Notes from the 9th Annual Conference of Young Women Affected by Breast Cancer

Sorry for the delay but here's my notes from the conference in Dallas.

9^th Annual Conference for Young Women

Affected by Breast Cancer 2009

Medical Update

• Tamoxifen is the standard for 5 years for those premenopausal.
• ER + Tamoxifen & oophorectomy, AI should not be a standard treatment for premenopausal
• Triple negative with high recurrence after dx but once reach 5 years may possibly be cured

Bone Health

• Causes of breast cancer and bone loss: steroids, chemo, lower estrogen, AI
• Tamoxifen for premenstrual can decrease bone density by 1.4 % a year
• AI can decrease by 2.6% a year.
• Suggestions: premenstrual take 1200 mg of Ca and post 1500 mg throughout the day and on an empty stomach; foods/drinks high in Ca includes milk, yogurt, fortified food, cheese; vitamin D3 1000 IU; weight bearing exercise 30 minutes three to four times a day; bisphosphonates can help improve bone lost
• Premenopausal women should check the z score and post the T score

Navigating Health Insurance

• Individual policies are not subject to HIPAA, regulated by state, must claim pre-existing, can ask for a list of those that guarantee coverage and does NOT look at pre-existing
• Medicare donut hole plan D gap coverage closes donut hole; get gap coverage if need lots of meds; $4600 for prescription once met patient pays 5% of full cost; www.needymeds.com may help
• Pre-existing better to be off of HMO because it’s very restrictive
• Patient Advocate Foundation www.patientadvocate.org or Co-Pay Relief www.copays.org

Sexuality Renewal after Breast Cancer

• Most common sexual problems after breast cancer is lack of desire/pleasure, pain, dryness, and discomfort during sex
• Predictors for low desire after breast cancer is being younger at dx, chemotherapy, relationship conflict and general life stress
• Techniques to enhance desire by identify and promote activities that increase sexual desire: physical sports or dance, intimate talks, cuddling, romance, erotic stories, videos, fantasies, make sure partner knows how to please you, get counseling, change meds that could be interfering, treat any sexual pain or vaginal dryness
• Communication tips: create a safe space and time to talk, choose one or two goals for change, focus on specific, positive requests, avoid conflict about the past, discuss fears of rejection, discuss fears about survival and QOL, be a good listener too

Advanced Breast Cancer: Living with Uncertainty

• Coping activities: making short and long range goals, locate and access resources, identify strengths and weaknesses, remember you always have a choice
• Have a team. List those on your team.
• Live by staying in the moment, focus on priorities and do what you can when you can
• Use self care strategies like journal writing, relaxation, hobbies, reframe challenges and humor