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On March 31, 2017 I attended the Advocacy for Metastatic Breast Cancer (MBC) workshop held by Rethink Breast Cancer.

The room was full of energy, laughs, long sighs, and nodding heads – without knowing no one would ever think all of these women share one thing in common – they had all been diagnosed with a terminal illness – MBC.  It was a day where everyone understood the struggle – the advancements in care and the lags, being heard and ignored, the good and bad days.

Judith Saunders a patient advocate presented on Advocating to Improve the Lives of Women with MBC and oncologist Dr. Rayson, Medical Oncologist from Halifax presented on From the Outside Looking In – Reflections of a Medical Oncologist still learning about MBC.

The day focused around advocacy which lit a fire inside me like no other – that something needs to be done and it needed to be done now. MBC can no longer be ignored – it needs attention, research, funding and ultimately a cure.

The workshop was small and intimate which allowed for lots of sharing – in some way or another I could relate to everything that was being shared – whether it was about the specific needs of MBC patients, how patient values need to be woven into care, ways to motivate MBC specific research, and living well with MBC. Being newly diagnosed with MBC this was all new to me, but I knew I wanted to know more and get more involved. I had so many ideas percolating in my head for days after the workshop; it was a great introduction to the importance of this work. The one message that I took away with me was the importance of having our voices heard by EDUCATING, DEMONSTRATING and ADVOCATING for MBC.

-Jaspreet

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For ways to get involved with Rethink’s Access to Treatment campaigns click HERE.

Name: Rose Anne Crisostomo

Age: 39

Occupation: Human Resources Manager

Age when diagnosed with breast cancer: 36

Breast cancer type: Invasive Ductal Carcinoma

Breast cancer stage: Stage 2 (estrogen and progesterone positive), BRCA 2 POSITIVE.

Treatment: Six rounds of Chemo, 25 rounds of Radiation, Surgery ( which included a double mastectomy, fat grafting, expanders, and nipple tattoo)

Tell us a fun fact about yourself that has nothing to do with cancer

When I was little most girls played teacher, I played lawyer. I asked my mom to buy me files, paper and pens and I would draft up divorce papers.

What’s your go-to pick-me-up song?

Happy by Pharrell Williams

How did you discover your breast cancer?

I was 24 weeks pregnant at the time, and noticed a big hard lump on my right breast, as it was my first pregnancy I thought it was a clogged milk duct.

What went through your head when you received your diagnosis?

I went numb. I did not cry until later that day, but I started to think, what’s going to happen to me?, what’s going to happen to my unborn child?, what about my family and friends?

What’s the craziest thing someone said to you after being diagnosed with breast cancer?

If it was going to happen to anyone it would be you, your mentally stronger than I am. (my thoughts were….did she just really say that to me?????) Ignorance is bliss I guess.

Who or what is/was your biggest source of support throughout your experience with cancer?

I would not have made it without the help of my mom, who moved in with us for seven months (just after I was diagnosed with cancer) and took care of me, my husband and ultimately little Benjamin. At 72 years young, she stepped up to the plate and looked after us all. Through emotions, exhaustion, and never ending work of looking after a newborn, she was my rock, and my very best friend. Of course my husband as well, he was there for me at my lowest points, your know your marriage is strong when he has the strength to shave his wife’s head.

What is/was the most difficult part of being a young woman with breast cancer?

I think the unknown. You live your life day by day, but you really don’t know what the future has in store for you. You will always be nervous when you have to do routine blood work, and annual check ups. Neither my fight nor my journey is over, but I’m hopefully the worst is behind me.

What’s something unexpected you learned about yourself as a result of having breast cancer?

I am stronger than I was before, and even though I’m not always confident, I know I am a fighter. I’m happy, and blessed to be alive.

In one sentence, what words of wisdom would you pass on to another young woman who has just been diagnosed with breast cancer?

Fight like crazy to get your life back because after all that’s what you’re fighting for: your life.

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For more #YWBC profiles click here or to be featured contact Shawna@Rethinkbreastcancer.com

When “traditionally” getting pregnant becomes less of a reality women may start to seek out other family planning options like adoption and surrogacy or gestational carrier (yes, there is a difference which we will explain below).

Getting information for the latter is tricky and especially challenging when you don’t have the means or resources. We asked one woman who went down this road what advice she would give to another and here is what she said.

Gestational Carrier or Surrogate?

You can’t begin to do your research until you know what you are researching. Many people use surrogacy synonymously with gestational carrier. There is a big difference.  A gestational carrier or gestational surrogate is a woman who carries a child conceived through the process of in-vitro fertilization utilizing the egg and sperm of either the intended parents and/or an egg donor or a sperm donor.  In vitro fertilization (IVF) is a necessary part of this arrangement because eggs from one woman are used to create an embryo implanted in another. In IVF, fertilization occurs after eggs and sperm are combined in a laboratory. The resulting embryo or embryos are then transferred to the gestational surrogate’s uterus. The traditional surrogate is the baby’s biological mother because it’s her egg that was fertilized by the intended father’s sperm.

Selecting a clinic

There are a variety of fertility and reproductive clinics in Canada from which to chose. My oncologist took care of the referrals however he was inexperienced with fertility and reproductive clinics so referred to the clinics upon my request.  Our experience was with two different carriers – friends who volunteered to help us have a child. We tried two rounds with our first clinic/carrier and when a pregnancy was not successful we were ready to quit. When a second carrier came forward we attempted a third round at the second clinic and a pregnancy ensued. The experience with both clinics was very different one from the other. The first clinic was affiliated with a hospital while the second was an independent organization (private clinic). The hospital affiliated clinic felt very regimented in their approach, while the private clinic’s approach was more personalized taking into account the special circumstances of individuals.  At the private clinic we saw the primary physician (as opposed to a resident), who was well- versed with surrogacy and worked efficiently as part of their team.   When I compare my experience between both clinics….it was like night and day.  I had not previously considered how important the choice of clinic would be.

Choosing a lawyer

There is a lot of legal information that needs to be discussed and the contractual agreements between all parties are extensive.  It is imperative that the lawyer be well versed in Surrogacy Law.  Employing a lawyer that is unfamiliar with Surrogacy Law can result in confusion, delays and unnecessary costs.   As an example, three lawyers were involved in the successful pregnancy process: one lawyer drafting the contractual agreement on behalf of us (the intended parents).  Once the pregnancy was successful another lawyer was required.   Each lawyer specializes in specific tasks and responsibilities.  Finding out upfront “who” is responsible for “what” is important as it will minimize confusion of expectations and better prepare for costs.

Expenses

The entire process from carrier selection to post delivery is very expensive.  There are opportunities to apply for funding assistance through Fertile Future – however we weren’t successful in completing the application due to issues with my insurance company and the way their billing worked. Fertility clinics do provide upfront an approximate fee schedule providing details relating to the cost of the various processes and fertility drugs etc., but then there are legal fees, potential donor/potential carrier/fertility clinic fees, and expenses paid to the surrogate (which is a capped amount).  Some drug plans do not cover any of the fertility medication for the egg retrieval process or for implantation – important information to be aware of before beginning the process. There are also costs associated with agencies that assist in securing anonymous egg or sperm donors that can provide additional possibilities to potential parents, or agencies that can help find a carrier.

– Anonymous

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For more information on fertility issues post-cancer treatment click HERE.

Sylvie Normandeau was diagnosed with stage 3 aggressive breast cancer in April 2011. She had a double mastectomy, chemotherapy, radiation and took Tamoxifen for five years.

She was a personal trainer and freelance nutritionist who worked out three to five times a week and followed a healthy diet.

“I was already doing all the right things, and breast cancer still appeared,” she says.

Like many cancer patients undergoing treatment, the now 37-year-old found working out during treatment difficult. She took “a huge step back” and turned to more low-impact activities like yoga and meditation so she wouldn’t push her body too hard.

She even wondered if her body was meant to get cancer no matter how she treated it, so she gave up her green smoothies and other healthy habits. But they returned.

“I came back to giving my body a fighting chance, and I know these things are shown to improve your body functioning better overall,” she says.

[perfectpullquote align=”full” cite=”” link=”” color=”” class=”” size=””]“I came back to giving my body a fighting chance, and I know these things are shown to improve your body functioning better overall,” she says.[/perfectpullquote]

As it turns out, Normandeau is right to believe that continuing to exercise after her breast cancer diagnosis gives her “a fighting chance,” as she puts it. A few weeks ago, the issue of breast cancer and exercise made headlines again, when a doctor and her research assistant at Toronto’s Sunnybrook Health Sciences Centre released a review of the most up-to-date research on the relationship between lifestyle factors, such as exercise, and the risk of breast cancer recurrence and mortality.

The problem was, conflicting headlines may have left readers wondering what to believe.

CBC News suggested that, “Exercise, keeping weight down help prevent breast cancer recurrence, review finds.” But the Globe and Mail said: “Analysis suggests lifestyle changes may not fend off breast cancer.”

The same analysis obviously didn’t offer two different conclusions, so we asked some experts, and the doctor herself, what the findings really mean.

The review

Dr. Ellen Warner and her research assistant, Julia Hamer, gathered together dozens of research papers, analyses and reviews that looked at how breast cancer recurrence or mortality are affected by lifestyle factors such as weight gain, exercise, diet (including soy and fats), smoking, alcohol and certain vitamins.

They found that, of all of the lifestyle factors, exercise had the “most robust effect” on breast cancer recurrence and mortality. In fact, starting an exercise regimen (or maintaining one) from the time of diagnosis right through treatment and afterward – a regimen is defined as 30 minutes of moderate to vigorous physical activity five times a week – increased chance of survival by 40 per cent.

“I was more surprised by the magnitude of the benefit because the benefit of the exercise is the same amount that we see with conventional treatment,” Warner said in an interview. That’s not to say that doctors should start advising women to replace conventional treatments, such as radiation and chemotherapy, with physical activity, she warned.

“We cannot say, ‘chemo reduces recurrence by 20 per cent, but with exercise we reduce it by 40 per cent so we’re not going to give you chemo,’” she said.

[perfectpullquote align=”full” cite=”” link=”” color=”” class=”” size=””]“We cannot say, ‘chemo reduces recurrence by 20 per cent, but with exercise we reduce it by 40 per cent so we’re not going to give you chemo,’” she said.[/perfectpullquote]

Exercise should still be only a part of an overall treatment plan. As Warner points out, exercise is also proven to lessen the side effects of treatment, including aches and pains, fatigue, anxiety and depression.

Normandeau herself isn’t surprised by the study’s findings. She believes exercise is “really vital” for overall health.

“Whether it’s for prevention of breast cancer or any other illness,” she said. “But I think prevention of recurrence is not a one-prong thing, it’s a lot of factors.”

[perfectpullquote align=”full” cite=”” link=”” color=”” class=”” size=””]“Whether it’s for prevention of breast cancer or any other illness,” she said. “But I think prevention of recurrence is not a one-prong thing, it’s a lot of factors.”[/perfectpullquote]

 

What is it doing?

There is much still to learn about how, exactly, exercise is helping to reduce the risk of cancer recurrence and mortality. But research indicates that it affects several physiological pathways.

Exercise appears to impact how the body metabolizes sugars, Warner points out, and some studies have found a link between a diabetic or pre-diabetic state and cancer risk and recurrence.

Also, exercise regulates hormone levels, which could be beneficial when treating hormone-related tumours.

Physical activity also appears to reduce inflammation, which may explain why it reduces the aches and pains experienced by patients during treatment.

And of course, it can help with weight loss. According to Warner’s review, gaining more than 10 per cent of one’s initial body weight after diagnosis is linked to an increased risk of recurrence and death.

How much is best?

But questions do remain about how much, and at what frequency, is best. The 30 minutes, five times a week recommendation lines up now with not only what the Canadian Cancer Society and the American Cancer Society recommend, but what Health Canada advises everyone should set as their physical fitness goal just to maintain overall health.

What about specific “dosages” of physical activity being tailored to each patient to maximize the benefits? Research is headed in that direction to find if, and how, we can get to more personalized exercise “prescriptions.”

Dr. Christine Friedenreich, a world leader in research on the connections between physical activity and cancer, has found significant reductions in the risk of not only breast, but also prostate and endometrial cancers, with regular exercise.

Friedenreich, scientific leader for cancer epidemiology and prevention research at Alberta Health Services and adjunct professor and division head for preventive oncology at the Cumming School of Medicine, says the current guidelines, which add up to 150 minutes of moderate activity per week, or 75 minutes of vigorous activity, “are fine.”

“But there are lots of questions about exactly the dose, the timing, the duration, the frequency, the type of activity that we’re still investigating and that we don’t have the definitive evidence yet,” Friedenreich says. “

“But while that evidence is accumulating,” she adds, the American and Canadian Cancer Societies have at least deemed exercise safe for patients.

Dr. Daniel Santa Mina certainly agrees with that. He’s a scientist in the cancer rehabilitation and survivorship program at Princess Margaret Hospital and an assistant professor at the University of Toronto’s faculty of kinesiology and physical education.

He runs a wellness and exercise program at PMH that conducts comprehensive fitness assessments of referred patients before assigning them to a rehabilitation centre, an off-site program such as Wellspring or Gilda’s Club, or an eight-week group fitness program at the hospital that includes education on everything from fatigue to diet to emotional health.

As often as possible, his team aims to get patients physically active close to their time of diagnosis, before they begin treatment, so they know how their exercises are supposed to feel when their body is healthy.  That education can also help prevent them from over-exerting themselves.

“I think that for the most part, people are aware that exercise is good for them, but after a cancer diagnosis, and especially after some of these complex treatments, knowing what they should and should not do is very challenging, it’s very stressful. So making decisions sometimes becomes more difficult than it’s worth, and rather than trying something or finding somewhere to go, they remain inactive,” Santa Mina said.

“So we try to provide them with the education to become active even after the program ends.”

[perfectpullquote align=”full” cite=”” link=”” color=”” class=”” size=””]“So we try to provide them with the education to become active even after the program ends.”[/perfectpullquote]

While his team tailors programs to each patient, he said the question of dosage is really key for scientists to focus on to “optimize the effect” of exercise.

Although 150 minutes of physical activity each week may be the current target, “it’s not the only target,” he says. Patients who are not physically active at the time of diagnosis have to start somewhere.

“If you are doing nothing, then your target is whatever is a little bit more than nothing,” he says. “Then you incrementally gain benefit as you incrementally increase your physical activity.”

 Vigorous activity = better?

It’s been Friedenreich’s research that has led the way to reaching many of the conclusions that currently guide physicians’ recommendations, and for setting the path to study how it is that exercise actually impacts the body to reduce cancer risk.

The Alberta Physical Activity and Breast Cancer Prevention (ALPHA) Trial and the follow-up BETA trial looked at the impact of 45 minutes of moderate-to-vigorous exercise five days a week on what Friedenreich calls the “intermediate factors” for breast cancer: body fat, insulin resistance, sex hormone levels and inflammation.

In ALPHA, the researchers found that the more women exercised, the greater the impact on these markers. In BETA, some women were randomized to do 150 minutes of exercise per week, while others were given 300 minutes.

While both groups saw impacts in all areas, the group that did twice as much exercise didn’t enjoy a significantly greater benefit. However, women who spent more time in their target heart rate zone – meaning they did more vigorous exercise – did.

“So it does seem like if you’re able to do more vigorous intensity activity that there might be even more benefit to you,” she says.

[perfectpullquote align=”full” cite=”” link=”” color=”” class=”” size=””]“So it does seem like if you’re able to do more vigorous intensity activity that there might be even more benefit to you,” she says.[/perfectpullquote]

These studies looked specifically at post-menopausal women. And while the findings are “somewhat applicable” for pre-menopausal women, she said, there is research underway that will help drill down on how exercise might uniquely affect younger patients.

Friedenreich has a cohort study underway, the AMBER study, where 1,500 breast cancer patients are being recruited at time of diagnosis. Unlike observational studies, which require participants to fill out surveys or self-report their physical activity levels and other factors, a cohort study includes specific measurements of exercise, diet, other lifestyle factors, as well as blood tests and other physical assessments. The participants will also wear accelerometers to measure physical fitness levels, and they will be followed up with at one, three and five years.

The research team will also collect biological samples to study the participants’ tumours and gather information on their treatment to determine if there are any tumour subtypes that may be more responsive to physical activity, she said.

For Santa Mina, Warner’s review and other research are all part of a “snowball” that’s been building since as far back as the 1980s, when findings about the benefits of exercise for breast cancer patients began to emerge.

“The point being is physical activity is good for the healthy person without cancer in a very similar way that it is for people with cancer,” he says.

But getting people to do it “is the tricky part,” and patients will exercise for different reasons, enjoy different activities and tolerate didn’t levels of discomfort, he said.

Ultimately: “The dose that works, is the dose that someone is willing to commit to.”

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Andrea Janus is a freelance writer and editor in Toronto whose work can be found at CBC.ca/Toronto and the Toronto Star, among other outlets. She spent seven years as a health and politics reporter at CTVNews.ca, and has always had a keen interest in breast-cancer research and related issues due to a strong family history of the disease. You can reach her at andrea@andreajanus.com.

Andrea

Part 2: Central Support

Now that you have started to re-build your physical strength after surgery with the exercises in Part 1 of this series, you should be feeling an increased range of motion and mobility, and hopefully a greater sense of ease and confidence in your body along with it. Now is the perfect time add to this next group of exercises to your routine. This series will hone your focus on your spine and build central support for your entire body from the inside, out.

One way to think about how the body works is to consider a central support system built around the spine. Just as the mast of a ship is the centre that holds the sails, so the spine is the key support of the entire body. Another image that is often helpful when we think of the centre of the body is a ½ wetsuit. It wraps the torso and covers the hips and shoulders. Everything inside the wetsuit contributes to the support systems that keep us upright, stable and mobile. So, even though the trauma point of this surgery is in your upper body, adding exercises that focus on your spine will set the stage to build strength along the centre line and create three-dimensional support for your entire body.

Deep in the body, some muscles form what is called a girdle of support. Nestled along the spine, we have the multifidi muscles which are responsible for almost 70% of the spine’s stability. Next are the more than 20 muscles we use to breathe. Conditioning our breathing muscles is critical to creating a stable yet mobile ribcage which is the bony base of support for the shoulders. More superficial we have the abdominal obliques, which provide the muscular support around the ribs. These muscles connect to the primary muscles in our shoulders and help control smooth, efficient movement in the upper body. Finally, the muscles of the buttocks and back work to create a posterior sling, like a diagonal seat belt running from each hip to the opposite shoulder.

These four sets of muscles, when in sync, help us feel stable, aligned and secure in the midriff: like we have a base to rely on for all our daily movements of the upper body. When you access and target these muscle systems correctly, you create support that will help balance out pain, strain or weakness in the body, in this case, your upper body.

There is no magic bullet to this process but commitment and work. After 4-6 weeks of doing these exercises 3-5 times a week, you should be feeling physically powerful and stronger, and mentally and emotionally confident as a result.

Guidelines

  • This is a 3-part, stage 1 exercise series designed to recondition your entire body before you return to regular workouts that are weight-bearing on the arms.
  • You should not feel any pulling or ripping sensations. If you feel any strain, make your range of motion smaller. If this does not help, omit the exercise altogether and revisit in in a week.
  • Do 6-10 reps of each exercise one after the other, then do three sets of the entire series. (Approx. 15 minutes)
  • Start with 3 – 5 times a week. Begin these exercises, based on the recommendation of your physician.

Breathing (lateral and back)

Sit or stand and wrap a stretchy band (or even a pair of tights) around your midriff. Cross the ends over each other in the front and pull on them, so the band feels snug around your ribs and abdomen. Breathe laterally, (out to the sides), and backwards, so your torso expands into the band. Then, as you exhale, deflate and narrow your torso to squeeze the air out. As you exhale, tug on the band so at the same time, so it pulls in around you. Don’t worry about taking a big breath. Focus on expanding sideways and back without raising shoulders and straining your neck. Keep it small to start and if you feel strain or excessive tightening in your neck, ease off.

Rocking (multifidi)

Stand in a split stance with one foot forward and one foot back. Rock from foot to foot in a rhythmic motion. Allow your arms to swing easily. It is unlikely you will feel your back muscles and instead, may be aware of muscles in your buttocks and legs. Repeat on the other side.

Hip Sway (obliques)

Lie on your back with knees bent and feet flat. Lay arms at sides, like an A-frame. Sway your knees to the left until you feel heavy on your left buttocks and shoulder with right buttock and lower back lifted off the ground. If easy and comfortable, keep your shoulders square. If not, allow them to move with you. Roll back to centre as if unwinding the spine until you return to the start position. Repeat on the other side.

Neutral Bridge (buttocks and back)

Lie on your back with knees bent and feet flat. Lay your arms at your sides. Press your feet and the back of your shoulders into the floor and raise your hips toward the sky. Then, lower your hips with control. When you lift your hips, imagine a long diagonal line from your shoulders to your knees. If you feel your lower back working a lot, lower your hips slightly: you may feel your buttocks immediately or not. Avoid squeezing them as this may strain your knees.  

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Margot McKinnon (B.Ed., M.Ed.) is a Pilates and Movement Specialist dedicated to helping train teachers and the general public to move with ease and integrity. 

Name:  Amanda Blakley

Age: 38

City: Toronto

What do you do when you are not changing the world with philanthropic gestures?

I am a mom to two little boys, Archer & Atticus, a constant tourist and a family-friendly travel expert contributing prose to some of Canada’s preeminent publications.

www.adventuresofatticus.com

What is one thing you have re-thought in your life?  How did you approach it?

In my late 20’s I re-thought my life and career. My business partner and I had an epiphany that the two could and should be more correlated than we had initially been lead to believe. We passionately chased the harmony of lifestyle and career as a whole (as opposed to two competing silos) and we created a business that was also a movement – a place where our passions intersected with our pursuits (and drove revenue, created opportunity, inspired others and ultimately delivered on our mission of making culture relevant and approachable for young people). Today this is nothing ground breaking, but 12 years ago the idea of leaving a stable 9-5 job to create a business that was nontraditional was a risk.

I love this quote by Steve Jobs:

“Your time is limited so don’t waste it living someone else’s life. Don’t be trapped by dogma, which is living with the results of other people’s thinking. Don’t let the noise of others’ opinions drown out your own inner voice. And most important, have the courage to follow your heart and intuition, they somehow already know what you truly want to become. Everything else is secondary.”

After running this successful business for ten years, my parter and I both started families at the same time. And again, I re-thought my career and lifestyle. My new life with a baby was drastically different and what I wanted out of life also shifted. I would say that my second profession is still evolving and shape-shifting but I could not have dreamed of a more perfect compliment to my life as a parent and wife. I re-thought the lifestyle that I wanted and focused on the end goal instead of the means goal, and now I get to travel the world with my tots in tow, writing about the places, people and travel brands that inspire me.

What is the most important thing to know when it comes to donating to a cause?

I think it’s important to know that there is more than one way to donate. People make the common assumption that it must be a financial contribution for it to be significant. But guess what? As a donor and volunteer, in most cases, it is actually our connections, competence, craft, prowess, trade, skillfulness or smarts that can be the most significant and meaningful contribution to the charity or cause.

A person who gives back that you aspire to:

I have always known my parents to be extremely charitable – not just financially but setting an example for my siblings and I by truly caring about humanity. Stepping up when it counts – not for the accolades but because it’s the right thing to do. That is what I try to emulate and aspire to in my life.

How do you find a cause you are passionate about?

I think we are all touched and inspired by different things throughout our life – the good and the bad. If something moves you to action, honour that impulse, whether it’s politics, health-related issues, environmental issues – find a way to use your skill set to help, on a local level, or even a global scale. Unfortunately there are so many causes out there and all can use some extra skilled hands.

What is innovative about the Rethink approach?

I admire the way they speak to a younger generation – they have made a concerted effort to remove the fear and scare-based tactics used by many charities and causes to market to their donors

What inspires you daily?

Artists and creative individuals making their own rules and breaking everyone else’s. My own children who are both so different and so divine. They are too young to be swayed by convention and their rawness and innocence make me want to do more and be more on the daily.

Why should people support a cause they are passionate about?

Because what could be more important than contributing to our environment (both local and at large) our earth, our fellow humans? To stand up for what we believe in and make a small or mighty difference for someone – or lots of someones, that should be what life is all about.

When I give back I feel:

connected.

Reclaiming Your Body + The Boudoir

Body image and sexuality are tricky topics for all of us, but they can be especially tender subjects after cancer as you learn to navigate a whole new landscape. There can often be an instinct to skip ahead and try to get things back to “normal”, but just remember: there is no such thing as “normal”. You can absolutely take your time and be conscious about the process of reconnecting to your body and your sexuality. Checking in with yourself regularly will help ensure you move at a pace that feels right for you.

Here are five ways to support you in fostering a relationship with your body and sexuality that is grounded in joy.

Do Things That Make You Feel Like You

Just as there’s more than one way to look sexy, there are endless ways to feel sexy. Take the time to think about what really makes you feel good in your own skin. When do you feel most grounded and “in the flow”? What are the moments when you lose track of time, your mind is still, and you’re rooted in your sense of self?

The answers to these questions can be as unique as you are! It could be a yoga practice, a walk outdoors, a belly dancing class, or cooking a beautiful meal.

Now is the time to prioritize the activities that help you connect to your most vibrant self. Practices involving physical movement are particularly powerful, because they serve as a literal reminder of your strength and resilience.

Bring Back Your Flair

Medical gowns and hospital slippers are all about practicality and efficiency. They don’t offer much comfort, let alone room for your originality to shine through. It’s no wonder you might have started to feel less “you.” How we choose to adorn ourselves matters – it’s one of the ways we reflect our values.

Start to re-incorporate the items that speak to your own unique style, whether that’s your favourite sparkly earrings, your combat boots, or your giant red purse.

The more you physically embody your personal values, the easier it is to tap into a feeling of connection to your sense of self.

Bask In Possibility

When it comes to the bedroom, there are endless options. However, as a society we tend to act like there’s just one main goal – intercourse – and rush through or skip ahead to the end. We rarely slow down and ask, what if?

What if I caressed the back of your knee?

What if I trailed my fingertips down your arm?

What if I kissed the curve of your spine?

What if now was an opportunity to ask those questions? What if, instead of this being a time when things have been taken off the table, you’ve been gifted a delicious new menu of options to explore?

By the way, it’s easy to think of these activities as “foreplay”, but that implies that they have to lead up to some “main event.” Instead, try to see them as pleasurable acts in and of themselves.

Ask For What You Need

Good sex always requires good communication. Now’s a good time to practice that skill! Would wearing a t-shift make you more comfortable? Are certain kinds of touch now off-limits? What else do you need? Be honest with yourself and don’t apologize for how you feel.

You may discover things along the way that don’t feel the way they once did. If so, either redirect the focus (for example, by saying, “can you touch me here instead?”) or if the experience has shifted your energy and you’re no longer in the mood, please speak up! Turning it into an obligation (either to yourself or a partner) creates a negative association for the future – a loop that doesn’t serve anyone. Instead, set a precedent that the journey is about exploration, connection, and pleasure. That mindset is more likely to get you excited for future romps.

Pour On The Self-Compassion And A Dash Of Courage

It’s important to listen to your gut about what feels right for you – while also recognizing there may be areas where you never feel fully ready.

On the other hand, you may actually need to push out of your comfort zone.

There’s a big difference between the reality of what has changed and the limiting beliefs we create for ourselves – the ones that tell us it won’t feel as good, that we don’t look as sexy, or that it isn’t worth trying.

Please don’t let fear be what holds you back from enjoying a rich, deeply satisfying relationship to your body and pleasure.

It might be helpful to get in the practice of asking yourself, “Who is talking right now?” Is it the voice of negativity? If so, kick it to the curb! Or is it your intuition telling you that you’re not ready? If so, change direction and find what does feel right.

Only you will know the answer.

For more expert advice on The 411 click HERE

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Kim Sedgwick is a sexuality educator, coach and co-founder of the Red Tent Sisters, a Toronto based practice that offers holistic fertility, sexuality + contraceptive solutions for every woman.

Kim cropped

Many of the challenges that couples face when trying to navigate a sexual relationship after breast cancer are based on assumptions and expectations about how sex should be.  Here are four common myths that can get in the way of reclaiming your sexual relationship, and tips on how to bust them.

Myth #1: Eventually sex will and MUST go back to “normal”

This common myth puts a lot of pressure on couples. This added pressure makes the discomfort and distress associated with sexual changes feel even worse, and can lead to feelings of frustration and resentment.  Hanging on to this myth also gets in the way of discovering new experiences.  Sexual relationships are constantly evolving, who we are sexually changes over the years, the definition of “normal” also evolves.

Myth Buster: Accepting that things are different

  • Acceptance means assessing the situation and developing realistic expectations about your current and future sexual relationship
  • Acceptance opens the door to new and exciting ways of being sexual
  • Acceptance also means acknowledging the grief and how you feel about the loss of your old sexual relationship (this can include loss of breasts, loss of certain sexual activities). It’s ok to be sad and miss these things.

Myth #2: Different means worse

Remember that you are in new territory here.  The landscape is different, your body is different, emotionally you are both different, and sex might never be exactly the way was before.  It’s important to acknowledge that yes, things will be different, but this doesn’t mean they can’t be as good – including sex!  A first step to busting this myth is to shift your thinking from “I will never be the same again” to “life will be different, and I have the resources I need to find new ways of satisfaction.”

Myth Buster: Flexibility and Persistence

  • Get creative! Be flexible and open to new experiences
  • Experiment with new sexual/sensual activities and ways of being physical
  • Try things a few times even when they feel new, awkward, or uncomfortable, and don’t give up because something didn’t work the first time

 Myth #3: Sex will spontaneously and effortlessly resume

Going through breast cancer and treatment takes a lot of physical and mental energy. It should come as no surprise that sex can take a back seat as your focus on your treatment and recovery. Many couples assume that with time they will seamlessly fall back into their natural sexual rhythm.  Time is often not enough; it’s what we do with this time that counts.  Think about it:  If you are an avid runner who breaks an ankle, you will likely be out of commission for a while.  Time alone will not magically fix your ankle; you need to work at it and gradually build up to running the way you were before.  Sex after breast cancer is no different.

Myth Buster: Back to Basics

  • Find new ways to connect and feel close…date, start a new activity together, make an active effort to spend more time together, learn new things about other
  • Ease back into sex. Communicate about expectations and comfort levels.
  • Take pleasure in getting reacquainted each other’s’ bodies

Myth Buster: Scheduling Sex

  • There will always be something keeping you busy, and it may seem like there is no room/time for your relationship. This is why scheduling is so important!
  • Think of scheduling as PRIORITIZING your relationship
  • The short- and long-term benefits of scheduling quality time together are worth this extra effort
  • Sex doesn’t need to be spontaneous to be great!!!

Myth #4:  If we aren’t having sex, physical affection is also off limits

Don’t assume that stopping sexual activity means stopping physical affection.  By the same token, don’t assume that physical affection always leads to sex.  Physical expressions of affection can be especially important when you aren’t having sex because it enhances feelings of closeness and intimacy

Myth Buster: Express Affection

  • Expressing affection is an important step towards finding your way back to sex
  • Physical expressions of affection can include kissing, cuddling, massages, holding hands, making out, heavy petting, prolonged foreplay, and engaging in non-penetrative sex
  • ALL expressions of affection count: Do the things that increase closeness and intimacy
  • What can you and your partner do to make each other feel good and/or attractive?
  • What are some day to day things that make you feel closer to your partner? (e.g when my partner brings me coffee in the morning, when my partner sends me a text in the middle of the day)

For more expert advice on The 411 click HERE!

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Kim Cullen is a PhD candidate in Clinical Psychology whose research and clinical work has been dedicated to enhancing the sexual health and wellbeing of women with cancer. Through her work and public appearances, she hopes to empower women to openly discuss the impact of breast cancer on their sexual quality of life and is an advocate for the development of available resources to address these issues. 

Kim C.

I’m staring at my Facebook feed, looking with rage at someone’s copied-and-pasted status update about breast cancer “awareness.” I walk away from my feed for a few minutes and pace my living room before sending a screenshot of the status to my best friend and expressing my feelings with colourful words.

This type of status is not helpful. It’s about making the person who posted it feel like they are doing something supportive while not actually doing anything substantive. It’s about making people without cancer feel better at the expense of people who do have it. The story turns a mirror on the non-cancer audience and says, “Make another person’s illness all about your own character development!” You also see this with memes involving disabilities: “Look at what this person with a disability is doing! What’s your excuse for not doing something-or-other?”

Barf.

As someone who both has gone through breast cancer and is disabled, I am not here to be anyone’s special learning moment and character development catalyst. Reducing someone to one aspect of who they are is dehumanizing. I am more than my cancer. I am more than my disability.

Post an emoji on your Facebook status with no context. Post a selfie with no makeup. We should have a feeling that this is all in good fun, according to those who spread these types of memes. Awareness campaigns need to be careful to do more than making someone without cancer feel momentarily good.

I didn’t get the memo that breast cancer is supposed to be fun. This mirth eluded me during multiple surgeries, hospital stays, chemo, Herceptin, radiation, and infections. Breast cancer wasn’t fun as I stared my mortality in the face for nearly two years and wondered if I was going to live to see my son grow up.

I still get to wonder that.

This blog post was inspired by the people who chimed in on a recent conversation on Rethink’s Young Women’s Network Facebook community group about how problematic these memes are. The consensus was that breast cancer memes trivialize our illnesses. We find such supposed awareness aggravating, upsetting, and offensive as people who live in the slog of breast cancer treatments and reality. The sentiments rarely share actual information about breast cancer; they do nothing to help those of us with this disease. And the way these ideas are generally spread, via cis women (cis referring to someone whose gender identity matches their gender assigned at birth) leaves out the reality that many cis men as well as genderqueer, nonbinary, trans, and two-spirited folks also get breast cancer.

A piece of advice next time you want to share a meme or join the conversation about something serious: don’t be guilt-tripped into thinking that you need to re-post because 93 per cent of people—a statistic that is often quoted in memes but never given a citation—won’t do it. Those who do have the condition you want to raise awareness of may be critical of something you copied and pasted. A sentiment in your own words might be a better choice.

We are beyond needing simple awareness about breast cancer. We all know breast cancer exists, and there is hardly anyone whose life hasn’t been touched by it in some way. Instead of spreading awareness memes, what can you do instead?

If you can afford it, donate to breast cancer charitable organizations like Rethink to help with breast cancer advocacy, education, research, and support. Until there are cures, we need these things. Make specific offers of help to people who have breast cancer, and pass on messages to others of what they can do as well.

Finally, I’ll share my plan, credit for which goes to fellow Rethink Breast Cancer community group member Jill W. for suggesting it. Going forward, whenever I see one of those breast cancer awareness memes, I’m going to post a factual, educational article on a breast cancer topic in response. You should do the same because we need to share education about breast cancer and move away from awareness.

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Beatrice Aucoin is a Calgary-based writer and breast cancer survivor. She is a mom to Sam and wife to Brett who is in the midst of a gender transition. Their journeys have tangled and intersected in unexpected but celebrated ways.

For a lot of people, December is filled with parties and social gatherings. If you are one of the brave ones throwing a holiday party this year, we have a couple of helpful tips to help you stay calm and enjoy yourself.

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A casual cocktail style party rather than a seated dinner leaves more room for mingling. Giving guests a larger window for arrival creates an “open-house” feel and implies that they are welcome to drop-in as they please, which can take away the stress of making it to all of your holiday engagements.

Utilizing Space

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Most people tend to congregate in the kitchen, therefore setting up a bar cart or drink station at the opposite end of your living space will help create a flow and avoid overcrowding in one area. Take advantage every square inch by using patio or balcony space for storing beverages. Might as well make good use of the chilly weather!

Simple & Elegant Decorations

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An abundance of decor can often make the room look cluttered and smaller, therefore it’s best to keep things simple if you are tight for space. String lights and hanging decor such as mistletoe or garland are great options.

Use Fresh + Seasonal Ingredients

n0pqessfyiu-neha-deshmukhUsing seasonal cocktail garnishes like cranberries, rosemary, or mint leaves add a festive touch without too much fuss. Candles in seasonal scents are also an easy way to add warmth and ambiance.

Make Your Life Simple

5xz2sytoyvq-annie-sprattDon’t always feel like you have to make everything from scratch. Mixing homemade with store bought items allow you to spend more time with your family and friends, which they will appreciate more than an extra apple pie.

For more on The List click HERE.