Wednesday, June 30, 2010

Breast Cancer and Work

This article was written by Betsy Lee-Frye

A cancer diagnosis can be terrifying on so many levels, not the least of which is how the disease and treatment will affect an individual's ability to work. Not only is income a necessity, but often, so is the health insurance provided by the employer. Before divulging the diagnosis, take the time to research the company's policies, including medical leave and flex time. It may also make sense to find an office mentor who has already navigated the maze of accommodations and disability pay.

Telling the Boss and Colleagues

Typically, sharing life news with those at work isn't difficult, but when talking about a breast cancer diagnosis, the words can get caught in your mouth.

First, don't rush it. There is no reason to talk to the boss or colleagues so soon after receiving the news. Wait until it feels as comfortable as possible.

There is no right or wrong way to divulge a cancer diagnosis. Some people might feel more comfortable talking to their boss or supervisor first, avoiding the miscommunication that can stem from the office gossip mill. Consider setting up a meeting or a lunch, so you can be sure to have his full attention. Also, remember that discussions between a boss and employee are protected. A supervisor has a legal obligation to keep the information private. However, co-workers do not have the same obligation.

Talking to colleagues about a cancer diagnosis isn't a necessity; however, co-workers can be an unexpected source of support. According to a survey of human resources managers conducted by the International Foundation of Employee Benefit Plans, a nonprofit organization based in Brookfield, Wisconsin, colleagues often organized volunteer support for those with breast cancer. Twenty-seven percent of the office managers surveyed said co-workers had provided personal assistance to the woman with breast cancer, 19% organized a fundraising campaign and 15% donated vacation days.

Be prepared for questions. Colleagues might inquire about treatment plans and side effects. Don't feel obligated to share information you'd rather keep private. A supervisor or boss might want to know what accommodations might be necessary. The American Cancer Society suggests having a plan in mind before talking to your boss. But for those who aren't sure yet, don't be afraid to simply say, "I'm don't know yet. Can I get back to you?"

Asking for Accommodations

Employers are required by federal law to provide "reasonable accommodations" for anyone with a disability. According to the Americans with Disabilities Act (ADA), cancer qualifies as a disability when the disease or its effects of treatment hinder an individual's "major life activities." See the following section for more about the qualifications of cancer as a disability.

These accommodations can vary greatly, depending on a person's need. According to the U.S. Equal Employment Opportunity Commission (EEOC), examples of accommodations include:

Time off for physician appointments and to recover from treatment
Short breaks during the workday to rest and recover
An altered work schedule
Temporarily assigning some job tasks to another employee
Changes to the workplace environment, such as temperature changes or workstation changes to insure comfort
A work-from-home arrangement
According to the EEOC, the word reasonable is key. Employees with breast cancer can't make requests of their employer that would cause them "undue hardship." The term "undue hardship" is different for every company. But according to a 2006 survey conducted by the University of Iowa's Law, Health, Policy and Disability Center, nearly 75% of employers reported that accommodations for individuals with any disability, not just cancer, cost them less than $500 per year.

The International Foundation of Employee Benefit Plans' survey, which focused on women working with breast cancer, found that employers were typically more than willing to provide accommodations. With regard to scheduling, the survey reported that about 85% allowed an employee with breast cancer to reduce her hours, 79% permitted a flexible schedule, 47% made telecommuting an option for the employee and 62% agreed to short breaks during the day for resting and recovering.

Employers said they also made arrangements to alter the employee's workload, including assigning different work (58%), altering deadlines or other previously agreed upon schedules (60%) and job sharing (28%).

Legal Rights: Disability and FMLA

Under the ADA, cancer qualifies on a case-by-case basis. The act protects individuals from losing their jobs due to disability and sets guidelines for employers regarding required accommodations. The U.S. EEOC, which enforces the ADA, offers the following example of a woman with breast cancer who would qualify for job protection under the act.

"Following a lumpectomy and radiation for aggressive breast cancer, a computer sales representative experienced extreme nausea and constant fatigue for six months. She continued to work during her treatment, although she frequently had to come in later in the morning, work later in the evening to make up the time, and take breaks when she experienced nausea and vomiting. She was too exhausted when she came home to cook, shop or do household chores and had to rely almost exclusively on her husband and children to do these tasks. This individual's cancer is a disability because it substantially limits her ability to care for herself."

If you feel your rights have been violated or you've been dismissed from a job due to your diagnosis, you need to file a charge "within 180 days of the alleged discriminatory action," according to the EEOC. The EEOC can be reached at (800) 669-4000.

Many companies offer disability pay for seriously ill or injured employees, but often these plans require an employee contribution. Talk to a human resources representative about disability pay and how to collect if your employer offers a plan.

The Family Medical Leave Act (FMLA) of 1993 also protects the jobs of people with a cancer diagnosis. However, not everyone qualifies for FMLA protection. An employee must have worked for the employer for at least 12 months prior to the FMLA request and have worked more than 1,250 hours in that calendar year. In addition, employers who have fewer than 50 employees do not have to follow FMLA regulations.

If protected by the FMLA, you can to take up to 12 weeks of unpaid leave from work. The act allows employees with serious medical illness, such as breast cancer, to use their leave "intermittently." This means an employee could take off 1 day each week or take 2 weeks off to recover from surgery, while saving the remaining weeks to use during radiation or chemotherapy treatment.

Wednesday, June 23, 2010

I'm Alive

Today I called Dr. Anke Ott-Young's assistant to schedule a final procedure in which Dr. Ott-Young will fill in a dented scar on my left breast with fat to perfect my cleavage. Dr. Ott-Young promised me she would take care of this before I embarked on a Mediterranean Cruise, July 9th. "You deserve this vacation after all you've been through and I want you to look great in a bathing suit on the cruise," she exclaimed.

When I asked her about her own vacation plans, she said she would not be able to take time off this summer because she had too many new breast patients. Linda, her assistant, confirmed this as she tried to squeeze me in. Apparently, Dr.Ott-Young has taken on 10 new breast cancer patients in Connecticut alone--and all of the women are under 40 years old. One of her new patients is only 28 and still nursing a baby.

Never mind the fact that Dr. Ott-Young has two daughters under eight years old, a high-powered financier husband and two ailing older parents living in Germany. Every day, Dr. Ott-Young puts her cancer-stricken patients first.

I am so grateful to all my doctors. Dr. Mary Pronovost, my breast surgeon, had to be the bearer of bad news and tell me a mastectomy was necessary for my survival. She taught me to think long term and not fret the immediacy of my treatment. She told me to trust the process and everything would work out. She was right. That 10 months of treatment went by in a snap. I covered my bald head for all of eight months--not much time for someone who's lived 51 years.

The humble, Harvard-educated Dr. Neil Fischback, mixed a chemo cocktail so unique to my particular breast cancer, that he has been written up in several medical journals for completely obliterating a tumor the size of a baseball in my left breast. Dr. Susan Dunbar, my radiation doctor, told me: "Do you realized how famous your case is because of what Dr.Fischback achieved?" According to Dr.Dunbar, when they "bread loaved" my left breast tissue, it was completely void of even the tiniest microscopic cancer cell.

Had it not been for these dedicated and talented doctors, who knows where I would be today? One thing I know for sure, thanks to them, I'm alive.

Tuesday, June 22, 2010

Happy Father's Day, Dad

This is a belated tribute, to my dad--Happy Father's Day.

We didn't have a lot in common, but we did share music. I love this jazz rendition, Song For My Father. I dedicate it to you, dad.

Mom, Tom, the boys and I miss you so much, on this day that celebrates fathers.

Love you, Marcy

Tuesday, June 15, 2010

Obama, Have Mercy

Okay, enough is enough. Every time I turn on the T.V. I have to endure the pain of watching those plumes of raw oil blasting into the waters of the Gulf of Mexico. I have repeatedly changed the channels but I can't keep ignoring this catostraphic disaster.

Tonight, I fiercely hoped that the leader of our nation would come up with a solution for this epic problem that has continued for some 53-plus days.

Instead, all he could do was preach to the American public about how we have to come up with alternative energy solutions, and PRAY for the debaucle in the Gulf of Mexica.

HELLO, we all know about alternative energy solutions, thanks to Al Gore's An Inconvenient Truth. What we needed to hear from our fearless leader is how he was going to STOP this oil spill, pronto.

He didn't even come close to giving us a solution. Let's fire him, now.

I am so dissapointed in him. This isn't a terrorist attack that Bush has to deal with, this is a natural disaster, and our president is clueless.

Shame on you, Mr. President. tonight, you have lost all your credibility with me.

Thursday, June 10, 2010

Congratulations Alex!

Last week my nephew, Alex, graduated with a 4.4 average from High School.

As his godmother, I remember all the stages of his childhood. For years, around his birthday, we had a tradition of spending a day together. Sometimes we would carve pumpkins or I would take him to a movie. I took him to his Broadway play, Wicked.

About six years ago, our tradition of spending a day together for his birthday stopped. But I understood, he had bigger and better things to do. He got involved with Habitat For Humanity and has traveled to Chicago and Puerto Rico to build homes for the homeless. By giving of himself, my nephew discovered spirituality.

That spirituality has served him in good stead over the past couple years, as he's moved to a different part of the country and shuttled back and forth between his mom and dad.

Alex has a bright future ahead of him. He wants to be a doctor and is going to a college with an outstanding pre-med program, Elon University in North Carolina. My mom, brother and I can't wait to see how Alex will blossom and grow over the next four years as he crosses the bridge to adulthood.

He has proven to be an academic overchiever throughout school and it will be pleasure to see him move into a career that saves people's lives.

Congratuations, Alex, we are so proud of you!

Saturday, June 5, 2010

Proud To Be A Survivor

There is nothing more exhilarating than to be among a group of women that traveled through the same dark tunnel you did, and came out better on the other side. Today, for going through that harrowing journey, many of us were treated like queens at the Susan G. Komen Race for The Cure.

This morning, us breast cancer survivors of Connecticut paraded through Bushnell Park of Hartford and were greeted with enthusiastic applause. I felt like a rock star. Mom was there, cheering me on and braved the heat and humidity to walk with me.

At the Surivivor's Breakfast, I even won a $50,00 gift certificate. This is something I will do every year as a way of showing my gratitude for all the doctors, family and friends that got me through my battle with breast cancer. It was truly a priviledge to be standing along side fellow survivors that felt the same way I did--stronger and more grateful for life. We did it!!!

Thursday, June 3, 2010

Do What You Love

One of the best lessons I learned from Joe is to honor your creativity.

During the time I was going through cancer treatment and spending way too much time sick on the couch, I would watch in amazement how Joe would come home, eat dinner, and spend the rest of the evening either painting, drawing, writing, playing the guitar or composing music. He was religous about it.

I asked him, how you can you be so disciplined about doing something creative everyday? His response? "I don't do it because I have to, I do it because it's my way of unwinding at the end of day. I do it because I have a drive to express myself. It's not that I'm forcing creativity, I'm simply letting it flow."

Then I realized he would get irritated when I turned on the T.V. and vegged out for the rest of the evening. So through his urging, I turned off the T.V. and participated. Soon, we were writing song lyrics together, dreaming up story plots for novels. Singing harmony to his guitar.

He helped teach me that when you have an idea, write it down, work on it. Don't wait, because before you know it, the inspiration will pass, and you missed out on a magical moment to express yourself. Seize the moment, let it flow.

Tonight he showed me all his latest drawings, and played some of his new songs. He is a perennial creative soul. Thank you Joe, for teaching me not to put my creativity on the shelf as though I was saving it for a rainy day.

Tuesday, June 1, 2010

Newsweek Review of Suzanne Somers' book about curing cancer

BREAKING: Health Author Suzanne Somers Mostly Wrong About Science, Medicine
It’s the book every medical writer in the country wants to ignore. Suzanne Somers’s latest “health” tome hit the bookstores this week, and this time she's offering her advice on how to cure and prevent cancer. As if people with cancer don’t have enough problems. When the review copy arrived, we decided to give it a once-over—so you don’t have to.

The gist of Somers’s argument is that conventional cancer treatments—surgery, radiation, chemotherapy—take a destructive approach and that chemo, in particular, is overused. Long an advocate of alternative therapies, Somers argues that it makes more sense to build up the body to fight cancer than it does to tear it down through radiation and chemicals. She is particularly enamored of nutritional “cures.”

Of course, Somers has had no formal medical or scientific training, but considers herself an authority—in part because she’s survived breast cancer after choosing not to have chemotherapy, and because she’s a regular on the alternative-medicine circuit. This book, like her others, consists mainly of transcripts of her conversations with various alternative-medicine doctors, as well as lots of details about her own experiences and prevention regimen, which she has spelled out many times before, most notably on Oprah earlier this year. It’s noteworthy that her promotion of the book began by publicly blaming Patrick Swayze’s recent death on chemotherapy, rather than his pancreatic cancer. (She has since apologized to his family.)

Cancer is a highly emotional topic, particularly since the war on cancer isn’t going particularly well. As my colleague Sharon Begley recently put it, “Cancer is on track to kill 565,650 people in the United States this year—more than 1,500 a day, equivalent to three jumbo jets crashing and killing everyone aboard 365 days a year.” The fact is that modern medicine is far from understanding everything we need to know about cancer, and the most effective treatments available often come with nasty side effects. We all wish there were more effective and less toxic options, and we need to stay open-minded about new discoveries and alternatives. Maybe some of the doctors Somers interviewed in her book will eventually prove to be on to something.

But there is a big difference between staying open-minded and tossing aside treatments that have been proven effective after rigorous testing in favor of new “natural” therapies that have undergone much flimsier scrutiny. If you’re someone who needs answers now, and want to make health decisions based on solid scientific findings rather than wishful thinking, there’s not much in Somers’s latest book to help you. The basic problem with the book, says Dr. Otis Brawley, the American Cancer Society’s chief medical officer, “is that it’s really inaccurate” when it describes the science behind current treatments and lacks a basic understanding of the scientific method. Not all research findings are equally authoritative. Just because something sounds good doesn’t mean it works. “Some people confuse what they believe with what they know," Brawley said.

Even if some patients are cancer-free after following a certain treatment plan, that doesn’t prove that it was the treatment that cured them, especially if no control group was used for comparison. “We’re finding that about 25 to 30 percent of some cancers stop growing at some point,” Brawley says. ”That can make some treatments look good that aren’t doing anything.” Until doctors figure out how to identify which patients have cancers that won’t progress, he said, the only option is to treat everyone.

Somers relies heavily on patient testimonials, but any scientist knows that talking only to those who benefited from a treatment can give less than objective results. A case in point: she lavishes praise on the research of Dr. Nicholas Gonzalez, who uses a combination of enzymes, massive amounts of nutritional supplements (130 to 175 a day—yes, you read that right), a strict diet, and daily coffee enemas, which he says can cure pancreatic cancer. However, just about two months before Somers’s book was published, the Journal of Clinical Oncology published the results of a controlled observational trial of Gonzalez’s protocol vs. chemotherapy for patients with inoperable pancreatic cancer. The study was funded by the National Cancer Institute and enrolled 55 patients who met strict clinical criteria. A year into the study, 56 percent of those using chemotherapy were still alive, compared with only 16 percent of those who chose the enzyme therapy. In other words, those who picked chemo over the alternative treatment lived three times as long. Interestingly, the study was concluded in 2005, yet Somers doesn’t mention this in the book.

Somers also shines the spotlight on Dr. Stanislaw Burzynski of Houston, whose controversial cancer treatments have resulted in years of battles with the FDA and the courts. Over the past 30 years, despite government investment, he has failed to provide compelling data that his expensive treatments work. More recently he expanded his research efforts into anti-wrinkle creams. (Side note: it is more than a little ironic that Somers is touting the work of Burzynski, who synthesizes peptides from human urine to create what he says is a cancer cure. In the books she’s written about hormones, Somers has expressed nothing but disdain for FDA-approved hormones synthesized from horse urine.)

Another treatment that gets the sign of approval from Somers is mistletoe extract, which is a popular treatment in Germany, and which she credits with keeping her cancer-free for years. There are some intriguing studies, but good science requires looking at all the studies, not just the ones that support your opinion. When German scientists published a review of the data on mistletoe as a cancer treatment in 2008, they found that the evidence was “weak.” Other reviews have concluded that there were quality problems with many of the studies and that more research is necessary.

Not all the recommendations Somers makes in the book raise eyebrows. She says eating healthy and exercising, reducing stress, and getting a good night's sleep may reduce the risk of cancer. That's true, but it's not news. She’s right that not every woman with stage I breast cancer needs chemo. Few doctors would argue. In fact, they have the technology to calculate the size of the likely benefit, and agree that sometimes it’s quite small. Most doctors offer it as a choice to women who want to do everything possible to prevent cancer’s return.

“And she’s right when she says that only some leukemias, lymphomas, and testicular cancers can be cured with chemotherapy,” Brawley says. “We admit that many conventional treatments are not as beneficial as we would like. But that doesn’t dismiss evidence that screenings have reduced the death rates of breast and colon cancer, or that the lives of other patients with cancer can be saved with early treatment or that chemo prolongs lives. Even in cases of stage IV breast cancer, or lung or prostate or colon cancer, when the cancer has spread throughout the body and particularly into the bone, we can’t cure people with chemotherapy, but we can prolong life and increase their quality of life. In her book, Somers completely rejects the idea that chemotherapy has any of these benefits.”

When I interviewed Somers earlier this year, she said that she gets irritated when the media identify her as the former ditsy blonde from the TV sitcom Three’s Company. She would rather be identified as an author; after all, she’s written 18 books, most on the topics of weight loss (even though she’s admitted to Larry King that she’s used liposuction) and hormones (she recommends treatments most hormone specialists and oncologists describe as potentially risky.)

For her next book, we’d like to suggest a topic she knows very well: media manipulation. You have to love the fact that the only blurb on the back of the book (“Ms. Somers writes with the passion of the prophet”—) comes from a review trashing an earlier book. Somers’s real specialty is understanding that when a celebrity writes a controversial book, it doesn’t matter how much mainstream doctors and serious researchers attack it, or whether people’s health is put at risk. Attacks bring publicity, and publicity sells books. Here’s hoping that this time the public proves her wrong.

Wingert is a NEWSWEEK correspondent and the coauthor of The Menopause Book.

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