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Outcomes for Waikato Maori women diagnosed with breast cancer (February 2012)
Sentinel Node Biopsy Trials (February 2012)
BCS members enjoy inaugural Social Walk (January 2012)
BCS hosts inaugural Retreat for women (November 2011)
Outcomes for Waikato Maori women diagnosed with breast cancer
Reproduced with the kind permission of the Waikato Breast Cancer Trust.
Article written by Jenni Scarlet, Research Nurse, Breast Cancer Research Office, Waikato Hospital
Posted February 2012
Although our incidence of breast cancer is very similar to Australia, death rates from breast cancer are 20% higher in NZ.
In NZ, Maori women fare even worse, with a higher risk of developing breast cancer and a significantly poorer chanceof survival compared with non-Māori. In 2008, the death rate for Maori women was found to be significantly higher, at 31.8 per 100,000 women, compared to 17.9 per 100,000 for non-Maori.
The increased number of deaths from breast cancer among Maori women is particularly an issue for women younger than 60 years. Possible factors that may lead to worse outcomes amongst Maori include; later stage at presentation, more aggressive cancer biology amongst Maori, and/or inferior treatment compared with non-Maori. There is already a body of evidence indicating that later stage at presentation in Maori women plays a role. There is limited evidence to suggest that Maori women may have worse tumour biology with higher grade breast cancers and a possible higher frequency of
breast cancers that are HER2 positive – these subtypes of cancer are more aggressive.
Further research is required to examine the differences in the characteristics of breast cancer in Māori women diagnosed with breast cancer,the impact of breast cancer screening and any variations in recommended standards of care that may influence outcomes.We urgently need to identify areas where improvements can be made to reduce the inequalities in outcome for Maori, either through earlier diagnosis, improving access to breast screening and breast diagnostic facilities, and ensuring culturally appropriate and improved management and care of Maori women with breast cancer.
This is a project from the Waikato Breast Care Register data that a PhD student will undertake over the next three years.
Sentinel Note Biopsy Trials
Reproduced with the kind permission of the Waikato Breast Cancer Trust
Article written by Jenni Scarlet, Research Nurse, Breast Cancer Research Office, Waikato Hospital
Posted February 2012
Over 2500 women are diagnosed with breast cancer every year in NZ, most need surgery to remove the cancer. On top of that more surgery is often performed on the lymph nodes in the armpit to determine if the breast cancer has spread.
When the lymph nodes are affected, there is an increased likelihood that cancer cells have spread through the bloodstream to other parts of the body. Until recently, the standard way to determine if breast cancer cells had spread was to remove most of the lymph glands in the armpit (axillary clearance). This operation can cause varying degrees of ongoing pain, shoulder stiffness, upper arm numbness and arm swelling (lymphoedema).
The potential problems associated with axillary clearance led surgeons in Australia and NZ to try a new technique, called sentinel node biopsy, and a clinical trial was set up to prove that this technique would produce similar cancer outcomes, and with fewer side effects. Sentinel node biopsy involves finding and only removing the lymph nodes most closely related to the breast cancer.
The initial trial, called the “Sentinel Node biopsy versus Axillary Clearance”, or “SNAC” trial involved 1088 women from throughout Australia and NZ. Women in the SNAC 1 trial were randomly assigned to have their surgery based on either sentinel node biopsy or axillary clearance. Follow-up of women in the SNAC 1 trial continues so long-term cancer outcomes of both operations can be determined.
A second trial, SNAC 2 is currently underway. This is the first trial in the world that will determine whether sentinel node biopsy is also preferable for women with breast tumours that are larger or multiple. The Waikato is the lead NZ centre for both SNAC trials. There are a number of NZ centres for the second sentinel node biopsy trial (SNAC 2). These are North Shore, Palmerston North, Tauranga and Christchurch Hospitals.
Jenni Scarlet | Research Nurse
Breast Cancer Research Office, Waikato Hospital
BCS members enjoy inaugural Social Walk
Sunday 21 January 2012
This report from West Auckland Member Debbie
After weeks of rain over the Christmas holiday period it was with delight I woke up on Sunday, 21st January to a beautiful day with hardly a cloud in the sky.
At the civilised time of 9.30 am I met approximately 15 other ladies and their friends, husbands and support people at Cornwall Park for our inaugural social walk. We were also fortunate to be joined by a very friendly contingent from the Northshore Nordic walking group. Car parking was easy and the park was buzzing with walkers of all ages, sizes and levels of fitness.
After a quick discussion we all started out by walking along the Twin Oak Drive and then around the base of One Tree Hill. The vistas from many points along our walk were amazing including the crisply painted Pah Homestead surrounded by trees in Onehunga and the sparkling Manukau Harbour. For the keen (and somewhat fitter) members of our walk, who challenged themselves to walk up the summit of Maungakiekie (One Tree Hill), they had a perfect 360° view over Auckland City.
Within 40 minutes most of the group had finished their walk at a variety of speeds and depending on how much talking there was! We then shared a delicious morning tea on the verandah of Acacia Cottage which was built in 1841 and moved to Cornwall Park in 1920. This social walk was a great way to dust off my walking shoes and see in the New Year revisiting one of Auckland’s truly beautiful parks. What a special gift Sir John Logan Campbell made of Cornwall Park to the people of Auckland.
Thank you to everyone who came along and made this a special event. The weather was definitely on our side. I’d much rather walk and talk with a friend while I exercise than do it on my own. It is hoped we will have some more social walks as this was great way to catch up with other BCS people and with the bonus of seeing a new part of Auckland. If you have any suggestions of places we may have our next social walk from please email us with your suggestions!
A weekend of freedom, relaxation and fellowship
The BCS Retreat
Twenty one women attended the inaugural BCS Retreat held at the St Francis Retreat Centre in Auckland’s Hillsborough, enjoying two days of rest, relaxation and nurturing activities facilitated by Soul Path Journey practioners Misha Crosbie, Jessica Fleming, Elizabeth Crago and Elizabeth Meadows.
The women came from all parts of Auckland to attend, representing each of the six support groups and the ages ranged from 35 to early 70s.
For some sessions, attendees were grouped together according to age – the concerns and issues for young women aged 35-49 were different to those in the 49+ group. Younger women shared concerns over family and children and a ‘lack of nurturing’ for themselves as they are always ‘giving out’ to others. "A weekend like this lets women think about themselves,” said Misha. “Many have to leap out of bed every morning, fix breakfast, get children off to school ... this weekend offers them freedom to just walk in and have nothing to do.’
The Retreat is structured to take women on a nurturing journey of self discovery. The initial session takes place on the first evening where women bond with each other. Participants are asked to bring a ‘nurturing object’ to represent what 'nurturing' means to them. The objects are placed on a nurturing table and remain there for the duration of the Retreat, becoming lasting symbols to take home as reminders of the Retreat experience.
Women are asked to discover how they currently nurture themselves – and many are surprised to learn that they are not doing that very well, with family, work and other concerns taking precedence. On the Saturday evening, participants are invited to walk the labyrinth, a symbolic, meditative walking of the journey they find themselves on and the following day, the walking is discussed and shared.
At the conclusion of the Retreat, participants are asked to write a letter of commitment to themselves which the facilitators collect and post out 2/3 months after the Retreat. The re-entry back into life is discussed too because family and friends may not understand the Retreat process and skills to cope are outlined.
The focus of the Retreat was on self-nurturing and all women were offered sessions of therapies of Reiki and Jin Shin Jyutsu, modalities used widely in the USA – and becoming more popular here – as complements to conventional medical treatments. Participants were free to do whatever they wanted during the Retreat time- they could sleep, enjoy time at the creative table, walk the beautiful grounds, attend sessions .. or not. As co-organiser Misha Crosbie said, “’Should’ve’ has gone away to a conference for the weekend!”
Expected outcomes of the Retreat were that the women would feel looked after and treated with respect and nurturing, that they would have time to focus on themselves without feeling selfish or self-absorbed, that they would receive the opportunity to be with others on a similar journey in a relaxed and safe environment and be able to discuss spiritual and emotional aspects of their cancer journeys.
Retreat sessions provided venues for sharing and discussion, opportunities for listening to the stories of others, all shared with a generosity of spirit and honesty. In the telling, women gained hope, confidence and understanding. There was also an ongoing exchange of practical tips and information about treatments and side effects, reassuring for those about to begin chemotherapy or radiotherapy treatment regimes.
Comments from some of the women included: ‘It’s a real treat to have a break away from routines and focus on self healing and it’s great to meet others, sharing strengths and hopes.’
‘Having this time has been so valuable – it’s cozy and safe here.’
‘You just bond so quickly,” said one, “like sisters. It’s an extension of family.’
‘We put ridiculous expectations and pressures on ourselves – they are too great. This is something I’m learning.’
In the future BCS will consider holding an annual two-day Retreat, review the potential to host one-day Retreats and workshops, and discuss the need for more targeted support at specific stages of a woman’s journey with breast cancer.
"These are other forms of support that BCS could offer,” said BCS Chair Deirdre Parr, "and the need is definitely there."
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