March 2009 Meeting

• March League Meeting Minutes
  
  The March league meeting convened on the 20th at 10:00 in the home of Debra Joyce. Beth Hall co-hosted. Refreshments were served as members visited and met the guest speaker.
  
  At approximately 10:30, Dr. Ilana Kadmon of Hadassah Medical Center informed and entertained the group for over an hour. Although she sports the title of doctor, this passionate carer proudly hails from the ranks of nursing. At her mother’s suggestion some years back, Ilana decided to pursue a career in this burgeoning academic discipline. While nurses have been around as long as medicine, the profession was moving into a more respected area in the early 1980s.
  

...........................Ilana receiving a welcome gift from Beth Hall

Hadassah offered one of the first advanced degree in nursing and Ilana secured a place and received her BA. After graduation, she worked at Hadassah in the general surgical ward and was ‘exposed to breasts’. A scholarship in France and an opportunity in Edinburgh, Scotland led to a PhD in nursing and a specialization in breast cancer. Not only did Ilana gain an international education but a Chinese husband in the process.

The couple spent a number of years living in Israel where he taught Chinese at University and she researched, wrote, and worked. Ilana discussed her PhD thesis that reflected a novel approach to breast cancer treatment titled “Women’s Decision Making in Breast Cancer Care”. In the late 1980’s the totality of care; surgeons, oncologists, radiologists, the nursing staff, and the patient all working together, was beginning to take hold and Ilana stood on the forefront of this revolutionary medical movement. Today this ‘one stop shopping’ is gaining world popularity and allows women to gather her personalized information and use it to make the most informed decisions about her own treatment and recovery.

Assisted by high-profile celebrities discussing their own experiences, breast cancer was elevated to a new platform in the medical community. With awareness came funding and programs were expanded in developed countries around the world. Today, there are 30 full-time breast cancer nurses in Israel and exposing China to this type of specialized care is Ilana’s current project.

Hadassah has a long history of cooperation and shared goals with the Mainland and this latest foray is just another attempt to improve the health of the Chinese people. Unfortunately, a number of hurdles exist that Ilana struggles with at this time; the humble perception of nurses, the lack of governmental priority, and the barriers to conducting meaningful research in China. The situation is further complicated by the rise in the breast cancer rate due to the modernization of diet and lifestyle. However, this does not dampen her spirit and she passionately discusses her upcoming trips and ongoing Hadassah initiatives.

Ilana then walked the group through the advancements made in areas of breast cancer prevention, detection and treatment.

PREVENTION

Prevention is increasingly more elusive as diets gets fattier and less fibrous, exercise and sleep decrease, and stress levels rise. However, we can combat the effects by improving our lifestyles and being diligent about what we put into our bodies.

Although estrogen gets a uniformly bad rap, there are different types from different sources. High levels of estrogen produced in our bodies serves as a risk factor so women who have their menses early, experience late menopause and those who have no or late-in-life children should be aware of their prolonged production of this hormone. Birth control pills, while presenting other complications, also seem not to increase the cancer rates. However, a link has been established in the use of estrogen to combat menopausal symptoms and this type of cancer. Ilana notes that breast cancer deaths continue to decline as fewer women opt out of hormone therapy.

EARLY DETECTION

Our guest is heartened by the fact that woman have more choices in health care professionals and are becoming more breast aware. While Ilana does not diminish the intent of self-examinations, the new approach stresses looking for changes rather than being expected to ‘detect a problem’. She asks members to share the message with friends and family to look at your breasts and note changes in color, lumps, or the nipples and talk to a trusted professional.

Diagnostics have evolved through the years and now we have more than a ‘one tool per age group’ type of approach. While Israel requires the governmental heath fund to give a mammogram to every woman over 50, most countries do not afford such comprehensive coverage. However, woman must take control and monitor their breasts, visit their doctors, and understand when to request a mammogram and/or an ultrasound.
While still fraught with limitations, a mammogram is the best diagnostic tool to detect cancer in older breasts where the tissue and muscles are not as dense.
Mammograms have reduced the death rate by 30%!
An ultrasound is most effective in younger breasts or as a secondary ‘set of eyes’ after a mammogram

TREATMENT

As discussed above, the future wave in breast cancer care is the comprehensive one. A facility that is dedicated to the physical, medical, psychological and holistic approach to this specialty is most effective. By having all involved parties at the table, those in decision making positions can take into account all protocols and tailor the treatment, accordingly. Ilana posits that these cooperatives would be best served with a breast cancer nurse coordinating each woman’s care.

While it would be ideal if China were on board with mass screening and comprehensive treatment, they are not there, yet. Ilana hopes that with each instructional visit, the benefits will become more obvious and resources allocated.

The question regarding prophylactic mastectomy elicited an interesting response. Ilana stated that a woman with the mutated gene (a small percentage of the population and ethnically centralized) may want to consider this option but also must be aware that this mutation increases the risk of ovarian cancer. This cancer is more dangerous and difficult to detect in early stages so a candidate may opt to have her ovaries removed before her breasts.

A query about the Chinese government’s reluctance to accept Western imported medical techniques moved into a brief discussion about both the political and geographical hurdles in this vast country.

A final suggestion that stress plays a role in the rise of breast cancer rates was emphatically reinforced by our guest.

Our lively speaker closed with how she met Kathy Chiron and came to share her story with the League.

Kathy reminded everyone about the May 12th annual meeting to begin at 11:30 at the Congress Restaurant at the Convention Center. She then asked if the April 14th meeting was on schedule and Sandra Collins-de Lange, Robin Ernest, and Adrienne Urbanec stated they were working on a venue and speaker.

Debbie Verity then spoke briefly on the League activities in the US. Debbie was president of the HK league in 2004 and is now president of her local unit in Thousand Oaks, California. Debbie told us that the League in the US is comprised mostly of energetic, intelligent retirees who have the time and the inclination to become involved in local political situations. She mentioned that each League chapter in a particular area (e.g., Los Angeles County) is headed by a “leader” while the “president” oversees all chapters in the area. She has been involved in many local issues, including the frequent California ballot referenda.

The meeting concluded just after 11:30 and most members headed to lunch at the Pacific Club. Our thanks to Debra Joyce for arranging the excellent buffet luncheon.



Submitted by Adrienne Urbanec