Doctor-cancer survivor to recount her journey

Dr. Carolyn Kaelin had treated hundreds of women with breast cancer. But she changed roles when she found her own breast cancer during a monthly self-exam. There was a small area where the skin had pulled inward ever so slightly, forming a tiny dimple.

As many as 15 percent of breast cancers in the early stage don't show up on mammogram, although that remains the best tool for identifying and treating breast cancer at an early and treatable stage. That's why doing a self-exam is also important, said Kaelin, director of the Comprehensive Breast Health Center at Brigham and Women's Hospital at Harvard Medical School in Massachusetts.

Kaelin, the author of "Living Through Breast Cancer," will be featured Oct. 11, 7 p.m., at the Huntsman Cancer Institute's 2000 Circle of Hope in the sixth-floor auditorium. In her talk (admission is free, but reservations are required because of limited seating) she'll tell what she learned on her journey from physician to patient. Much of that centers on preserving your self-image while you're making sure you get the best care possible.

Even young women should be performing breast self-exams, ideally one week after the onset of menses when the hormones are lowest. At age 40, a mammogram should become an annual event. And Kaelin tells her patients that self-exam involves not only feeling for lumps and changes but observing, looking closely at the breasts, first with the arms at rest, then overhead, then on the waist and squeezing.

Women also can help themselves by paying attention to the lifestyle factors that seem to increase the risk of developing breast cancer, Kaelin said. Alcohol is one. The more one drinks the greater the risk.

Research also hints, though it's not yet conclusive, that people who maintain a healthy weight and who are physically active have a smaller chance of developing a first breast cancer than people who struggle with weight or are sedentary. It is clear that after treatment for breast cancer, those who are active and keep their weight down have a "markedly decreased chance" of developing a second breast cancer, she said.

"Physical activity doesn't require running a marathon or biking a century," Kaelin said. Walking three to five hours a week will do. "It's very attainable."

As for weight, those who gain 12 or fewer pounds during chemotherapy have fewer relapses than those who gain 13 or more pounds. "Those who are able to maintain a healthy body-mass index are less at risk for a relapse than those who continue to gain weight," she said.