5 PowerPoint Presentations - LinkedIn

Breast Cancer Prevention and

Exercise

Debra A. Neirinck

Oncology/Hospital Massage Specialist

Agenda

Risk Factors

Benign vs Malignant

Pathophysiology of Cancer

Estrogen role

Signs and Symptoms of Cancer

Deadliest/most aggressive BC

Exercise Physiology 101

Risk Factors

Cannot control Female

Over age 50

Family history

Personal history of BC

2 or more 1st degree

relatives

Known mutations

Abnormal growth

DCIS

LCIS

Early menarche / late

menopause

Radiation to chest wall

Risk Factors

Cannot control Genetic links (BRCA1

and BRCA2)

Risk Factors

Can control Oral contraceptives

Postmenopausal obesity

Alcohol use

Obesity and high-fat diet

Hormone replacement therapy

Facts

It isn’t the cancer that kills most cancer pts

Infection (No. 1 killer of cancer patients)

DVT (No. 2 killer of cancer patients)

Pneumonia


Three things must be present

Exposure to toxins

Immunocompromised

Genetics of cell


Benign Tumor

Quiet

Contact inhibition

Encapsulated

Inactive Cancer

Does not move

Non-Invasive


Malignant Tumor

Disregard normal cell

function

Invasive

Fast-moving

Parasitic

Vampiric

Establishes own blood

supply

Aggressive

Does not die!!!

http://repairstemcell.wordpress.com


How is cancer created?

How does cancer

grow?

How does cancer

spread?

http://www.alkalizeforhealth.net


http://www.cksinfo.com/clipart/medicine/normal-and-cancer-cells.png


http://www.cancerhelp.org.uk/about-cancer/what-is-cancer/cells/the-cancer-cell#normal

Signs, Symptoms, and Treatment

Inflammatory Breast Cancer

Breast Cancer

Where spreads to

Signs / Symptoms

Lymphedema

Chemotherapy

Radiation


Inflammatory Breast Cancer

Red!!

Hot to touch

Larger

Heavier

Something like pus coming out of nipple

Puckered, orange peel skin

Nipple inverts


Breast Cancer

Lump / thickening in breast or under arm or along

breast bone

Change in breast size, shape, or appearance

Blood-stained or clear fluid nipple discharge

Change in skin appearance of breast

Redness around nipple

Misshapen areola

Marble-like hardness under the skin


Chemotherapy for Breast Cancer

Beginner combo of drugs (4 treatments)

“Punch” after pt stabilizes (every 3-4 wks)

Drug to prevent nausea; vomiting

Steroid



Short-term side effects

Profound fatigue Nausea

Depression

Anxiety

Self-esteem

Physical activity

Weight control

Neuropathy in fingers and toes

Immunosuppression

Bone marrow suppression

Anemia

Fatigue

Fatigue

Fatigue

Profound fatigue


And . . . .

Hair loss

Skin

Eyes

Mouth

Nose

Stomach

Intestine


Keep going ….

Blood

Reproductive system

Cardiac system

Nervous system

Brain

Respiratory system

Lungs

Pregnant? Fetal developments



Long-term side effects

Reproductive

Joints

Organs


Radiation for Breast Cancer Side effects (short-term)

Organ damage

Fibrotic tissue

Burn/damage lymph node

Reddening/blushing

Permanently damages lymph vessels

Sensitive to sun and pressure

Side effects (long-term)

Cardiomyopathy

Skin

Bones / tissue

Reduced function of heart and lungs

Infertility

How Exercise Affects Cancer Tx


Muscles need oxygen

Blood carries oxygen and iron to tissues in the

body

Muscle contractions stimulate lymphatic flow (the

immune system)

How Exercise Prevents Cancer

Blood turbulence

↑ immune system function

↑ blood cell production

↓ cardiomyopathy

Aerobic Exercise and Cancer Patients

Reduces premature death

Reduces premature death from heart disease

Improved psychological well-being

Reduces development of high blood pressure

Reduces depression / anxiety

Improvement in weight control

Maintains bone, muscle, and joint health

Exercise Ideas

Stairs vs. elevator

Park farther away

Go down every aisle in grocery store –

whether you need to or not

Stroll the mall

Work out in water

Tai Chi, Qi Gong, or Yoga

Gardening

Anything that you enjoy

Statistics

230 different types of cancers

Breast cancer – American women

90% of cancer deaths from spreading

1 in 8 in this room will be diagnosed

10% of cancer has a genetic link

90% environmentally related

Leading cause of death in ages 1-14

10 Ways to Prevent Cancer

More fruits and vegetables

Exercise: 30 minutes x 4x/week

Sleep 8 hours a night

Reduce stress

East organic when possible

Drink more water and green tea

Avoid alcohol, sodium and excess fat

Avoid or reduce exposure to toxins

Love yourself and those around you

Communicate clearly, openly and honestly

Final Thoughts

Cancer doesn’t kill the patient, . . . .

Keep yourself healthy.

Exercise has a profound effect on the

prevention of cancer.

Debra A. Neirinck

[email protected]

Bibliography

Alfano, Sean. Stop Cancer with ‘Real’ Exercise. CBSNews.com. Sept. 28, 2006.

http://www.cbsnews.com/stories/2006/09/28/health/webmd/main2050251.shtml.

American Cancer Society. Detailed Guide: Breast Cancer Hormone Therapy. 3-2-2009.

http://www.cancer.org/docroot/CRI/content/CRI_2_4_4X_Hormone_Therapy_5.asp?sitearea=

CancerConsultants.com. Exercise and Cancer Overview. Sept 10, 2008.

http://patient.cancerconsultants.com/HealthWellness.aspx?TierId=1334

Cancer Research UK. Your blood, bone marrow and cancer drugs. 10-22-2008.

http://www.cancerhelp.org.uk/help/default.asp?page=314

curetoday.com. During Treatment: Side Effects of Therapy. (date unknown)

http://www.curetoday.com/index.cfm/fuseaction/article.show/id/2/article_id/1005

Drouin, Jacqueline and Pfalzer, Lucinda. Cancer and Exercise. The National Center on Physical

Activity and Disability. Mar 5, 2009.

http://www.ncpad.org/disability/fact_sheet.php?sheet=195

National Cancer Institute. Understanding Cancer Series: Estrogen Receptors/SERMs. 4-27-2006.

http://www.cancer.gov/cancertopics/understandingcancer/estrogenreceptors

Versagi, Charlotte Michael, William Beaumont Hospital School of Allied Health Oncology/Hospital

Massage Program Instructional Manual, Oct. 2008.

Weiss, Marisa, M.D. Stages of Breast Cancer. BreastCancer.org. Aug 7. 2008.

http://www.breastcancer.org/symptoms/diagnosis/staging.jsp

CancerConsultants.com. Adult Weight Change Influences Risk of Breast Cancer. 12-20-2007

http://patient.cancerconsultants.com/CancerTips.aspx?DocumentId=38061

http://www.cbsnews.com/stories/2006/09/28/health/webmd/main2050251.shtml








Walking as a Cancer

Preventative

Debra A. Neirinck

Oncology/Hospital Massage Specialist

Agenda

Risk Factors

Benign vs Malignant


Signs and Symptoms of Cancer

Side Effects of Treatment


Specific Hormonal Influences

Disclaimer

Smoking and alcohol

Facts

Cancer deaths in America

2012 577,000 Americans died from cancer

2/3 could have been prevented

1/3 died from tobacco use

1/3 died from obesity, poor nutrition, physical inactivity, overweight

Lung cancer - 1st

Obesity – 2nd

Colorectal cancer - 3rd

Source: “Cancer Prevention & Early Detection Facts & Figures 2012” www.cancer.org

Risk Factors – Lung Cancer

Single largest preventable cause of

cancer deaths in Americans

443,000 deaths annually

50,000 are non-smokers


Risk Factors – Lung Cancer

Can control Cigarette smoking

Occupational exposure to

Asbestos

Arsenic

Coal products

Etc

Second hand smoke

Source: A Cancer Source Book for Nurses, Eighth Edition

Risk Factors – Effects of Obesity

2nd leading cause of cancer deaths in

America Obesity

Physical inactivity

Poor nutrition


Risk Factors – Colorectal Cancer

3rd leading cause of cancer death

Cannot control Over age 60

Family history

Family genetic syndromes

Inflammatory bowel conditions


Risk Factors – Colorectal Cancer

Can control Sedentary lifestyle

High fat diet

Weight

Diet low in fruits

Diet low in vegetables

Heavy alcohol consumption

Risk Factors – Breast Cancer

Death rates declining since 1990 60% diagnosed at a localized state

Education

Early detection

5-year survival rate at 99%



Cannot control Female

Over age 50

Family history

Personal history of BC

2 or more 1st degree

relatives

Known mutations

Abnormal growth

DCIS

LCIS

Early menarche / late

menopause

Radiation to chest wall


Cannot control Genetic links (BRCA1

and BRCA2)


Can control Oral contraceptives

Postmenopausal obesity

Alcohol use

Obesity and high-fat diet

Hormone replacement therapy

Risk Factors – Prostate Cancer

Cannot control Male

Over age 50

Family history

African American

Family history of 1st degree

relatives

Risk Factors – Prostate Cancer

Can control High fat diet

Types of Cancer

Cancer is a complex condition

Five major types of cancer

Carcinomas

Leukemias

Myelomas

Lymphomas

Sarcomas


Facts

It isn’t the cancer that kills most cancer pts

Infection (No. 1 killer of cancer patients)

DVT (No. 2 killer of cancer patients)

Pneumonia


Three things must be present

Exposure to toxins

Immunocompromised

Genetics of cell


Benign Tumor

Quiet

Contact inhibition

Encapsulated

Inactive Cancer

Does not move

Non-Invasive


Malignant Tumor

Disregard normal cell

function

Invasive

Fast-reproducing

Parasitic

Vampiric

Establishes own blood

supply

Aggressive

Does not die!!!



How is cancer created?

How does cancer

grow?

How does cancer

spread?



Pain

Not typical in early stages

Severe enough to alter lifestyle

40% intermediate stages

60% advanced stages


Cancer

Where spreads to

Signs / Symptoms

Lymphedema

Chemotherapy

Radiation


Cancer

Lump / thickening in tissue (breast/testicles)

Change in wart or mole

Change in bowel/bladder habits/appearance

Persistent cough (even mild)

Chronic stomach upset (indigestion)


Diagnosis

Stage I

Stage II

Stage III

Stage IV


Chemotherapy

Beginner combo of drugs (4 treatments)

“Punch” after pt stabilizes (every 3-4 wks)

Drug to prevent nausea; vomiting

Steroid


Chemotherapy

Short-term side effects

Profound fatigue Nausea

Depression

Anxiety

Self-esteem

Physical activity

Weight control

Neuropathy in fingers and toes

Immunosuppression

Bone marrow suppression

Anemia

Fatigue

Fatigue

Fatigue

Profound fatigue


Keep going ….

Blood

Reproductive system

Cardiac system

Nervous system

Brain

Respiratory system

Lungs



Chemotherapy


Reproductive

Joints

Organs


Radiation Side effects (short-term)

Organ damage

Fibrotic tissue


Reddening/blushing




Cardiomyopathy

Skin

Bones / tissue

Reduced function of heart and lungs (if in chest area)

Infertility

How Exercise Affects Cancer Tx


Muscles need oxygen

Blood carries oxygen and iron to tissues in the

body

Muscle contractions stimulate lymphatic flow (the

immune system)

How Exercise Prevents Cancer

Blood turbulence

↑ immune system function

↑ blood cell production

↓ cardiomyopathy

Aerobic Exercise and Cancer

Reduces premature death

Reduces premature death from heart disease

Improved psychological well-being

Reduces development of high blood pressure

Reduces depression / anxiety

Improvement in weight control

Maintains bone, muscle, and joint health

Hormone & Cholesterol Efficiency

Cholesterol meds = $26 billion annually

25.6 million Americans 20+ years of age

diagnosed with Type 2 Diabetes (as of 2011)

79 million Americans have pre-diabetes

Epidemic of insufficient sleep


Hormones

Estrogen

Cortisol

Insulin


Estrogen

Fast reproducing cells


Cortisol


Insulin


Cholesterol

Not just related to heart disease

What is it, really?

Do we need it?

Influential factors

Diabetes, stress, diet, weight


Review

Key hormones and function

Contribution to development of cancer

Walking assists optimum function of body

Exercise Ideas

Stairs vs. elevator

Park farther away

Go down every aisle in grocery store –

whether you need to or not

Stroll the mall

Work out in water

Tai Chi, Qi Gong, or Yoga

Gardening

Anything that you enjoy

Statistics

230 different types of cancers

Breast cancer – American women

90% of cancer deaths from spreading

1 in 8 in this room will be diagnosed

10% of cancer has a genetic link

90% environmentally related

Leading cause of death in ages 1-14

10 Ways to Prevent Cancer

More fruits and vegetables

Exercise: 30 minutes x 4x/week

Sleep 8 hours a night

Reduce stress

Eat organic when possible

Drink more water and green tea

Avoid alcohol, sodium and excess fat

Avoid or reduce exposure to toxins

Love yourself and those around you

Communicate clearly, openly, and honestly

Final Thoughts

Cancer doesn’t kill the patient, . . . .


Brisk walking has a profound effect on the


Debra A. Neirinck

[email protected]

Bibliography






























Massage for Cancer Patients

Debra A. Neirinck

Oncology & Hospital Massage Specialist

Disclaimer

What we will discuss

Cancer

Treatment

Side Effects

What will not be discussed

Agenda

What is Touch

Benefits of massage during treatment

Benefits of massage after treatment

The Disease

Mind-Body Connection

Oncology Massage

Review of Information

Definitions

“Touch” (World English Dictionary)

the state of being in physical contact

to bring (the hand, finger, etc., or something held)

into contact with something

the act or an instance of something coming into

contact with the body

www.dictionary.com

Definitions

Definition of Oncology

1. the branch of medical science dealing with tumors, including the origin, development, diagnosis, and treatment of malignant neoplasms.

2. the study of cancer.

Definition of Oncology Massage

The adaptation of massage to safely nurturethe body, mind and spirit of anyonediagnosed with cancer.

Society for Oncology Massage

www.dictionary.com

Oncology Massage: A Recognized

Modality

Recommended by:

American Cancer Society

Society for Integrative Oncology

LiveStrong

Offered at many cancer centers:

William Beaumont Hospitals (Troy & Royal

Oak)

St. Joseph’s Hospital (Ann Arbor &

Pontiac)

Henry Ford Health System (West

Oncology Massage: A Recognized

Modality My personal experiences

Massage Benefits During Tx

Reduces short-term pain, anxiety, fatigue,

feelings of isolation

Enhances mood

Contributes to better rest

Improves perception of treatment


What is cancer?

How does it grow?

How does it

spread?


Pathophysiology of Cancer Benign Tumor

Quiet

Encapsulated

Inactive Cancer

In situ

Does not move

Non-Invasive



Malignant Tumor

Disregard normal cell function

Invasive

Fast-moving

Parasitic

Vampiric

Established own blood supply

Aggressive

Does not die!!!

Treatment

Surgery

Chemotherapy

Radiation

Treatment – Surgery (p.63)

Short-Term Effects

Risk for blood clots

Depression of immune system

Tenderness at incisional site

Long-Term Effects

Risk of lymphedema

Scarring

Numbness / hypersensitivity

Body Image

Unconscious guarding of surgical site

Treatment – Chemotherapy

Short-term side effects Profound fatigue Nausea Depression Anxiety Self-esteem Physical activity Weight control Neuropathy in fingers and toes Immunosuppression Bone marrow suppression Anemia Fatigue Fatigue Fatigue Profound fatigue


And . . . .

Hair loss

Skin

Eyes

Mouth

Nose

Stomach

Intestine


Keep going ….

Blood

Reproductive system

Cardiac system

Nervous system

Brain

Respiratory system

Lungs




Reproductive

Joints

Organs

Treatment – Radiation (p. 65)

Side effects (short-term)

Organ damage

Fibrotic tissue


Reddening/blushing




Cardiomyopathy

Skin

Bones / tissue

Reduced function of heart and lungs

Infertility

Research Studies and Results

Safety and Efficacy of Massage Therapy for Patients with Cancer (2005) MEDLINE and CINAHL database study showing strongest evidence for

stress reduction with trends toward pain reduction

Massage Therapy for Symptom Control: Outcome Study at a Major Cancer Center Memorial Sloan Kettering observational study of 1,290 patients

Rated symptoms (pain, nausea, fatigue, anxiety, and depression) pre-and post-massage with immediate reduction in all areas

Massage Therapy May Have Immediate Positive Effect on Pain and Mood for Advanced Cancer Patients (2008) NIH funded study

Randomized trial of 380 advanced cancer patients at 15 US hospices

Improvement in pain and mood following massage compared with simple touch

Massage Benefits After Tx (p. 41)

Restores a feeling of wholeness to the body

Increases range of motion and suppleness to areas affected by surgery and radiation

Stress reduction/ restorative rest

Pain reduction

Massage Benefits after Tx (cont’d)

Take from S4OM slides and p. 41

Massage for Cancer Patients

Take from S4OM slides and p. 41

Cancer Patient = Warrior

Rest, Warrior (by Tracy Walton, LMT, MS)

Printed in Massage Today, June 2009, Vol. 09,

Issue 06

Massage for Cancer Patients - Final

Thoughts Cancer doesn’t kill the patient, . . . .


Exercise has a profound effect on the


Bibliography




http://www.cancer.org/docroot/CRI/content/CRI_2_4_4X_Hormone_Therapy_5.asp?sitear

ea=

























Thank You!

Debra A. Neirinck

Oncology & Hospital Massage Specialist

248-770-2298

[email protected]

The Silent Disease

Debra A. Neirinck

April 19, 2007

Statistics

1.5 million fractures annually

hip

spine

wrist

Vertebral fractures >50 years

1 in 2 women

1 in 4 men

Future concern

Worldwide

Children

Statistics

U.S. ranks 1st among countries

15 billion gallons sold

53 gallons per year Americans

65 gallons per year teenagers

1970-1997: 118% soft drinks

23% in milk

1999-2002: teens 3x more than milk

• Weak / fragile

• Painful

• Lose ability to stand / walk

• Lose height

• Debilitating fractures

• Sometimes fatal

Osteoporosis

Bones

• Living organs

• Hardest and most durable substance

• Support us

• Allow us to move

• Protect heart, lungs, brain

• Store essential minerals

Anatomy

Remodeling

• Continually breakdown

• Continually rebuild

• Matrix of fibers provide

strength

• Hardened with calcium,

phosphorus, minerals

Anatomy

Destruction

• Natural bone loss

• Poor eating habits

• Broken bones

• Calcium leeched from

bones

Calcium

• Muscle contraction (including heartbeat)

• Nerve conduction

• Blood pressure

• Blood clotting

• Enzyme regulation

• Deposited / withdrawn every day

Phosphorus

• Found naturally in some foods

• 85% in bones and teeth

• Assists with muscle contraction

• Kidney function

• Nerve conduction

• Maintains regular heartbeat

Phosphoric Acid

• Preservative added to soft drinks

• Sharpens flavor

• Binds to calcium in gut

• Directly influences bone mineral

density

• Affects parathyroid hormone activity

• Major contributor to osteoporosis

Prevention

• Adequate Calcium

• Adequate Vitamin D

• Exercise

• Don’t smoke

• Reduce alcohol consumption

• Reduce consumption of soft drinks

Get Healthy,

Be Healthy,

Stay Healthy

Debra A. Neirinck

Oncology/Hospital Massage Therapist

Immune System

Importance

Clear infection

Function Collect “trash”

from tissues

Exchange between

blood and cells

through capillaries

Introduction

Introduction

Origin of Lymph

Greek = “pure, clear stream”

Latin = “clear water”

Originates as blood plasma

90% water

100 different solutes

Nutrients, gases, hormones, wastes

Products of cell activity, ions, and

Proteins

Introduction

Rob says:

Protein molecules are picked up by the lymphatic

system, because they are not picked up by the

venous system.

If the lymphatic system did not pick these up,

you’d die within 24 hours.

Why?

Regulate cell function

Regulate immune system

Introduction

Plasma proteins

Albumin

Prevents blood from leaking out of vessels

Carries molecules for tissue growth and healing

Osmotic pressure

Globulin

Alpha, beta, and gamma types

Some made by immune system

Bind with hemoglobin to transport substances to fight

infection

Lymphatic Vessels

http://www.lymphnotes.com/article.php/id/151/

http://www.lymphnotes.com/article.php/id/151/

Lymphatic Vessels

http://pennhealth.com/health_info/animationplayer/lymph_nodes.html

http://pennhealth.com/health_info/animationplayer/lymph_nodes.html

Lymph Nodes

• Organs and

tissues of the

immune system

• 2 functions

• Remove

debris from

body

• Activate

immune

system

Lymphocytes

B Cells

Produce

antibodies

Lymphocytes

T Cells

Patrol for foreign

invaders

Comparison

Cardiovascular System

(Blood)

Lymphatic System

(Lymph)

Blood collects and distributes

oxygen and nutrients to tissues

Blood flows in continuous loop

Blood is pumped

Blood transports red and white

cells

Blood is visible and damage

causes visible signs: bleeding

or bruising

Blood is filtered by kidneys

Blood vessel damage or

insufficiency produces swelling

with low-protein fluid

Lymph collects and removes

waste from tissues

Lymph flows in open circuit

Lymph is not pumped

Lymph that has been filtered is

clear or milky white

Lymph is invisible and damage is

not known until swelling occurs

Lymph is filtered by lymph nodes

Lymphatic vessel damage or

insufficiency produces swelling

with protein-rich fluid

http://www.lymphnotes.com/article.php/id/15

0/

Lymphatic Drainage

“as gentle as a butterfly’s kiss”

stimulates flow from one area to another

encourages formation of new lymph

increases lymph flow

extends lymphangion wall

increases lymphangion function

Lymphatic Drainage

Improved during exercise

Lymph is mostly water, so drinking water is a

good thing

Beneficial for many ailments and diseases

Chronic swelling

Multiple sclerosis

Sinus problems

Upper respiratory problems

Erectile dysfunction

Summary

Vessels and nodes

B Cells and T Cells

Manual stimulation

Stimulates parasympathetic nervous system

Causes deep relaxation

Increases lymphatic activity

Stimulates immune system

How About You?

Maintenance

Protection

Future performance

Word Scramble

http://www.armoredpenguin.com/wordscramb

le/Data/2007.12/12849.0.html

http://www.armoredpenguin.com/wordscramble/Data/2007.12/12849.0.html

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