Older women were more satisfied with the physical appearance of their breasts long-term when their breast cancer was treated with less radiation. Although the study found reduced radiation was associated with a slightly increased risk of disease recurrence.

This came from the first study evaluating patient-reported cosmetic outcomes in a population-based cohort of older women by The University of Texas MD Anderson Cancer Center

The findings, presented at the 2016 San Antonio Breast Cancer Symposium in a poster session by Cameron W. Swanick, M.D., should serve as an important discussion point between older patients and their physicians when making treatment decisions.

Like younger patients, older women with early stage breast cancer often have several treatment options, including:

• lumpectomy and whole breast irradiation (Lump + WBI);

• lumpectomy plus brachytherapy (Lump + Brachy);

• lumpectomy alone (Lump alone);

• mastectomy without radiation (Mast alone); and

• mastectomy plus radiation (Mast +RT).

However, cosmetic and other quality of life outcomes associated with these treatment options have not been compared in this age population.

“There’s very little in the literature regarding older patient-reported outcomes – either they were not included in previous studies, or were not asked about their cosmetic satisfaction” says Swanick.

The study builds on research published in 2012 by Benjamin D. Smith, M.D., which found that accelerated partial breast irradiation (APBI) brachytherapy is associated with higher rate of later mastectomy, increased radiation-related toxicities and post-operative complications, compared to traditional WBI.

“Despite the findings, brachytherapy advocates felt strongly that patients were happy with their outcomes. It was important for us to take a different methodology to learn from the patient experience and determine their preferences,” says Smith, associate professor, Radiation Oncology.

Swanick and Smith used Medicare claims to prospectively identify women 67 or older and diagnosed with non-metastatic breast cancer in 2009.

The women must have received one of five treatment options and were alive in 2015. From this cohort, 1,650 patients (330 patients per local therapy) were randomly selected. Potential participants were mailed a survey designed using several validated instruments to assess cosmetic satisfaction in breast cancer patients.

Using Lump +WBI as the reference group, as it’s the most widely accepted as standard of care, cosmetic satisfaction scores were higher for Lump + Brachy and Lump alone. Looking at the two mastectomy groups, patients who had Mast +RT reported significantly worse cosmetic outcomes compared to Lump and WBI. There was no difference between Lump + WBI and Mast alone in this cohort.

Patients also reported if their breast cancer had recurred. A small but statistically significant number of patients, six percent, reported recurrences in the Lump + Brachy and Lump alone cohort, compared to patients treated with Lump and WBI.

Given their previous findings, the researchers were surprised that Lump + Brachy performed so well, but noted the higher incidence of recurrence. These findings show that, overall, the less radiation given, the better for the long-term cosmetic satisfaction of the patient, say the researchers.

To that goal, Smith is launching a radiation study looking at two-to- two-and-a-half weeks of treatment of external beam treating a large area surrounding the tumor bed.

“These are important data to discuss with patients, because some women may accept a higher local recurrence risk in exchange change for better cosmetic satisfaction,” says Swanick.

A visit to the ER can be especially stressful. It may go more smoothly if you can take along:

• Your health insurance card or policy number
• A list of your medications
• A list of your health problems
• The names and phone numbers of your doctor and one or two family members or friends.

Some people find it helpful to have this information with them at all times.

You may have to wait for a long time in the ER to see a doctor. Taking something to read and a sweater in case the room is cold can make the wait more comfortable.

The Ventura Choraliers is a group of people who love to sing.  They rehearse every Tuesday 2:00 to 4:30 p.m at VACE  (Ventura Adult and Continuing Education) at 5200 Valentine Road, Ventura, Room 104. They would like to invite you to sing with them.  It’s great fun and very friendly. Choraliers perform at senior facilities as well as various women’s clubs, etc.  All of the songs are well known and easy to sing.   For more information call  Betty White, 323-5927.

Livingston Memorial Visiting Nurse Association supports the total well-being of our community.  As part of their services, they host free monthly education classes throughout the county which include the following in Ventura:

Adult Bereavement Support Group Wednesdays, February 1, 8, 15, 22, from 6:30-8:00 pm.    These groups are open to individuals who have experienced loss and are free of charge.

Newly Bereaved Support Group Thursday, February 9th from 6-7:30pm.  This monthly group is designed for adults who have recently experienced the loss of a loved one and is free. Call 642-0239 for more information or email [email protected].  These groups meet every 2nd Thursday of each month.

Diabetes Classes: Tuesday, February 7th from 1-2:30pm.  These meetings are held on 1st Tuesday of each month.  General information is provided about Type 2 Diabetes including prediabetes, with emphasis on meal planning, medication, exercise, blood sugar monitoring, and new developments in diabetes.

Joint Replacement Classes: Thursday, February 2nd from 1:00-2:00pm. You will learn what to expect before, during and after knee or hip replacement surgery and how to be an active participant in your care. These meetings are 1st Thursday of each month.  For information or to RSVP call Dinah Davis at  642-0239 ext. 739.

February 13th for both English and Spanish speaking.  English 4:00-5:00 pm and Spanish 5:30-6:30 pm. You will learn what to expect before, during and after knee or hip replacement surgery and how to be an active participant in your care.  For information or to RSVP call Dinah Davis at  642-0239 ext. 739.

Held at Livingston Memorial Visiting Nurse Association office, 1996 Eastman Ave., Suite 109

A good night’s sleep can make a big difference in how you feel. Here are some suggestions to help you.

Follow a regular schedule. Go to sleep and wake up at the same time, even on weekends. Sticking to a regular bedtime and wake time schedule helps keep you in sync with your body’s circadian clock, a 24-hour internal rhythm affected by sunlight.

Try to exercise at regular times each day. Exercising regularly improves the quality of your nighttime sleep and helps you sleep more soundly. Try to finish your workout at least three hours before bedtime.

Try to get some natural light in the afternoon each day.

Be careful about what you eat. Don’t drink beverages with caffeine late in the day. Caffeine is a stimulant and can keep you awake. Also, if you like a snack before bed, a warm beverage and a few crackers may help.

Don’t drink alcohol or smoke cigarettes to help you sleep. Even small amounts of alcohol can make it harder to stay asleep. Smoking is dangerous for many reasons, including the hazard of falling asleep with a lit cigarette. Also, the nicotine in cigarettes is a stimulant. Surprisingly cannabis has been known to help people who suffer with sleep disorders, such as insomnia to get a better night’s sleep. Certain types of cannabis strains and extracts have helped people get the best night’s sleep that they are so desperately craving. You can Visit this website if this is something that you would like to learn more about.

Create a safe and comfortable place to sleep. Make sure there are locks on all doors and smoke alarms on each floor. A lamp that’s easy to turn on and a phone by your bed may be helpful. The room should be dark, well ventilated, and as quiet as possible. If you currently sleep on a mattress that is not as comfortable as you would like, you can always look into a company like Leesa, who provide high quality bedding and help you get the best sleep, every night.

Develop a bedtime routine. Do the same things each night to tell your body that it’s time to wind down. Some people watch the evening news, read a book, or soak in a warm bath.

Use your bedroom only for sleeping. After turning off the light, give yourself about 15 minutes to fall asleep. If you are still awake and not drowsy, get out of bed. When you get sleepy, go back to bed.

Try not to worry about your sleep. Some people find that playing mental games is helpful. For example, think black — a black cat on a black velvet pillow on a black corduroy sofa, etc. Or, tell yourself it’s five minutes before you have to get up and you’re just trying to get a few extra winks.

If you are so tired during the day that you cannot function normally and if this lasts for more than 2 to 3 weeks, you should see your family doctor or a sleep disorders specialist.

by NCOA

For most older adults, good health ensures independence, security, and productivity as they age. Yet millions struggle every day with health and safety challenges such as chronic disease, falls, and mental health issues—all of which can severely impact quality of life.

Approximately 92% of older adults have at least one chronic disease, and 77% have at least two. Four chronic diseases—heart disease, cancer, stroke, and diabetes—cause almost two-thirds of all deaths each year.

Chronic diseases account for 75% of the money our nation spends on health care, yet only 1% of health dollars are spent on public efforts to improve overall health.

Diabetes affects 12.2 million Americans aged 60+, or 23% of the older population. An additional 57 million Americans aged 20+ have pre-diabetes, which increases a person’s risk of developing type 2 diabetes, heart disease, and stroke. In a 2007 Centers for Disease Control and Prevention program for people at high risk for developing diabetes, lifestyle intervention reduced risk by 71% among those aged 60+.

90% of Americans aged 55+ are at risk for hypertension, or high blood pressure. Women are more likely than men to develop hypertension, with half of women aged 60+ and 77% of women aged 75+ having this condition. Hypertension affects 64% of men aged 75+.

Every 15 seconds, an older adult is treated in the emergency room for a fall; every 29 minutes, an older adult dies following a fall.

Among older adults, falls are the leading cause of fractures, hospital admissions for trauma, and injury deaths. Falls are also the most common cause of older adult traumatic brain injuries, accounting for over 46% of fatal falls.

The nation spends $30 billion a year treating older adults for the effects of falls. If we cannot stem the rate of falls, it’s projected that direct treatment costs will reach $59.6 billion by 2020. A quarter of hip fracture patients will be in a nursing home for at least a year, further adding to Medicaid costs.

One in four older adults experiences some mental disorder including depression and anxiety disorders, and dementia. This number is expected to double to 15 million by 2030.

Depression affects seven million older Americans, and many do not receive treatment.

Two-thirds of older adults with mental health problems do not receive the treatment they need. Current preventative services for this population are extremely limited.

Untreated substance abuse and mental health problems among older adults are associated with poor health outcomes, higher health care utilization, increased complexity of the course and prognosis of many illnesses, increased disability and impairment, compromised quality of life, increased caregiver stress, increased mortality, and higher risk of suicide.

People aged 85+ have the highest suicide rate of any age group. Older white men have a suicide rate almost six times that of the general population.

NCOA leads several collaborative efforts that are designed to empower older adults to live healthier lives. NCOA’s Center for Healthy Aging connects community organizations with evidence-based programs that help older adults learn how to manage chronic disease, improve their behavioral health, stay physically active, eat well, and more.

To learn more about the National Council On Aging (NCOA) visit https://www.ncoa.org/.

Passengers an ambitious attempt but fails to deliver (3 palm trees)
by Richard Lieberman

Latest science fiction movie with a blockbuster budget, and starring two of the biggest names in Hollywood, Jennifer Lawrence and Chris Pratt. Not just about a space romance, but a movie that tries to challenge you, and does at first only to sink into more predictable, safe version of Hollywood’s vision of the space genre.

Written by Jon Spaihts and directed by Morten Tyldum, Passengers is about 5000 humans traveling from Earth to a new planet, a trip that will take 120 years of space travel. Something goes wrong and only 30 years into the journey one of the suspended animation pods mysteriously opens, condemning Jim (Chris Pratt) with 90 years of space travel and no way to re-enter suspended animation. He can’t go back to sleep, there is no help available and he will die long before the ship reaches its destination.

That is the first engaging dilemma Passengers  hits us with. How would you handle this?, How would you spend the time?,  Could you adjust to the  inevitability of spending the rest of your life alone, on a sterile ship. Would you make the same decision Jim does?

After a year on the ship after awakening exhausting every available option, Jim becomes so lonely he decides to awaken another passenger. The passenger a young woman he has been obsessing about for some time named Aurora, played by Jennifer Lawrence. Waking Aurora is the same as murdering her, already in her 30s, she won’t live another 90 years until they reach their destination. Jim is aware of this, but wakes her anyway. After waking her he lies to her claiming it was a malfunction of the suspended animation pod.

All this occurs in the first act of the movie so I am not spilling all the beans. This decision however is the core of the movies premise. It is a selfish act, and now he has condemned Aurora because of his loneliness.

Whatever you feel about so horrible an act Passengers is centered on this cruelty. The fact that the movie so early on centers on this cruel act almost makes the movie interesting on its own. Few Hollywood movies of this size and scope would ever touch a moral dilemma like this.

The problems with Passengers begins almost at the moment he wakes her up, the film wants us to root for the couple to be together. Jim’s lie should have cast a bigger shadow over his and Auroras relationship, but it doesn’t. It just feels all kind of wrong when you already know what Jim has done. His action gets a big moment, but then just forgotten.

Disappointing and swaying from the original premise the film does not explore the fascinating facts about 5000 fellow human beings who have embarked a vast journey. We are left with no in depth knowledge about the how’s and whys of such a journey. What is their plan? Unfortunately we never really find out. rated PG13

Help and Hope is a program for people in the early stages of Alzheimer’s disease or related dementia and their partners, providing essential information to promote quality of life and family health. Help and Hope offers four modules over a two-day program (Feb.25 and March 25 from 10 a.m. to 2 p.m.), delivered in a combination of presentations from experts, handouts, Q&A, discussions and exercises.

Topics include overview of diagnosis, communication strategies, legal and financial planning, treatment options, community resources and stress-relieving strategies. There is no charge for participation. Registration is required. For more information, please contact Monica Schrader at 494.5200, Ext. 101 or [email protected]. A program of the Alzheimer’s Association California Central Chapter, co- sponsored by and presented at the Camarillo Library.

Also on Saturday, February 4th  from 10:00 a.m.—noon at  St. Demetrios Greek Orthodox Church located at 5575 Santa Rosa Road, Camarillo. There will be a special presentation about Alzheimer’s disease. Learn about the difference between normal aging and Alzheimer’s. What to do if you suspect memory loss and how to maneuver through the disease. Presented by Monica Schrader from the Alzheimer’s Association and a guest panel (two physicians, one pharmacist, and a caregiver). Refreshments provided. Free event. Call  494-5200 to RSVP by February 1st.

by Lori Harasta, with excerpts from https://healthfinder.gov

Caregivers are vulnerable.  It is stressful work, both physically and mentally.

About 1 in 3 Americans are caregivers. Most caregivers also have other jobs and spend an average of 24 hours a week caring for a loved one.

Caregivers are more at risk for colds and the flu. They are also more likely to have long-term health problems, like arthritis, diabetes, or depression.

You may be a stressed caregiver if you feel angry, sad or overwhelmed, feel as if you don’t have time to care for yourself, or you are eating and/or sleeping too much or too little. The good news is that you can lower your risk for health problems if you take care of yourself and get support.

Find out about professional and volunteer services that can help:

• Transportation, meals, care management, fall prevention, caregiver support groups:  Ventura County Area Agency on Aging http://www.ventura.org/vcaaa, or call 477-7300.
• Respite services to give you a break from caregiving are available through Livingston CareGivers.  For more information, call  642-9570
• Ventura Caregivers has volunteers who can help 2-4 hours per week for low income seniors.  Call  658-8530.
• If you are caring for a veteran, call the VA Caregiver support line:  855-260-3274
• If you are caring for someone with Alzheimer’s or other dementia, call 800.272.3900.
• Livingston has a caregiver support group in Ojai.  Check the calendar:  http://lmvna.org/calendar/index.html, or call 642-0239.

If you are feeling overwhelmed, talk with your doctor about depression.

Take care of your body:

Making smart food choices will help protect you from heart disease, bone loss, and high blood pressure.

Being active is not only good for the body; it is a great stress reducer. Aim for 2 hours and 30 minutes a week of moderate aerobic activity, like walking fast or dancing.

Take steps to prevent back pain, like keeping your back straight and bending your knees when you lift something heavy, doing shoulder rolls, and engaging your stomach muscles to counter “computer hunch”

Make sure you get enough sleep. Most adults need 7 to 8 hours of sleep each night.

Manage mental stress:

Start by taking a few slow, deep breaths.

Do something for yourself. Spend time reading, listening to music, or talking to a friend.

Ask a neighbor to visit with your loved one while you take a walk.

Get support from others to help you cope with the emotional stress of caregiving.

Ask for help.  You don’t need to do it all yourself. Ask family members, friends, and neighbors to share caregiving tasks.

Don’t let the role of caregiver rob you of the relationship role you once had with your loved one, whether it be spouse, child, or dear friend.  Take care of yourself and ask for help!