October 2009 Mayo Clinic Women's HealthSource Highlights Ductal Carcinoma In Situ, New Hearing Aid Options and Self-Acceptance

Saturday, October 24, 2009 General News
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ROCHESTER, Minn., Oct. 23 Here are highlights from the October issue of Mayo Clinic Women's HealthSource. You may cite this publication as often as you wish. Mayo Clinic Women's HealthSource attribution is required. Reprinting is allowed for a fee. Include the following subscription information as your editorial policies permit: Visit www.bookstore.mayoclinic.com or call toll-free for subscription information, 800-876-8633, extension 9751.

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Ductal Carcinoma In Situ -- A Highly Treatable Breast Cancer; Questions Remain on how Aggressively to Treat

ROCHESTER, Minn. -- Doctors and their patients with a specific type of breast cancer called ductal carcinoma in situ (DCIS) are successfully employing treatments to beat the disease, with 10-year survival rates approaching nearly 100 percent.

But questions remain on how aggressively to treat this cancer. The October issue of Mayo Clinic Women's HealthSource lays out the issues and treatment choices.

DCIS occurs when abnormal cells multiply and form a growth within a breast's milk duct. The cells are considered cancerous but have remained in place within the milk duct. "In situ" means "in place."

More than 62,000 cases of DCIS are diagnosed in the United States annually, making it the most rapidly increasing type of noninvasive cancer. The majority of DCIS cases -- about 90 percent -- are discovered during routine mammograms. DCIS usually has no outward signs or symptoms.

DCIS isn't considered life threatening, but, if not detected and treated, it can progress to a more serious form of invasive cancer. The best treatment approach is still being debated.

Lumpectomy or mastectomy: Most women with DCIS are good candidates for a lumpectomy, where a portion of breast tissue is removed. However, there's a slightly higher chance that the cancer will return after a lumpectomy than after a mastectomy, which involves removal of breast tissue, skin, areola and nipple.

Mastectomy is commonly recommended when the area of DCIS is large or in several parts of one breast. Women may choose this option if they can't have or don't want radiation. Some women choose to have both breasts removed to prevent recurrence or a new cancer.

Radiation therapy: Radiation therapy is almost always recommended after a lumpectomy. Research has shown that it significantly reduces the chances that DCIS will recur or progress to an invasive form of cancer. Radiation is usually given five days a week for five to six weeks. Some research has questioned whether this approach is overly aggressive, particularly for older women with small, slow-growing tumors.

Tamoxifen therapy: Tamoxifen is a synthetic hormone that can be used to help treat or prevent the development of breast cancers. It's approved as therapy after surgery or radiation to prevent recurrence of DCIS or a new cancer in the opposite breast. But, some doctors don't recommend it because no evidence shows that tamoxifen improves long-term survival with this type of cancer. Taking tamoxifen can result in side effects such as hot flashes. And tamoxifen may increase the risk of blood clots and cancer of the uterus.

Researchers are attempting to better understand which women with DCIS are at highest and lowest risk of recurrence. That information would help in determining the most appropriate treatment. In the meantime, patients and their care providers should discuss the pros and cons of all treatment approaches.

New Hearing Aid Options: Looking Good and Sounding Better

ROCHESTER, Minn. -- Advances in hearing aid design and technology mean more and better choices for consumers. The October issue of Mayo Clinic Women's HealthSource covers the pros and cons of various styles, from those that are barely noticeable to others that resemble the latest phones and come in stylish colors.

Most of today's hearing aids work by providing more amplification for soft sounds and less amplification for loud sounds, making soft and average conversational speech loud enough to hear. Digital technology allows for smaller hearing aids that can be programmed and adjusted to better match an individual's unique hearing loss, usually with better sound quality, less feedback (squealing) and better noise reduction.

In general, the smaller the hearing aid, the less powerful and flexible it is and the shorter its battery life. For hearing aids that tuck completely in the ear canal, the battery life is three to five days. For styles that are larger, batteries last up to two weeks. Because each situation is unique, an individual may not be a candidate for all styles and types of hearing aids.

Mayo Clinic Women's HealthSource offers these tips for buying a hearing aid:

Start with an audiologist: This hearing specialist will conduct a thorough evaluation for various tones and words and suggest the most appropriate type of hearing aid.

Understand the adjustment period: Most states require a 30- to 45-day adjustment period to allow time for rechecks with an audiologist and any needed reprogramming in the hearing aid. During this time, hearing aids can be returned. When hearing aids are returned, patients are typically still charged a fee for fitting.

Check the warranty: It should cover parts, maintenance and repairs for a specified time.

Beware of misleading claims: Hearing aids can't restore perfect hearing or eliminate all background noises. Free consultations may not be the source of unbiased advice, especially when the provider is selling only one brand of hearing aid.

Plan for the expense: Medicare doesn't pay for hearing aids. Some insurers pay for part or all of the cost. Costs can vary considerably, up to several thousand dollars.

Allow adjustment time: It takes time, patience and practice to get used to wearing a hearing aid.

When Wrinkles Appear: Tips for the Beauty of Self-Acceptance

ROCHESTER, Minn. -- In a culture that values super-model-Barbie-doll-celebrity-of-the-moment ideals, how does a woman cope when dealing with a round belly, gray hair and flabby arms?

The October issue of Mayo Clinic Women's HealthSource looks at American cultural pressure on youthful appearance and offers ways to accept the changes of aging -- wrinkles and all.

At any age, those bad moments in front of the mirror can seep into a woman's psyche, leading to low self-esteem, emotional distress, anxiety, depression and eating disorders. The inevitable changes of aging lead to a whole new set of challenges. The changes, from wrinkles to weight gain, are normal and natural. But in the United States, they often are seen as disastrous.

Accepting the changes that come with an aging body creates a solid foundation for self-esteem and contentment. Consider these ways to develop the beauty of self-acceptance:

Remember that self-worth is more than appearance: Seeing oneself as a whole person, rather than a collection of parts that need improvement, can boost self-worth. Consider the people you admire most. Are their bodies perfect? Does it matter?

Emphasize good health: Regular exercise and healthy eating promote physical and emotional well-being.

Say yes to a sex life: Anxiety about appearance may cause women to withdraw from intimacy. But, sexual intimacy reduces stress, improves sleep and supports connectedness.

Appreciate the body as it is: A body that runs, walks, dances, works, laughs or dreams is to be admired -- no matter what shape it is.

Think positively: Renaming body parts can help change negative self perceptions. Consider "soft belly" instead of "fat stomach." Spend time with others who accept their body size and appearance.

Spend time and energy on affirming activities: Affirmation may come from a session of stretching or yoga, or cooking a meal for an older relative.

Many women find that aging brings a newfound sense of self-acceptance and freedom from the need to conform to social standards. When women feel good about themselves, they carry a sense of confidence and openness that makes them beautiful inside and out.

Mayo Clinic Women's HealthSource is published monthly to help women enjoy healthier, more productive lives. Revenue from subscriptions is used to support medical research at Mayo Clinic. To subscribe, please call 800-876-8633, extension 9751, (toll-free) or visit www.bookstore.mayoclinic.com.

SOURCE Mayo Clinic

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