by Debra Grant, RDH, CA
A writer for the New York Daily News wrote not too long ago, "An anguished Elizabeth Edwards decided to stay with her cheating husband because she is dying and worried about their two young children, her closest friend says. ‘It's just tragic. That's all I can say about it,' Hargrave McElroy, Elizabeth's best friend, told the Daily News."
Whether we have experienced any of the above emotions or a similar diagnosis, our hearts can certainly feel for this courageous woman and her family. A diagnosis of breast cancer triggers the obvious reaction of fear, but for many of us, it also brings on so many other questions about how it will affect our loved ones, before we even have a plan of what to do for ourselves.
I have missed all of you very much — your prayers, the hugs, the notes, and most importantly, the chocolate! Thank you for showing me what community is all about and the strength we have within us. I did not realize this column had become another part of my body, as if it were attached to me like a third arm (or breast in this case!). I had a conversation with Mark Hartley at the RDH Under One Roof conference in Chicago about bringing back this column. He encouraged me to meet the deadline for the October issue.
I feel like a year has been taken out of my life. I've missed so much time with friends, yet I have cultivated some deeper relationships that desperately needed cultivating while being treated and recuperating from breast cancer treatment. As I'm thinking about this column, I realize October is National Breast Cancer Awareness Month! Perfect! Let us talk about the mind, body, and spirit of the breast cancer patient and the dental hygienist. October is (obviously to all of us) also National Dental Hygiene Month.
I was lurking on Amysrdhlist.com, reading all of the wonderful comments. Sherri Bush, RDH, from Tennessee posted an article titled, "Breaking the News About Breast Cancer" (www.everydayhealth.com). It addresses the mind of a woman who learns of her diagnosis with breast cancer. Even though she is going through so many emotions herself, she is very careful about who and when to tell. This scenario reminded me of what Elizabeth Edwards may have been going through.
"Even when women are facing a breast cancer diagnosis, they are still concerned about caring for everyone else, especially the emotions of others," said study author Grace J. Yoo, a medical sociologist at San Francisco State University's Biobehavioral Research Center.
Why can't we just scream it out loud and cry like Linus from the Peanuts cartoons?
Yoo and her team interviewed 164 San Francisco-area breast cancer survivors (average age 57) of different ethnicities to evaluate the "emotion work" involved in telling others about the diagnosis.
In interviews with the researchers, the women talked about their feelings and actions after getting the diagnosis.
"Even telling someone, ‘I have breast cancer,' it's well thought out," Yoo said. "They know the statement, to some, can overwhelm." Women react in different ways — stifling their own emotions so they don't appear vulnerable, paying attention to the timing of their news, or sometimes letting it all out, she said.
Women find it somewhat easier to tell friends than family members, she found. "Women are trying to protect older, aging parents and younger children and even their spouses, even during illness. Women are socialized to care about others."
Ideally, Yoo said, women should do less of that at this time. "It's a time they should be caring about themselves, what decisions they should be making about breast cancer. They shouldn't emotionally burn themselves out by caring for others' emotions."
One woman, for example, told the interviewer that she didn't tell her mother about her breast cancer until after the surgery, because she knew her mother would worry. Many women said once they were told about the diagnosis, they were surprised about the outpouring of help, even from acquaintances. But some feared that if they told, people may not care enough to help.
Two of the biggest risk factors in breast cancer are:
- Being a woman
- Being over the age of 50 (the age group of 77% of women who are diagnosed with breast cancer)
One in seven women are diagnosed with breast cancer, and the majority of dental hygienists are women. There is also an increase in female dental school students and graduates.
My pointing out the risk factors supports the above statements from Grace Yoo. Women of the 50-and-over generation are known to have put everyone else ahead of ourselves. Many have let their health go, have sacrificed their needs for those of their children, dear friends, and family members. There is a famous expression that says, "We can't take care of anyone else until we take care of ourselves first." This rings true to many of us.
As a health care providers, we:
- Emerge as a counsel to many of our patients
- Give our patients hope by sharing the successes of other breast cancer survivors and our continued education
- Provide them with oral hygiene instruction and direction to combat any difficulties they may encounter
Knowledge is power. In order to help both our patients and ourselves as patients, we need to not be afraid of education. As dental hygienists, I find that this is not a problem. We are hungry for more all of the time. The key is to delicately encourage our patients to educate themselves. Some prefer to be ostriches and bury their heads into the sand and come up only in a crisis mode and be reactive as opposed to proactive.
For breast cancer education, I recommend the online CE course at Hu-Friedy (www.hufriedy.com) for dental hygienists. It will guide you as to specifics about breast cancer terminology, the physiological effects, and the emotional effects to help you understand the mindset of a breast cancer patient.
I received a refrigerator magnet from a dear friend who is a dental hygienist. Many of you know Millie Thaw as an RDH magazine cover girl. The refrigerator magnet read "Save the ta-ta's." I loved it, and it is still on my refrigerator today. It makes me smile and laugh. When I saw Millie at Under One Roof, she commented that a friend of hers mentioned that the magnet may be offensive to a breast cancer patient. Are you kidding?! I explained to Millie that we love to laugh and that one of the best remedies for healing is humor. I love my ta-ta's, thank you! I looked up their Web site (www.savethetatas.com); their purpose and goals are indeed in alignment with mine. Here they are:
Our Purpose — We exist to bring joy and healing to the world.
Our Core Values — We believe that laughter heals. We believe in leading with a spirit of excellence. We believe that integrity and generosity brings success for all. These are sacred and unchanging. These are our guiding principles for all we do.
Alternatively speaking, we can recommend some complementary therapy programs for the breast cancer patient.
- Therapeutic massage (Always check with oncologist)
- Guided imagery
- Art expression
- Reiki touch
- Tai chi
Complementary therapy during and after breast cancer treatment can be beneficial by focusing on stress reduction and promoting relaxation.
A pilot study conducted by the University of Texas M.D. Anderson Cancer Center released in 2006 found yoga to help women going through radiation therapy and its myriad side effects. Some of the benefits the women in the study experienced included increased energy levels and physical conditioning, and better physical functioning. Activities in which the yoga class participants reported higher levels of ability than their control group counterparts include the ability to walk a mile, the ability to climb stairs, and the ability to lift a bag of groceries.
There is an evidence-based study that has been done with breast cancer patients and aromatherapy.
Aromatherapy is one of the complementary and alternative medicines used to treat various diseases and symptoms. Essential oils have many kinds of pharmacologic actions including antimicrobial, sedative, analgesic, spasmolytic, and estrogen or steroid hormone-like effects. Since various kinds of essential oils such as true lavender, rose, mandarin, sweet orange, sandalwood, geranium, etc., have anxiolytic activity, aromatherapy has been used for the relief of depression and anxiety. We have clarified that aromatherapy massage reduced anxiety and depression in healthy subjects and that it increased CD8-positive and CD16-positive lymphocytes in peripheral blood. Furthermore, we found that aromatherapy massage improved mild depression. Patients with cancer tend to be very anxious about the recurrence of cancer, even after complete remission. This anxiety in turn might reduce immunologic activity, resulting in an increase in the probability of recurrence.
You may find the rest of the research at this link: http://ecam.oxfordjournals.org/cgi/content/full/nem073.
In conclusion, the best medicine that I can recommend from firsthand experience is: L&L (listen and laughter).
If you are diagnosed with a disease or are in ill-health ... take care of yourself first.
About the Author:
Debra Grant, RDH, CA, is owner of Oraspa, Inc. Debra is a national speaker on various subjects dealing with complementary and alternative dentistry and dental hygiene. She also serves on the Illinois State Dental Board. You may reach Debra at [email protected] or www.oraspa.com.