, Paul Revere’s Ride” and the first battles at Lexing-ton and Concord from 10 a.m. to 12:30 p.m. at St. Edward’s Epis-copal Church, 460 N. Grand-view St. The event is free. Call June Perry at 352-589-5855 or email [email protected] for information.
› Mega Motown Revue fea-turing your favorite mega-hits from Memphis, Muscle Shoals, Ala., and the Motor City in De-troit is at 7 p.m. at Elizabeth Ev-ans Park, 100 N. Donnelly St. For tickets and information, call 352-735-7183, or go to www.mountd-oralive.com.
OCTOBER 11 › Jefferson Starship “40 Years
in Space” is at 6 p.m. at The
Olympia banquet facility, 2728 W. Old Highway 441. The show features the cast of old and new players, including songwriter, gui-tarist and vocalist Paul Kantner and vocalist Marty Balin, both of whom founded the original Jefferson Airplane. Go to www.mountdoralive.com for tickets or call 352-383-2165.
OCTOBER 15 › Food Truck Night in Mount
Dora is from 5 to 8:30 p.m. at the corner of 4th Avenue and Alexan-der Street. Guests can enjoy mu-sic and food at Sunset Park and cuisine from a number of food trucks. For information, call the Mount Dora Area Chamber of Commerce at 352-383-2165.
OCTOBER 16 › Tea & History is from 2 to
4 p.m. at the Mount Dora His-tory Museum, 450 Royellou Lane.
Cost if $5 for guests to savor hot tea and fresh baked goods, along with conversation about Mount Dora history. For information go to, www.mountdorahistorymu-seum.com.
OCTOBER 17 › Lake Cares Chili-Cookoff is
from 3 to 7 p.m. at Elizabeth Ev-ans Park, 100 N, Donnelly St. For $5, guests will sample up to 20 different styles of chili. Proceeds benefit Lake Cares Food Pantry. Go to, www.lakecares.org/events or call 352-383-0100.
OCTOBER 17-18 › Renningers Steampunk &
Industrial Show is from 9 a.m. to 5 p.m. at Renningers Antique Center, 20651 US Highway 441. The event features two days of fantasy and hard-core industrial items, including original art in clothing, jewelry, Victorian hats,
shoes, and antiques of all types. Call 352-383-8393 or go to www.renningers.net.
OCTOBER 18 › Wag-N-Walk, presented by
Cornerstone Hospice Pet Peace of Mind is from 4 to 7 p.m. at Lake-side Inn, 100 N. Alexander St. in Mount Dora. The event is a fun-draiser providing funds to keep pets and families together during hospice care and will include a dog lure course, adoption parade, scavenger hunt, food, live mu-sic, vendors, pet adoptions and more. One pet per handler and no retractable leashes. For informa-tion, call Cornerstone Hospice at 352-343-1341.
OCTOBER 21 › The Amazing Kreskin per-
forms live at The Olympia in Mount Dora. Doors open at 7 p.m. and the show begins at 8 p.m.
Ghost sightings and more will take place. It is sponsored by Pledge4Patriots, with part of the proceeds benefiting military PTSD victims. For information and tickets, call 352-383-2165 or go to www.mountdoralive.com.
OCTOBER 23 › The 2nd Annual Ladies Leg-
acy Luncheon supporting the hospital Emergency Depart-ment takes place from 10 a.m. to 1:30 p.m. at Lake Receptions, 4425 N. Highway 19A. The event features exhibits and demonstra-tions and guest speaker Mitzi Eu-stis will share her story, “Life in the Foreign Service.” Tickets are $30 and can be purchased by calling Joan Ordazzo at 352-253-3270 or via email, [email protected].
OCTOBER 24-25 › The 31st Annual Mount
Dora Craft Fair with artisans in the streets of downtown Mount Dora is from 9 a.m. to 5 p.m.. This juried event attracts thousands of visitors and features more than 400 crafters. Go to www.MountDoraCraftFair.com or call 352-217-8390 for information.
OCTOBER 29 › Gary U.S. Bonds with Rocky
& The Rollers performs at 7 p.m. at the Mount Dora Community Building Theatre, 520 N. Baker St. Call Brian Young at 352-217-5072, email [email protected], or go to www.mount-doralive.com for information and tickets.
EUSTISOCTOBER 1
› Lake County Farmers & Flea Market is from 8:15 a.m.
16 NEIGHBORS September 2015
September 26th & 27th, 2015Saturday & Sunday 10am-5pmColony Plaza Shopping Center located within The Villages® community
FREE ADMISSION
For more information call561-746-6615 or 813-962-0388
#ACECraftFest
www.ArtFestival.cm
EVENTSFROM PAGE 15
SEE EVENTS, 21
September 2015 NEIGHBORS 17
D019451
October 2, 2015October 26 to 10pm
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Neighbors publishes the last Wednesday of every month in the South Lake Press and the last Thursday of the month in the Daily Commercial.
Neighbors is dedicated to exploring the extraordinary interests of everyday people in the communities of Lake County. If you have a neighbor who might be an interesting subject for a story, call Executive Editor Tom McNiff at 352-365-8250 or email [email protected].
To advertise, call Advertising Director Mary Manning-Jacobs at 352-365-8287.To submit an item for the Neighbors calendar, send an email to Pam
Fennimore at [email protected].
NEIGHBORS STAFF: Steve Skaggs ............................................................................................... Publisher Mary Manning-Jacobs .......................................................... Advertising Director Tom McNiff .........................................................................................................Editor Whitney Willard ................................................Copy Desk Chief, layout, design Brett LeBlanc ...........................................................................Staff Photographer Linda Charlton .......................................................... Contributing Photographer Roxanne Brown ...................................................................................... Staff Writer Pam Fennimore ...............................................................................Calendar Editor
NeighborsA publication of the Daily Commercial
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September 2015 NEIGHBORS 19
EXPLORE EUSTIS“Sample the Possibilities”Sunday, October 4, 2015
11am— 3pmEustis Downtown Entertainment District
Restaurants will provide a complimentary samplingof their signature dishes and beverages.
Participating Restaurants:
Stroll through downtown, eat, drink, listen to musicand enjoy our favorite Hometown!
1884 Restaurant & Bar / BakeryBarnwood BBQCrazy Gator
The Cuban PlaceThe Great Pizza Company
Harper’s AlleyMagnolia CaféSol de MexicoRhythms
Wine Cellars Uncorked
INFORMATION: [email protected]@eustis.org
ROXANNE BROWN [email protected]
For 10 years, the Greater Clermont Cancer Foundation has helped south Lake families touched by cancer get through their struggles.
For the non-profit, that means provid-ing financial aid, granting day wishes and awarding college scholarships. The GCCF has also set up a library at the InterCommunity Cancer Institute in Clermont, with books, information and free pamphlets about most types of cancer, treatments, testing, coping, nutrition and caregiving. The library is located at 1920 Don Wickham Drive, Suite 130 in Clermont and is open from 8 a.m. to 5 p.m. Monday to Friday.
Then, they have the Pink Ribbon Ladies.
“The ladies that run our support groups are amazing,” said GCCF Founder Phyllis Hutchinson.
The Pink Ribbon Ladies include five women who have survived breast cancer and now lead a breast cancer survivors’ support group that meets at 7 p.m. on the second Thursday of the each month at the National Training Center in Clermont.
The group is available to anyone who wants to learn how to live beyond breast cancer.
“We’re all breast cancer survivors and we’re here to prove that there’s life after breast cancer, a very good life,” said group mentor Betty Johnson, the GCCF’s new ambassador and 23-year breast cancer survivor.
The group provides area women
Survival guides
Breast cancer survivors show others how to keep going
DAILY COMMERCIAL FILE
Models pose for a group photo before taking to the runway to show off their personalized bras and boxers during ras for the Cause and Boxers Too event in April. The event helps fund breast cancer support groups.
SEE SUPPORT, 21
— also caregivers and men – the opportunity to support one another and discuss treatments, cop-ing and physical issues in a private environment.
“Unlike what some people may think, this group is not a pity party. We talk about things, we share information and we laugh,” said Johnson.
“Many times while undergoing chemo-therapy, peoples’ memory is affected. We have a joke about chemo-brain and I tell the girls that I have ‘sometimers’ — sometimes I remember and sometimes I don’t,”
Johnson said. “There’s a way of laughing at that part of the whole picture and it’s very important. There’s a healing thing about talking to others.”
But it’s not all fun.“Sometimes newly
diagnosed women feel like they don’t know what to do or where to go. I can only describe the looks on their faces sometimes as a deer in headlights. But we’ve had it (breast cancer), so we know. We know where to go for what. We know the doctors in the area, and know how they feel,” Johnson said. “We tell them, ‘Ok, you have breast cancer. So what are you gonna do about it?’ We em-power each other to make choices for ourselves.
“This is a sisterhood.”Johnson said she shares
her experiences of breast cancer and having had a mastectomy. She says she feels at the time of her surgery she should have had a double mastectomy instead of wondering sometimes whether she’ll have to go through again what she did in her other breast.
“Thankfully, I’m OK. But in retrospect, I think it’s something I would have done knowing what I know now, so that I wouldn’t have had to worry for 23 years,” she said.
They also encourage women to change things if they don’t like what is happening to them.
“Taking responsibility for yourself is OK. That’s what we tell them to do,” Johnson said.
People in the group also bond, she said, so there’s always someone who can provide rides, a listening ear and friendship when needed.
Johnson said Lake-Sumter State College sometimes sends their nursing students to ob-serve the group as a way of getting familiar with how to approach the issue and talk to those who have cancer. Johnson said that’s important because when patients are under-going cancer treatments, they see doctors and specialists but interact mostly with nurses.
Johnson said people are also put at ease when they know that the sup-port group has a Vegas mentality.
“Everything you say at support group stays at support group,” she said.
A related support group caters largely to young women dealing
with cancer issues. The Young Women Surviving Cancer group meets from 7 to 8 p.m. at the Agape House, located at 927 7th Street in Clermont on the second Monday of each month.
“This group is available for young women experi-encing the challenges of working, mothering and being a partner while sur-viving cancer,” the GCCF says about the group.
A third group, spon-sored by the First United Methodist Church in Cler-mont, caters to men and women who are patients of any other type of can-cer, besides breast cancer. That support group meets on the second Tuesday of every month at FUMC, located at 927 7th Street in Clermont.
Volunteers also ac-cept phone calls. Phone numbers are listed on the GCCF’s website.
“I get a lot of cold calls,” she said. “A woman may call and say: ” I just got a bad mammogram result. What now?” Sometimes
that’s all they need.”In addition, and since
the Pink Ladies group (or any other support group) is not allowed to ap-proach newly diagnosed breast cancer patients at any facility or other-wise to tell them about the groups because of HIPPA laws, they go out to eat once per month to promote themselves and have a great time together. That way, people can approach them if they so choose.
Johnson said they de-cide on a different restau-rant every month, show up wearing “as much pink as possible” and even have a mobile sign they stand at the table with them that identifies their group.
She said they have got-ten new members after being approached during their outings.
“We’ve been told by servers that sometimes customers ask them, “Who are those crazy ladies that are having so much fun?” she said.
20 NEIGHBORS September 2015
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to 1:30 p.m. at the Lake County Expo Center and Fairgrounds, 2101 County Road 452. The mar-ket is open year-round on Thurs-days, and no pets are allowed. For information, call Jane Allen at 352-357-9692 or email to, [email protected].
OCTOBER 2 › Eustis Live! will host a pi-
rate invasion with music and food in downtown Eustis from 6 to 10 p.m. For information, call 352-357-7969 or go to www.eu-stis.org.
OCTOBER 3 › The Pumpkin Patch has
opened at Santa’s Christmas Tree Forest in Eustis, where guests can enjoy a petting zoo, zip line, hay-rides, bounce pillow, pony rides and more through the end of October. Open on weekends, from 10 a.m. to 6 p.m. Santa’s Christmas Tree For-est is located at 35317 Huff Road in Eustis. Call Jodi Utsman at 352-357-9863, email [email protected] or go to, www.santaschrist-mastreeforest.com for information about the farm.
OCTOBER 10-11 › The Lake County Folk Festi-
val will be from 10 a.m. to 9 p.m. on Oct. 10 and 10 a.m. to 4 p.m. on Oct. 11 at Ferran Park on the Lake in Eustis. The free festival features more than 50 groups and 100 musicians. An arts and crafts show will also take place in the band shell. For informa-tion, call Jeff Friberg at 352-408-9800, email [email protected] or go to www.lakecountyfolkfest.org.
OCTOBER 20 › The Taste of Golden Trian-
gle and Business Expo, presented by the Lake Eustis Area Chamber of Commerce, will be from 5:30 to 8 p.m. at the Lake County Fair-grounds, 2101 County Road 452 in Eustis. For information or to be a sponsor, call the chamber at 352-357-3434.
OCTOBER 24 › The monthly classic car
cruise-in will be from 5 to 8 p.m. with around 150 cars in down-town Eustis. For information or to register a car, call 352-360-3712.
OCTOBER 25 › The Antique Appraisal Clinic
roadshow, a fundraiser event hosted by the Eustis Historical Museum, will be from 1 to 5 p.m. at the Eustis Community Cen-ter, 601 Northshore Drive. Cost is $5 per item. For details, call 352-483-0046 or 352-357-5433.
LEESBURGONGOING
› The Leesburg Saturday Morning Market is from 8 a.m. to 1 p.m. every Saturday at Towne Square, 501 W. Main St. in down-town. For information, call the Leesburg Partnership at 352-365-0053 or go to www.lees-burgpartnership.com.
OCTOBER 2-4 › The 4th Annual Lake County
Wings & Wildflowers Festival will be Friday, Oct. 2 through Sunday, Oct. 4 at Venetian Gardens, 109 E. Dixie Ave. in Leesburg. The festival is free, but participants may have to pay for some programs and tours. For information and times of events, call Yvonne Powers at 352-742-3925, email [email protected] or go to www.wingsandwildflowers.com.
OCTOBER 3 › The Great Scarecrow
Build-off and Expo at the Lees-burg Saturday Morning Mar-ket will be from 8 a.m. to 1 p.m. at Towne Square, 501 W. Main St. in downtown. Families, indi-viduals, organizations and busi-nesses are invited to showcase their scarecrow making abilities. Entry fee is $20. For information, call the Leesburg Partnership at 352-365-0053.
OCTOBER 8 › Zé Carter, the Roaming
Gourmet, will offer tips on quick and easy soups from 11 a.m. to 12:30 p.m. at the Leesburg Public Library, 100 E. Main St. The event is free and open to the public. For details, call Dusty Matthews at 352-728-9790.
OCTOBER 9 › The Quarterly Bird & But-
terfly Survey will be from 7:30 to 11 a.m. at PEAR Park Wildlife Con-servation Area, 4800 University Ave. in Leesburg, and volunteers are being sought. Experience is helpful but not required, and participants must bring binocu-lars and a field guide. Call Lake County Parks & Trails at 352-253-4950, email [email protected] or go to www.
lakecountyfl.gov/parks for details.
OCTOBER 10 › The Leesburg Food Truck-
N-Flick Night will be from 5 to 10 p.m. at Towne Square, 501 W. Main St. in downtown. Live music starts at 5 p.m., and the movie starts at sundown. Call
the Leesburg Partnership at 352-365-0053 for information.
› The 5th annual Local Au-thor Showcase will be from 9 a.m. to 1 p.m. at the Leesburg Public library, 100 E. Main St. in downtown. The event is free. For information, call Dusty Matthews at 352-728-9790.
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EVENTSFROM PAGE 16
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OCTOBER 16 › “The Octette Bridge Club,”
a sentimental comedy by P.J. Barry about American life in a by-gone era, will be from Oct. 16-18, Oct. 23-25 and Oct. 30-Nov.1 at Melon Patch Players, 311 N. 13th St. in Leesburg. Friday and Sat-urday shows are at 8 p.m., and Sunday shows are at 2 p.m. Cost is $18 for adults and $9 for stu-dents. Call Marie Cormier at 352-787-3013, email [email protected] or go to www.
melonpatchplayers.com for information.
OCTOBER 17 › The Leesburg Saturday
Morning Market’s Paint the Mar-ket Pink for Breast Cancer Aware-ness will be from 8 a.m. to 1 p.m. at Towne Square, 501 W. Main St. in downtown. Call the Leesburg Partnership at 352-365-0053 or go to www.leesburgpartnership.com for information.
OCTOBER 24 › Soap Box Derby Day will
be from 8 a.m. to 1 p.m. at Towne Square, 501 W. Main St. in
downtown, as part of the Lees-burg Saturday Morning Market. Lake District Boy Scouts, Cub Scouts and Girl Scouts will be running Soap Box Derby cars. Call the Leesburg Partnership at 352-365-0082 for information.
› Oktober Autofest will be from 10 a.m. to 1 p.m. at Ce-cil Clark Chevrolet, 8843 U.S. Highway 441 in Leesburg. This family friendly event will fea-ture live music, food trucks and face painting. Trophies will be awarded in the Best Unique Auto, Best Antique Auto and Best Truck categories. The first 25 par-ticipants to register will receive
a special dash plaque. Register at www.lakecountychevy.com/oaf or call Jennifer Warriner at 352-787-6888.
› A meet and greet honoring Patriot Guard Riders will be from 11 a.m. to 3 p.m. at AMVETS Post 2006, 501 N. Canal St. in Lees-burg. The special guest is retired Brigadear General Tim Sullivan. For information, call 352-323-8750 or email [email protected].
› The 5th annual Veterans Charity Ball, sponsored by the Rotary Club of Leesburg Foun-dation, will be from 5 to 10 p.m. at the Leesburg Armory on the
corner of 3rd and Meadown streets, offering dinner, dancing, raffles and live entertainment by the LC Swing Band with Dave Boyer. For tickets and informa-tion, call Larry Lutte at 352-728-8414 or email [email protected]. Funds raised will benefit local veterans organizations.
OCTOBER 29 › The annual Beast Feast, pre-
sented by the Leesburg Center for the Arts, will be from 5:30 to 7:30 p.m. at the historic Mote Mor-ris House, 1195 W. Magnolia St. in downtown Leesburg, featuring a wide variety of exotic and unusual meats accompanied by side dishes, beverages and live entertainment. Tickets are $25 in advance and $30 at the door. For information, call 352-365-0232 or go to, www.lees-burgcenter4arts.com.
› Ghosts of the Revolutionary War — Haunted Happenings will be from 1:30 to 2:30 p.m. at the Leesburg Public Library, 100 E. Main St. in downtown. The event is free. Call Dusty Matthews at 352-728-9790 for details.
OCTOBER 31 › The Leesburg Satur-
day Morning Market Boo Bash will be from 8 a.m. to 1 p.m. For
information, go to www.Lees-burgSaturdayMorningMarket.com or call the Leesburg Partner-ship at 352-365-0082.
› The 20th Annual Leesburg Main Street Christmas House will open at 10 a.m. at ViaPort Flor-ida, 10401 US Highway 441 in Leesburg, and continue through Dec. 12. For information, go to www.christmashouse.leesburg-partnership.com or call 352-365-0053. A Sneak peek event will be on Oct. 28 from 3 to 8 p.m.
TAVARESOCTOBER 1
› The Pink It Up Celebration will be from 4:30 to 6:30 p.m. at Florida Hospital Waterman, 1000 Waterman Way in Tavares. Guests are asked to bring a new bra for do-nation to the Haven of Lake and Sumter Counties. Go to www.flori-dahospital.com/waterman for in-formation or to join the Pink Army.
OCTOBER 10 › Tavares Rocktoberfest 2015,
a street party featuring live mu-sic, Jeep show, German food and photo booth, will begin at 3 p.m. at Wooton Park, 100 E. Ruby St. Call 352-205-5992 or email [email protected] for information.
OCTOBER 11 › Get Your Mocha On will be
from 3 to 4 p.m. at the Tavares Civic Center, 100 E. Caroline St. Guests will learn all about choco-late and taste some of its deca-dent flavors. Call Rosa Rosario at 352-742-6204 for information.
OCTOBER 13 › Jane Rosenbohm, Flori-
da’s first lady of guitar, will per-form from 3 to 4 p.m. at the Ta-vares Civic Center, 100 E. Caroline St. A free raffle will take place for guests with the lucky winner go-ing home with a Mountain Tyler guitar. Call Rosa Rosario at 352-742-6204 for information.
LADY LAKEOCTOBER 1
› World War II: In the Per-spective of Today, with special guest Dr. Donald Goldstein, will be at 2 p.m. at the Lady Lake Li-brary, 225 W. Guava St. Cost is $2. Call 352-259-4359, email [email protected] or go to www.ladylakemuseum.org for information.
OCTOBER 6 › The Lady Lake Farmer’s
Market will be from 9 a.m. to 1 p.m. every Tuesday at 106 S. Highway 27/441, offering fresh
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EVENTSFROM PAGE 21
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produce from many vendors. To be a vendor or for information, call 352-552-1266.
UMATILLAOCTOBER 10
› The 16th annual Florida Black Bear Festival will be from 9 a.m. to 4 p.m. at Cadwell Park, 3 Cassady St. in Umatilla. Admis-sion is free. For information, call Susan Martin at 352-669-3511, or go to www.umatillachamber.org or www.myfwc.com.
CLERMONTOCTOBER 3
› October GardenFest, the 14th Annual Garden Walk hosted by the Clermont Garden Club, takes place from 9 a.m. to 3 p.m. Guests will tour seven pri-vate residential gardens at their own pace beginning at the Cler-mont Garden Club, 849 West Ave. There will also be a plant sale, a raffle and prizes. Tickets are $10 per person. Email Margaret Piper
at, [email protected]. › The 10th annual afternoon
tea, The Power of Pink Tea for GCCF, benefits the Greater Cler-mont Cancer Foundation. It begins at 11:30 a.m. at First United Meth-odist Church, 715 Juanita St. Cost is $25. For tickets and information, call Phyllis Hutcheson at 352-394-8401, email [email protected], or go to www.gccf.us.com. Guests can also shop in the boutique dis-playing handmade items made by the pink ladies.
› Leader of the Lake Regatta, a 5K rowing regatta on Lake Min-neola, features youth and adult teams from Florida and the Southeast. Events take place from 7 a.m. to 2 p.m. at the Cler-mont Boathouse, 1050 Lake Min-neola Drive. Go to www.rowlcra.org for information.
OCTOBER 17 › A Community Celebration of
Hope a free music festival to ben-efit the Greater Clermont Can-cer Foundation, is from noon to 10 p.m. at Waterfront Park in Cl-ermont. Guests should bring lawn chairs and blankets. Call Cody Pevehouse at 407-860-3938 or email [email protected],
or call the Greater Clermont Can-cer Foundation at 352-435-3202.
› Paddlers will explore sections of the Palatlakaha Crooked River, including Lake Louisa and Lake Su-san, as part of this free paddling adventure beginning at 9 a.m. at Crooked River Preserve on Lake Louisa Road. For information and reservations, call the Lake County Water Authority at 352-343-3777, email [email protected], or go to www.lakecountyfl.gov/parks.
OCTOBER 24 › Equestrians of all ages and
abilities will trek through the Lake Louisa State Park for the Eques-trian Obstacle Trail Challenge, 7305 N. US Highway 27. Gates open at 7 a.m., registration begins at 8 a.m. and all riders must be checked in by 9:30 a.m. Other events include the 10 spooky obstacles, fun, food and a costume contest with your horse. Call 352-255-3355 or email [email protected], or go to www.llsp.org for information and registration.
› The Great Floridian Endur-ance Festival featuring, Ultra, Tri-America, Aqua Bike, Open Wa-ter, Sprint, 15K and 5K begins at 7 a.m. at Clermont Waterfront
Park, 330 3rd St. Call Sommer Sports at 352-394-1320 or email [email protected] for in-formation and registration.
› Halloween Trot or Treat will be held from 3 to 4 p.m. at Dreamcatcher Horse Ranch, 10639 Toad Road. The event fea-tures free admission, horse and pony rides, kids costume contest, horse and rider costume parade, haunted hay rides and more. Call Alison Wheatley at 407-702-8332, email [email protected], or go to www.dreamcatch-erhorses.com for information.
MINNEOLAOCTOBER 29
› There will be a costume party from 4 to 5 p.m. at the Minneola Schoolhouse Library, 100 S. Main Ave. Call Diane Merchant at 352-432-3921 or email [email protected] for information.
FERNDALEOCTOBER 30
› There will be a free bird and wildlife exploration hike from 8 to 10:30 a.m. at the Green Mountain
Scenic Overlook and Trailhead, 20700 County Road 455. Park rangers will lead the hike, and guests will spend some time in the tower watching for passing raptors and migrating birds, drag-onflies and butterflies. Call Lake County Parks & Trails at 352-253-4950 or email [email protected] for reservations.
OCTOBER 31 › Volunteers are needed to
assist in surveying the bird and
butterfly populations to help with management of the prop-erty at this quarterly bird and butterfly survey event from 7:30 to 11 a.m. Experience is help-ful but not required, and guests must bring binoculars and a field guide. The free event will take place at the Ferndale Pre-serve, 19220 County Road 455. Call Lake County Parks & Trails at 352-253-4950 or email [email protected] for information and reservations.
EVENTSFROM PAGE 22
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Before your physician enters the exam room toexamine you he is armed with a wealth of medicalinformation about you. Our Quality AssuranceDepartment with medically trained individuals hasperusedyourmedical recordtoensureyour screeningsare complete, your medicines are up to date, yourdiagnoses are consistentwith themedications you aretaking. In addition, this team reviews authorizationsthat were obtained for different tests and different
providers that can forewarn your physician to anynew conditions discovered outside of our practiceand appropriate action can be taken to manage yourcare by making an educated decision. “Our QADteam audits your record prior to your every visit withyour physician so no aspect of your medical careremains unaddressed. Your care is managed by anentire medical team, not just a single physician!!!!
Breast CancerOctober is Breast Cancer Awareness Month. The Physiciansand Staff at Premier Medical Associates would like you tojoin us in raising the awareness of the importance of earlydetection in the fight against breast cancer and the importance
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