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Should Komen's Nancy Brinker Step Down?

Sunday, February 05, 2012

You may be wondering if there’s anything left to say about Komen and Planned Parenthood? The anger and outrage over last week’s events have prompted countless newspaper articles, television news stories, blogs, Tweets and emails from every news outlet, Komen affiliate and breast cancer advocate who’s semi-conscious. Therefore, I will not rehash the specifics of whether Komen’s decision to halt breast cancer screening grants to Planned Parenthood had anything to do with abortion, politics or Komen’s new grant guidelines; why Komen rethought their decision, or whether Komen’s differing explanations portrays them as revisionists. However, to say Komen’s handled yet another incident poorly is an understatement.

While I consider much of my personal life fair game to write about, I steadfastly wear my journalist’s hat when reporting treatment modalities, current thinking about the causes and possible cures, along with ways to lessen risk of recurrence and lead healthier lives. Until now, I’ve also tried to keep my journalist’s hat on about Komen, only reporting the “who, what, when, where and why.” I’ve even gone out of my way to provide Komen with a public forum on this blog, in hopes they would reach out to the breast cancer community, say a few mea culpas and use it as a way to mend fractured relationships and some of their own policies. While I wasn’t holding my breath, I’d hoped for a small step forward, but that was not to be. Actually, there was a lot that went on behind the scenes I haven’t told you.<PREVIEWEND>

For starters, the national office of Komen approached me last August. While the reason for their call was never clear, I seized the opportunity to invite Leslie Aun, National Director of Marketing and Communications for Komen for the Cure®, to openly address the breast cancer community on my blog about the rage and anger over “Pinktober,” the endless stream of questionable pink products for sale, as well as Komen’s ill-thought-out perfume, Promise Me, and it’s carcinogenic ingredients. I suggested a post from Komen could
“be the first in a series of open dialogs with the goal of uniting breast cancer advocates and bloggers on common ground, while voicing our disagreements and working, together, to implement clearer fundraising and search for the cure mechanisms.”
Leslie Aun was receptive. I went on to tell her that in order for this dialog to have a chance of being successful, she couldn’t defend Komen. She would need to own up to their having made some poor decisions, like partnering with Kentucky Fried Chicken and Mike’s Hard Lemonade as fundraising partners. How could Komen lead the search for the cure while taking high profile dollars from corporations that produce alcohol and greasy processed foods, both proven risk factors for breast cancer and poor health in general? At the very least, I told her Komen would need to say something like “if we had it to do over again, Komen would have made different choices.” Ms. Aun liked my idea and agreed to write something to that effect in her post on BRENDA’S BLOG. While she did write a post, it was a rah, rah, Komen’s not done anything wrong.

Ms. Aun also agreed to engage in a dialog with readers of my blog by responding to their comments.
She did not.
This was to be the first in a series of regular dialogs with the breast cancer community that we would eventually move to Twitter or Facebook, to which she agreed. She has not returned any of my calls since my readers posted their unanswered comments.

When I told a blogger friend Komen had accepted my invitation to write a post on BRENDA’S BLOG, she suggested Komen was using me to disseminate their party line and that letting them write a post on my blog would make me look bad and ruin my credibility. I respectfully disagreed, saying any failure on Komen’s part to respond appropriately would only hurt Komen, not me. That is exactly what happened.

Time and again, Komen has failed to make well thought-out decisions.
The Susan G. Komen Foundation began as a promise to a dying Susan G. Komen, by her sister, Nancy Brinker, to find a cure for breast cancer. What started off as a lofty goal has morphed into a three-ringed circus with pink money mania in the center ring. The Planned Parenthood debacle is merely the latest in a string of insensitive high-profile failures. If nothing else, we should learn from history, but Komen seems to repeatedly ignore their history of missteps, followed by repeatedly defending them.

Some Komen critics say Komen is arrogant and out of touch. Regardless, their repeated fiascos have let everyone down who’s ever lost a loved one to breast cancer; every breast cancer survivor who prays for a cure; everyone who’s ever participated in a Komen walk for the cure and every fundraising partner who’s ever donated money to Komen and other charities that raise money for a good cause. In short, Komen has lost their credibility among more than just the breast cancer community.

Most organizations plagued with serial failure to learn from their own history ask their leaders to step down. Perhaps it’s time for Nancy Brinker to relinquish her reigns and let Komen rebuild their image. This weekend, Komen sought the advice of an executive vice president at the tony Ogilvy public relations firm as well as Ari Fleischer, former White House press secretary to George W. Bush. However, in order to rebuild their image, it’s crucial for Komen to have the support of breast cancer advocacy organizations and top breast cancer social media mavens.

Make no mistake, breast cancer bloggers have the ear of millions of survivors and their families, oncologists, surgeons and researchers, corporate sponsors and the media. While the Planned Parenthood story may have originated with traditional media, it’s gone viral because of social media. If Komen wants to rebuild their image, they must gather breast cancer bloggers into their fold, listen to our concerns and once again, gain our trust. Perhaps Komen should consider giving a breast cancer blogger a seat on their advisory board. The lives of our mothers and daughters and future sisters, named Susan, may depend on the strength and credibility of Komen. Please, Komen, don’t let them down, again.

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Dying in Cancer's Wilderness

Sunday, January 29, 2012

©Brenda Coffee. All rights reserved.

Every week I hear from lots of women. They tell me stories that inspire and some that make me question the nature and future of mankind. This is one of those stories. "Rhonda" is 44 years old and has late Stage IV metastatic breast cancer. "Mike," her husband of nine years, has gone as far as he wants to go as her caregiver and has asked his girlfriend to move in with him and Rhonda. It seems as though Mike is “tired” of cancer; tired of having a wife who doesn’t feel well, a wife he’s no longer attracted to and one who’s not interested in sex.

On the other hand, Mike’s girlfriend is healthy, younger and seems to have given Mike a new lease on life in the bedroom. But wait... There’s more. Mike has moved his wife into the guest room where she can hear her husband and his new girlfriend making love as she lies in bed alone, in pain, waiting to die. There is no delicate way of describing this demeaning end to a life and a marriage that at one time, had love and promise, but Mike and his girlfriend have given new meaning to the word “scum.”<PREVIEWEND>

Over and over I’ve asked myself what kind of man does this; what kind of girlfriend gets involved with a man like Mike, and how did Rhonda windup being so vulnerable that she feels she has no other option? I know what it’s like to be without my husband and to literally have no family, except for my mother who has dementia, but I have dear friends who would be there if I needed help. I’ve tried to put myself in Rhonda’s position. What must it feel like to be so lost and alone and without resources? What must if feel like to have your self worth thrown out like yesterday’s trash?

Sadly, there are endless variations to Rhonda’s story, women who are alone and in less than ideal settings as they go through breast cancer treatment and cope with end of life issues. My friend and fellow breast cancer blogger, Terri Wingham at A Fresh Chapter, recently wrote a blog about meeting women in Vietnam who’ve been abandoned by their husbands and left to fend for themselves with no money for food or treatment for their breast cancer. Another friend and breast cancer survivor, Philippa Kibugu-Decuir of Breast Cancer Initiative East Africa, has told me similar stories about women in her home country of Rwanda.

What must it be like to be treated as though you are to blame for your breast cancer, told that you are no longer wanted or valued? Some of this heartless behavior is a result of an uneducated populace in countries where survival of the fittest defines the basics of everyday life. Mike, however, lives in the wealthiest country in the world where he has a college education, a car, a job, a modern home and food in his refrigerator. So, how do the “Mikes” of the world come to be that way? Where does their lack of respect for life and family come from?

I wonder if the actions of other men influence them, men like John who ran for President of the United States, whose girlfriend gave birth to his child while his wife, Elizabeth, was fighting Stage IV breast cancer? Yes, these men give new meaning to the word “scum” along with “shallow,” “selfish” and “cruel.”

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An Educated Life

Sunday, January 22, 2012

©Brenda Coffee. All rights reserved.

I know an extraordinary amount of things most people would find trivial, boring or shocking. For instance I can discuss, in depth, tertiary yaws, those microscopic survivors from the Cenozoic Era that bore into the soft tissue of human feet and cause spontaneous amputation of the toes; I can give a scientific dissertation on how a basket of discarded tomato, potato and eggplant peels, when treated with 2-4-6 dimethyloxytropinone could make every man, woman and child in a small town hallucinate and swing from street lights like monkeys, and I know far more than I care to about the sexual appetites of some of America’s favorite rock stars. It’s not what you think, but I’m sworn to secrecy. Sorry.<PREVIEWEND>

My formal education has taken me from being able to read a book by myself at the age of three, play Rachmaninoff’s piano Concerto in D Sharp Minor when I was nine, come close to flunking my senior year of high school and finish college after two aborted attempts. None of the teachers I encountered along the way made much of an impression on me or imparted anything of real value, except for my college journalism professor. He forced me, against my will, to compose my thoughts at the keyboard and then to convey them in an inverted pyramid style, skills for which I am forever grateful.

My informal education is full of unorthodox and often outrageous teachers who taught me how to corner a 2000-pound, three-liter, rear engine car at 120 miles-per-hour without losing control; how to tether myself to a helicopter in flight, sit on the landing skids and take pictures without falling off and how to hang by one arm from the back of a moving train, then hoist myself successfully back on board. Unfortunately, none of my instructors are still among the living.

All in all, the variety of subject matter to which I’ve been exposed, as well as my learning curve, has failed to fit the profile of any standard curriculums. I am just now learning how to be still in the moment, how to talk to a mother I’ve had for nearly 60 years and how to recognize and give thanks for my many blessings. Before James died, my life was fuller and calmer than it had ever been. I had a husband who nurtured and loved me more than either one of my parents and who, daily, showed me the meaning of true character.

I’ve learned how to relate to women, to have girlfriends I look forward to spending time with and to talk about feelings, as opposed to power-to-weight ratios and return on investments. No longer am I looking for approval from, or am anchored by, the man in my life, and I’ve finally learned to live what most people call a “normal life.” I’ve learned what real love is, the giving of self, the grace of God, come to terms with the duplicity of man and I've realized that ego can be all encompassing.

Cancer has been one of my greatest teachers. Aside from giving me an up close and personal look at mortality, it has nurtured the deepest parts of my spiritual side; made me realize that while I’ll never have the mother I want, I can be the daughter she needs, and it’s helped me separate the people who matter from those who don’t. Cancer has made me more compassionate than I thought possible, has made me cry over something as simple as an apple pie and and made me determined to live my life out loud. 

What are the most profound lessons you’ve learned in your life?
Has life or cancer changed you; has it made you less judgmental and more open to try new things, or has it made you more fearful of the future? Since we don’t know whether we have a day, or a decade, I hope you: postpone death by living, eat pie, extend a hand, put yourself out there in ways that make you uncomfortable and become acquainted with God.

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Parabens: Do They Cause Cancer and Do They Prevent Chemo From Killing It?

Sunday, January 15, 2012

Parabens and their links to breast cancer are in the news again. Widely used as preservatives in many cosmetic and toiletry products like antiperspirants, parabens have been found to have an estrogen-like effect in the body, and estrogen is an established risk factor for breast cancer. Numerous studies have questioned whether parabens can be linked to the development, growth and progression of breast cancer. Most recently, the University of Reading, in England, studied 160 tissue samples from 40 women who underwent mastectomies between 2005 and 2008. This month, the findings were published online in the Journal of Applied Toxicology.<PREVIEWEND>

Ninety-nine percent of tissue samples were found to contain at least one paraben and 60 percent of samples were positive for five of the most common parabens (methylparaben, ethylparaben, propylparaben, butylparaben and isobutylparaben). Most importantly, women who said they never used deodorant--most deodorants are known to contain parabens--had measurable parabens in their breast tissue. The implications of this study seem to indicate that parabens are entering the breast from sources other than deodorant.

The study’s chief researcher, Dr. Philippa Darbre, did a similar but smaller study in 2004. The levels of parabens found in her most recent study were four times higher than the 2004 study. "Since 2004, many manufacturers, although not all, have been removing parabens from the underarm deodorant/antiperspirant products and so I was rather surprised when we found higher levels of parabens in these (more recent) breast tissues," Darbre said. Dr. Michael J. Thum, vice president emeritus of epidemiology and surveillance research for the American Cancer Society was quick to point out that just “because parabens were detected in the majority of the breast tissue samples cannot be taken to imply that they actually caused the breast cancer.”

So, where does this most recent study leave us? Should we avoid products that contain parabens or should we wait until more and larger studies are conducted? Dr. William Goodson, principal researcher at the California Pacific Medical Center says that methylparaben can also interfere with the effectiveness of drugs used to fight breast cancer. Goodman took noncancerous breast cells from high-risk patients, grew them in a laboratory and found that once the cells were exposed to methylparaben, they started behaving like cancer cells. Tamoxifen, a drug designed to prevent or treat cancer, slows down the growth of both healthy and cancerous breast cells and ultimately leads to their death. However, when tamoxifen was introduced in the lab, the cells exposed to methylparaben kept growing and didn't die. “Methylparaben not only mimics estrogen's ability to drive cancer, but appears to be even better than the natural hormone in bypassing the ability of drugs to treat it,” Goodson said.

Clearly more paraben/breast cancer studies need to be conducted. The FDA believes that “at the present time there is no reason for consumers to be concerned about the use of cosmetics containing parabens.” If parabens are winding up in breast tissue in ways other than deodorant, and parabens can interfere with chemo's ability to kill cancer, I’m not waiting for “the ultimate study” to tell me to avoid parabens.

There are lots of great body care and cosmetic products on the market that don’t contain parabens. If you have a Whole Foods in your area, ask the sales clerk to advise you. I’ve bought, and used, almost every deodorant, shampoo, facial cleanser and moisturizer Whole Food’s carries and have found my personal favorites that work best for me.

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Old Friends

Monday, January 09, 2012

©Brenda Coffee. All rights reserved.

I spent the weekend with three of my girlfriends from high school. Once again, our time together confirmed my belief that there’s no friend like an old friend. Old friends are a lot like your favorite pair of shoes: comfortable, yet supportive, and with just the right amount of pressure in all the right places. Each time my girlfriends and I see each other, we pick up the conversation as though no time has elapsed since we were last together. More importantly, we unconditionally accept one another, warts and all. While we’re still the same girls we were in high school, our common experiences have bonded us together above and beyond that of casual friends, and in the last year, those bonds have deepened in ways none of us could have predicted.<PREVIEWEND>

It was just a little over a year ago the four of us and our husbands got together to eat, drink and celebrate life. If a fortune teller had stepped into our midst that day and predicted what lay ahead, we would have told her to pack up her gypsy wagon and go sell crazy someplace else. Unfortunately, crazy happened, and to say it caught us all off-guard would be an understatement. Four week later, James died unexpectedly and his family painfully dissolved; three months later Bonnie’s husband died unexpectedly; six months later parts of Bonnie’s home was caught in the most destructive wildfire in Texas history, and the month after that, Gayle was diagnosed with breast cancer. This weekend though, none of us shed a tear over the events of last year. Instead, our tears were because at one time or another, each of us has set aside our own pain to reach for the other’s hand and pull her up.

Friendship is one of the intangibles in life. It can’t be measured or quantified, but it’s found in the laughter and the unspoken words of a compassionate heart. A real friend steps in when you need help the most, when everyone else doesn’t know what to do or say. One special friend in particular, my friend Joan, called me every single night, without fail, for six months after James died until she was certain I was in a better place.

As I made my way home, today, I listened to Paul Simon’s Diamonds on the Soles of Her Shoes and got to thinking: My girlfriends are the diamonds on the soles of my shoes. While the great girlfriends in our lives may never walk in our shoes, from time to time they stand in the same space with us and help us through things we never dreamed we could face.

When was the last time you called, not emailed, a girlfriend who helped you through breast cancer or another tough time and told her how much you love and appreciate her?
When’s the last time you encouraged her or said a prayer for her? Or, perhaps there’s someone you’d like to be friends with. If so, it takes a long time to become an old friend. What are you waiting for?

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Beginnings and Opportunities

Sunday, January 01, 2012

One of my favorite words is "beginning." No words are more powerful than “In the beginning, God created the heavens and the earth.” I am humbled and awestruck every time I contemplate the power of God. Perhaps for me, that’s why the word “beginning” conveys such strength and hope. In the beginning, everything is shiny and new, and we’re brimming with hope, good intentions and lots of can do attitude.

Beginnings are opportunities for us to start over, to begin again,<PREVIEWEND> whether it’s with a diet, a relationship or New Years’ resolutions. We don’t have to wait until New Years, however, to begin, again, because the dawning of each new day brings us the opportunity to recharge ourselves mentally and physically. I think most of us look forward to new beginnings because each one comes with the promise of something that has the power to change our lives. For the most part, we are the one who can change our lives, not a new job or a new year, but what we, and only we, do with the opportunities they present.

Beginning again is what our bodies do automatically. Without our being aware of it, with each new breath, our bodies refresh our brain and our other organs. It’s part of what God thoughtfully set in motion when He created man in His own image, and it’s one of the keys to our survival. Every breath is an opportunity to start over, to forgive, to love, to learn, to let go of the things that don’t serve us well and to consciously make an effort to seek out those things that refresh and stimulate us.

This weekend I was looking at television programming aimed primarily at women. I tried to watch a couple of Bravo’s “Real Housewives” reality series, but they only made me feel sorry for the women involved. Whether they’re from New Jersey, Atlanta or Beverly Hills, I’m saddened by their foul mouths and the disrespect they show themselves and one another. Granted, there’s a certain shock value and train wreck quality to them, and who isn’t curious about how other people live, but aren’t you afraid you’ll get some of “it” on you, and it won’t come off? I think it’s been a long time since any of these “housewives” were brimming with hope and can do attitude unless it involves tearing one another down, or having one too many drinks from the illusive fountain of youth.

We are what we eat, what we read and with what we surround ourselves. I don’t know about you, but life’s too short to spend it on things that just fill me up without nurturing anything other than an idle curiosity about the bad behavior of others. Instead of consuming mindless filler, what if we look for ways to renew and strengthen ourselves each and every day? Even if it’s for five or 10 minutes a day, every day, what if we make, and take, time to go within ourselves and be still; to breathe and find our little voice and then think about what it’s telling us? Just start there. We don’t need a long list of New Year’s resolutions we won’t keep, just a promise to be still and breathe for five or 10 minutes a day.

All of us have lived through painful life lessons. Some of us are dealing with depression or that we have cancer, and we’re scared; we’ve lost a significant someone, or we’re wondering how to reinvent ourselves and become the person we’d hoped to be? With every thing you battle in life, start with the knowledge that you are loved by God, and you are made in His image. Regardless of where you are in life, He’s blessed you beyond reason. The other thing I want you to know is that you are important to me.

With this breath, and the next, I hope you'll take this opportunity to begin, again.

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A Year Ago Today

Monday, December 26, 2011
Today is the one year anniversary of James’ death. I’ve tried to let the day unfold naturally, to let it be what it will be, but the circumstances and the aftermath of his death are still as surreal as they were a year ago.

I remember every detail of that day: the sound of the screen door as our neighbor stepped onto our porch and the anguished look on his face. His countenance delivered his message before he’d even said a word, and I remember feeling sorry for him that he was the one to bring me this news. Since then, I've run the gamut from numb to an eerie calm, punctuated by anger and depression over losing this special man, along with feeling the same anguish and crushing disappointment James felt the weekend he died.<PREVIEWEND>

There have been times this last year I thought the same disappointment would kill me, too. While his congenital heart problem would have eventually killed him, all of his doctors agreed the events of that last weekend most certainly hastened his death. On top of everything else James saw and heard that weekend, his daughter-in-law's words were further confirmation, and it was all more than he could take. I now understand when people say you can die of a broken heart.

Not a day goes by I don't tell James how much I miss him, how much I love him. I talk to him a lot, especially in the car. On my daily drive into town, I start by talking to God, thanking Him for the blessings He’s bestowed on me and my family, for His gift of grace, for walking beside me this last year and for sending James into my life. Sometimes I tell James about his “winter trees,” the cluster of oaks he loved because of their stick-like silhouettes against the late afternoon winter sky.

James had a special humor, a way of making even the most mundane things fun and interesting. He had an appreciation for all things living, for the way the birds made nests in the trees and the almost serendipitous effort it took to make bluebonnets bloom in the Spring. Nothing delighted him more than spending the day raising the skirts on an oak tree, cutting away dead limbs until an unnoticed tree became a thing of beauty. He could read animal tracks in the dirt and knew whether it was a big cat, a buck or a doe, or if it was running or walking and how much it weighed. He taught me the names of every grass and plant in Texas and long before anyone else, he recognized subtle signs that his beloved trees were beginning to suffer from the drought.

When James was alive I used to pray, twice a day, that God would wrap His protective light and love around James Daniel Coffee and keep him safe and free from all harm and return him safely to the Little House. God did that. He took James to work and back and kept him safe on the freeways, safe from all physical harm and illness, but I now think my prayers fell short. I should have asked God to keep James safe while he was here on the ranch, because it was here that James died.

The other night I sat outside and watched the moon rise. I could see glimpses of the far path James liked to walk and jog on, and I imagined him walking there and waving to me. I waved back and shouted, "I love you," and for a moment, I could almost see him waving back.

"Talk big," I hollered. My voice carried across the canyon. "I can't hear you."

In the moments before dusk melded into dark, I imagined him standing there, waving back. I wondered if some kind of parallel universe might somehow unfold between us. What if this time, every night, I could catch what I thought was a faint glimpse of James? Would it be enough to sustain me, and for how long?

I’ve driven to that side of the canyon, but someday I need to again resume my walks on this familiar path, to make my way to where he died. The Little Blue Stem and the other native grasses have now grown up to where they cover the road James cut, but no amount of tall grasses can hide the fact that under those trees is where his soul left his body, and that he'll never stand there, again, waving to me. 

My prayers have changed since James died. I now pray that all is well with James Daniel Coffee's soul, that he's with God and that he knows how much I love him.

"Thank you for loving me, James. Other than God and His precious Son, you are the best thing that's ever happened to me."

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The Year's Top 10 and More

Sunday, December 18, 2011
As the end of each year draws to a close, the news media publishes their Top 10 lists of the most important, most newsworthy, the most beautiful, the best movies.... The lists go on and on. While they are mildly interesting and usually remind me of events and people I’ve already forgotten, most of the things on these lists don’t matter a whit in the grand scheme of things.<PREVIEWEND>

For most of us, our families’ and friends’ health and well being is what matters; whether we have a job or enough money to keep our house and pay the taxes; whether we're good parents; whether we have the right words to comfort someone who’s dying or has lost someone dear to them, and whether our country is headed in the right direction. For me, I find myself thinking about so many of you who are fighting cancer, missing loved ones and coping with the blows life throws you. You, and so many others, are my top 10 and more. Daily, I lift each of you up in prayer.

In no particular order:
1. Christine S: Fighting recurrence of breast cancer and participating in a clinical trial.
2. Jacqueline J: Recovering from extensive complications from reconstruction surgery.
3. Lisa P: Breast cancer survivor & grieving the loss of her son.
4. Cindy TC: Her precious husband died Christmas Eve, last year.
5. Jan H: Two-time breast cancer survivor & recently separated from her husband.
6. Bonnie C: Her husband died early this year.
7. Ann L: Has gone through breast cancer alone.
8. Norma M: In hospice care.
9. Ruth G: Her cancer is Stage IV.
10. Linda H: Battling a long-term, incapacitating and undiagnosed immune problem.
11. June McD: In treatment for Parkinson’s.
12. Cheryl R: In hospice care & I can’t reach her.
13. Gayle H: Bravely participating in a clinical trial to treat her breast cancer.
14. Deb T: Has battled depression and recurrence of her breast cancer.
15. Marie O’C: Lost her unborn child and her mother.
16. Anna R: Living with metastatic breast cancer.
17. Glenn M: Recently diagnosed with three separate cancers.
18. Joanie F: In hospice care.
19. Norm H: Stage IV cancer.
20. Philippa K-D: Breast cancer survivor & advocate, recovering from back surgery.
21. Lee C: One of the strongest, wisest women I know.
22. Single working mothers everywhere.
23. Loving, faithful husbands and fathers.
24. Those who’ve been diagnosed with cancer.
25. Those who’ve lost loved ones.
26. Every member of my church.
27. The United States of America.

28. Role models of every age and sex.


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Help for Vaginal Dryness

Sunday, December 11, 2011
It’s no surprise that Diane Keaton’s and Jack Nicholson’s film, Something’s Gotta Give, resonated with women of a certain age. The movie portrayed a 50-60ish woman who, after having sex for the first time in a while, was ecstatic to discover she wasn’t “closed for business.” Women who are involuntarily closed for business are not having intercourse. More than likely they've had their ovaries removed, are post menopausal, have had chemotherapy or are taking estrogen blockers like Arimidex. For many women, estrogen can restore their sex lives. If you can’t take estrogen, however, there may be several things you can do, but before we go there, let's talk about the relationship between estrogen and sex.<PREVIEWEND>

Without estrogen, the vagina atrophies: It becomes shorter, narrower, dryer and has less elasticity, plus the walls of the vagina can tear easily, and sex can be extremely painful. The vagina may also be more prone to infections. A lack of estrogen can also contribute to a waning libido as can stress, having a baby and some medications. If you have vaginal problems or a low sex drive, you should first see your gynecologist to make sure nothing else is going on.

Last week I took Dr Susan Love to lunch, and we talked about estrogen and women who've had breast cancer. She was quick to point out that research on decreasing vaginal dryness has only been done on women who've not had breast cancer. Those studies found that estrogen creams appear to have a higher absorption than the low-dose Estring or Vagifem. If you've had breast cancer and your doctor approves you for estrogen, talk to him or her about prescribing Estring or Vagifem. Also, be aware that bioidentical hormones are still hormones, so don’t let anyone tell you they’re safer or better for you because they’re not.

If you can’t or don’t want to take hormones, Andrea Bradford, Ph.D. psychologist and instructor of Gynecologic Oncology at MD Anderson suggests using a combination of techniques. For starters, use a vaginal moisturizer several times a week and a lubricant each time you have sex. Check the labels on non hormonal over-the-counter products and avoid those with alcohol, propylene glycol and parabens. For some women, personal lubricants that are oil or silicon-based can cause more friction and therefore more pain, and lubricants with glycerin are known to promote yeast infections, so water-based products are preferable. My favorites are Replens Single-Use Disposable Applicators and Wet Naturals Barely Bare. This particular Replens and Barely Bare may be harder to find, but you can purchase them at the RETAIL THERAPY store on You may also want to read my blog, Breast Cancer, Vaginal Dryness and Sex for more information about lubricants and exactly where and how to apply them.

You might also want to find a specialist who treats painful intercourse and vaginal dryness. They may suggest a set of vaginal dilators that, over time and with lubricants, can stretch your vagina, plus you can order them online. The specialist will probably have you start with the smallest dilator you can comfortably fit into your vagina. Try to progress to a new size each week with the understanding that each new size will be uncomfortable. Take it slow.

Changes in self-image due to breast cancer and the natural aging process make some women less comfortable with their bodies. One of the biggest factors in a post menopausal woman’s sex life is her relationship with her partner and whether she’s comfortable talking explicitly about what works and what doesn’t work to get her aroused. Most women require more than hugging and kissing. They need direct stimulation to the genitals and more than they needed before menopause. Perhaps we should rename “foreplay” to “men-o-pause.” Men, oh pause here, longer!


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What Your Oncologist Doesn't Tell You About Sex

Sunday, December 04, 2011

Libido and/or lack of libido was a major topic of conversation at the recent Life Beyond Cancer Foundation’s Retreat in Austin, Texas. Many of the women there were angry at their oncologists for not telling them about the side effects breast cancer treatment might have on their sex life. While we know a diagnosis of breast cancer may result in the loss of our breasts, few of us know we may also lose our sexuality. As one of the women at the Retreat asked, “Why didn’t my oncologist warn me that after cancer treatment, I would no longer have any desire for sex? I do it for my husband, and I know he wants more sex, but since menopause, it’s painful, and I’m just not interested anymore. Why didn’t my oncologist tell me that?”<PREVIEWEND>

Many oncologists tell their estrogen positive breast cancer patients that cancer treatment may push them into premature menopause--hot flashes, night sweats and weight gain--but they fail to tell us menopause may cause our vaginal tissues to become dry and paper thin. As a result, our vaginal opening may atrophy and become smaller, and our tissues become less pliable which results in painful penetration by our sex partner. What’s worse, we feel guilty that we’re not interested and don’t want sex like we used to, and we worry our partners may look elsewhere to satisfy their needs. Could menopausal libidos and painful sex be a contributing factor as to why some men have historically taken up with younger and juicier women?

If we deconstruct the word “menopause,” we get “men-o-pause,” which implies we’ve reached a point in life where we’ve pushed men, and perhaps sex, to the sidelines. Our mothers’ generation suffered through menopause and any resulting lack of sexual desire in silence, but we are not our mothers. We’re not prepared to go through the rest of our lives as female eunuchs. We’re not only conscious of the effect our lack of libido may have on our sex partner, but we miss our sexuality. We’re not afraid to say that we like sex; we like pleasing our partners, and we like having orgasms. Sex feels good, and it’s fun! What a dirty trick that just at the time when our children have left the nest, and we have more time and money to travel and enjoy our partner, mother nature saddles us with men-o-pause.

For years men have made it clear they want to remain sexually active until the day they die. Whats more, their sexuality is often more important than whether they survive their cancers or not, as exemplified by one of James’ ski buddies, who was diagnosed with prostrate cancer and chose not to receive any treatment. In other words, he chose his sexual health and a shorter survival as opposed to living longer with the very real possibility of sexual impotency and/or incontinence.

Trust me, I’m more than OK with the fact that men can sire children ad nauseum while my days of having babies are behind me, but I’m not OK with the fact that I don’t have a good sexual libido/self-moisturizing alternative except for hormone replacement therapy. Before James died, I decided to look into solving this problem. I spent countless months talking to gynecologists, oncologists, researching alternatives to estrogen and meeting with prominent chemists around the country. Just when I caught a glimmer of hope, a way to moisturize my dry and withered vaginal tissues, the Food and Drug Administration (FDA) stepped in and crushed my bubble.

Because the FDA defines a personal internal moisturizer as “intended to affect the structure or function of the body,” such a product must go through the FDA. Unless I was willing to spend years and years and millions and millions of dollars taking my product through clinical trials, it would never be anything more than a fantasy... and not one of the sexual ilk. If I didn't go through the FDA, no reputable laboratory in the country would develop and/or manufacture such a product and if I somehow found one, here or abroad, the FDA could slap us with an injunction, shut us down and sue us for all the tea and orgasms in China.

So for now, we must make do with less than perfect herbal and over-the-counter remedies while we take a page from our male counterparts and raise our voices until we have a safer solution than hormone replacement to our problem.

PS: You didn’t really think I was going to leave it at that, did you? Next week, we’ll talk about some practical things you can do to help the situation.

PPS: To all of you who emailed and called, asking about Goldie, I thank you for your kind wishes and prayers. I’m over the moon to report she seems to have gotten rid of the incredible, mind-boggling amount of lace she consumed, but it wasn't easy. We'll leave it at that. From now on, I’m going to put her in the bathroom when I leave the house and take away all the towels and bathmats and soap. Goldie girl will only get a bare tile floor and a stainless steel bowl full of water until I feel like I can trust her again, but then again, hello! She's a dog! That's what they do... Oy vey!

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