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New Beginnings/ Old Friend

This  morning I saw Philadelphia native and award-winning photographer Bill Aron discusses his latest book, which celebrates the will to live and triumph over cancer. New Beginnings: The Triumphs of 120 Cancer Survivors follows 120 men, women, and children who vary in age, ethnicity, and diagnosis, but who all decided that the words “you have cancer” were the start of a new beginning, not an end to their lives. The book is a project by and for cancer survivors: their words, Aron’s photographs.

When I got the email about the program from the Gershman Y, I emailed Bill and asked if he was the Billy Aron whom I knew in the mid 60’s. Sure enough he was at Penn when I was at Temple and we hung around with the same crowd for several years. He showed slides of the images in the book and told highlights of stories that were both touching and inspiring. I bought the book and look forward to reading it cover to cover.





The Best Protection Is Early Detection

imagesAnnual mammograms made finding my cancer easier because it was small and not as invasive as it could have been. Get your annual mammogram and be safe!

Here is a history of the pink ribbon:

From the beginning, the pink ribbon connoting breast cancer awareness has been embroiled in controversy. Today, some members of the movement wear it proudly, giving thanks for both the symbol and its attendant charity-dollar largesse. Others hate it with a passion. But to much of the media and the world at large, the ribbon is the breast cancer movement. Where did the ribbon come from, where is it going, and what has it meant along the way?

The merging of the ribbon and symbolism in this country came about in two huge leaps. The first occurred in 1979, the year that Penney Laingen, wife of a hostage who’d been taken in Iran, was inspired by song to tie yellow ribbons around the trees in her front yard. The ribbon, Americans were told on the nightly news, signaled her desire to see her husband home again. For the first time, ribbon became medium, ribbon became message. Yellow ribbons sprouted up across the country in solidarity. That was step one.

Step two occurred 11 years later, when AIDS activists looked at the yellow ribbons that had been resurrected for soldiers fighting the Gulf War and said, “What about something for our boys dying here at home?” The activist art group Visual AIDS turned the ribbon bright red—“because it’s the color of passion”—looped it, spruced it up and sent it onto the national stage during the Tony awards, photogenically pinned to the chest of actor Jeremy Irons.

Ribbons had arrived. Overnight, every charitable cause had to have one. After just a short time, they were so ubiquitous that The New York Times declared 1992 “The Year of the Ribbon.”

The stage was set for the evolution of the breast cancer ribbon.

First on the scene was the Susan G. Komen Breast Cancer Foundation. Komen had been handing out bright pink visors to breast cancer survivors running in its Race for the Cure since late 1990. In fall 1991, mere months after Irons’ electrifying appearance, the foundation gave out pink ribbons to every participant in its New York City race. This first use of the ribbon, though, was for Komen just a detail in the larger and more important story of the race. To really break out, the pink ribbon would need a situation in which the ribbon was the event.

And it didn’t take long for that situation to arrive. Early in 1992, Alexandra Penney, then the editor in chief of Self, was busy designing the magazine’s second annual Breast Cancer Awareness Month issue. The previous year’s effort, inspired and guest edited by Evelyn Lauder—Estée Lauder senior corporate vice president and a breast cancer survivor—had been a huge hit. The question was, how to do it again and even better. Then Penney had a flash of inspiration—she would create a ribbon, and enlist the cosmetics giant to distribute it in New York City stores. Evelyn Lauder went her one better: She promised to put the ribbon on cosmetics counters across the country.

Penney recalls the birth of the ribbon now from her office at Ziff-Davis. “You know how it is when things are in the air,” Penney says.

“A week later Liz Smith wrote about a woman who was already doing a peach-colored ribbon for breast cancer.” The woman was 68-year-old Charlotte Haley, the granddaughter, sister, and mother of women who had battled breast cancer. Her peach-colored loops were handmade in her dining room. Each set of five came with a card saying: “The National Cancer Institute annual budget is $1.8 billion, only 5 percent goes for cancer prevention. Help us wake up our legislators and America by wearing this ribbon.”

Haley was strictly grassroots, handing the cards out at the local supermarket and writing prominent women, everyone from former First Ladies to Dear Abby. Her message spread by word of mouth. By the time Liz Smith printed her phone number, Haley had distributed thousands.

Then Self magazine called.

“We said, ‘We want to go in with you on this, we’ll give you national attention, there’s nothing in it for us,” Penney says. Even five years later, her voice still sounds startled by Haley’s answer. “She wanted nothing to do with us. Said we were too commercial.”

At the end of September 1992, Liz Smith printed a follow-up to Haley’s story. She reported that Estee Lauder had experienced “problems” trying to work with Haley, and quoted the activist claiming that Self had asked her to relinquish the concept of the ribbon. “We didn’t want to crowd her,” Penney says. “But we really wanted to do a ribbon. We asked our lawyers and they said, ‘ Come up with another color.”

They chose pink.

There are many choices to be made after you decide “pink ribbon.” According to C.M. Offray and Son, the largest ribbon-makers in the world (they supply the ribbon on which Olympic medals are hung), ribbons come in three basic styles: woven, grosgrain and craft, each with its own variations. Given the plethora of decisions that had to be made in designing October’s surprise, it’s startling that hue wasn’t one of them.

“There are so many different shades, but it would have been our ‘150 pink’—basic, standard pink,” says Ellie Schneider, vice president of publicity and public relations for Offray, when the ribbon is mentioned. “It’s pretty, a pastel pink without being too washed-out or powdery-looking. It’s one of our best-selling colors. It’s been in our line forever.”

Because Estée Lauder and its corporate philanthropy, the Breast Cancer Research Foundation, did not respond to repeated requests for interviews, we don’t know who exactly ordered the 150 pink in grosgrain. Penney recalls only that Estée Lauder made all the manufacturing choices, leaving her to publicize the promotion and edit the accompanying issue of her magazine.

What we do know is that because of Haley’s ribbon, Self and Estée Lauder had traded in a color that was merely peachy for one that was an icon, a semiotic superstar.

“Pink is the quintessential female color,” says Margaret Welch, director of the Color Association of the United States. “The profile on pink is playful, life-affirming. We have studies as to its calming effect, its quieting effect, its lessening of stress. [Pastel pink] is a shade known to be health-giving; that’s why we have expressions like ‘in the pink.’ You can’t say a bad thing about it.” Pink is, in other words, everything cancer notably is not.

NABCO’s executive director, Amy Langer, told The New York Times Magazine in 1996 that breast cancer, unlike other health threats to women, was “loaded”: “It’s about body image, it’s about nurturing—it’s certainly about femininity,” she was quoted as saying. For women who feel this way, who experience cancer as predominantly a loss of womanhood, what better color to pin on than pink—girlie, pretty, healthy pink?

In fall 1992, Estée Lauder makeup counters handed out 1.5 million ribbons, each accompanied by a laminated card describing a proper breast self-exam. They collected over 200,000 pink ribbon petitions urging the White House to push for increased funding for research.

Within a year, Charlotte Haley’s loop of peach ribbon was history.

At the same time that the pink ribbon was becoming a national symbol, a sea change was taking place in American boardrooms. Beginning in the mid-1980s, the corporate world was discovering cause-related marketing. Carol Cone, founder of Cone Communications, was a major force in this development. Research underwritten by her small Boston-based public relations firm proved that, given the same cost and quality, more than half of consumers would switch from a particular store or brand to one associated with a good cause. Armed with this data, Carol Cone set out to teach America how to do well by doing good. In the late ’80s, she engineered Reebok’s successful adoption of the human rights issue. And in 1993, she set about helping Avon cosmetics stake out a claim on breast cancer.

“The challenge for Avon at the time was creating a unique program,” Cone says. By her count, there were already 15 medium-to-large companies, including fellow cosmetics titan Estée Lauder, involved with this issue. Avon’s new campaign would have to push away from that pack but hold tight to the signifiers of breast cancer.

The fulcrum that made this maneuver possible was the pink ribbon. About two inches long, the original Avon pink ribbon is a weighty and formidable piece of jewelry, half pink enamel and half gold cast, winced in the middle by a flowering gold rose. It—and a smaller, more circumspect lapel pin, developed so men would feel comfortable wearing the symbol—retails for $2. The pink signaled breast cancer, but the addition of the color gold and the rose are distinctly Avon. In its first two years, the pin raised $10 million. Aprés pink pin, lé deluge.

In 1993, the October after Avon’s launch, Estée Lauder introduced a heart-shaped compact with an enameled pink ribbon design, profits to go to its Breast Cancer Research Fund. The Susan G. Komen Foundation began offering a pink rhinestone brooch. Carolee Jewelry designed another one—a female runner in midstride, flowing loop ribbon in hand. Nightshirts, angel statuettes, teddy bears, sports clothes, credit cards, Daytimers all hit the market and, with increasing speed, other companies joined in, each offering its own version of the traditional ribbon. December 1996 found the New York Times Magazine labeling breast cancer “this year’s hot charity.”

“Today there are 80 to 100 companies involved, and that’s only the ones big enough to get on your radar screen,” Cone says. Without pausing, she casually prognosticates about “the next 100 companies to get involved with breast cancer.”

She and the Times agree on the source of the disease’s peculiar popularity in corporate America. It is a quality that the breast cancer awareness ribbon both captures and enables. “Companies want to support breast cancer,” Cone says simply. “Breast cancer is safe.”

Unlike AIDS, breast cancer is free of what companies euphemistically call “lifestyle issues.” And, perhaps as importantly, breast cancer provides charitable credentials for what can be a very small investment. With the ribbon’s message of ”awareness” translating most often into a familiarity with early detection techniques, all a company has to do, to do good, is put a ribbon on its merchandise.

New Balance, for example, donates money from the sale of its Race for the Cure caps, socks and T-shirts to the Komen Foundation, but its pink ribbon sneakers, a Foundation spokesperson says, are ”just for awareness.” The sneakers have the tiny pale-pink outline of a ribbon sewn onto the corner of their tongues—difficult if not impossible for anyone except the owner to see. The possibility that those two wan loops might remind woman to get the mammogram that saves her life, however, provides the sneakers with their raison d’étre.

It is this dynamic that drives the pink ribbon’s detractors to distraction. “There is a value to awareness, but awareness of what, and to what end?” asks Barbara Brenner, activist and executive director of Breast Cancer Action (BCA) in San Francisco. “We need changes in the direction the research is going, we need access to care—beyond mammograms—we need to know what is causing the disease, and we need a cure. The pink ribbon is not indicative of any of that.”

Of course, not everyone in the breast cancer movement thinks that commercial benefit is bad. “Avon has used the symbol to touch people’s hearts and put money back into the cause,” says Beverly Baker, executive director of the Mautner Project for Lesbians with Cancer, which receives pink ribbon funding. “I certainly wouldn’t take issue with that.”

Between 1991 and 1996, federal funding for breast cancer research increased nearly fourfold to over $550 million. And according to the American Cancer Society, the percentage of women getting annual mammograms and clinical breast exams has more than doubled over the last decade. While the Komen Foundation lost out on patenting the ribbon, it has collected millions from companies that use it and donate the proceeds. Avon, which has raised $25 million purely from merchandise, is today the largest private funder of community-based nonprofit breast cancer programs.

But signs abound that the reign of today’s ribbon is waning. When the fashion industry took on breast cancer, they made their own symbol, a blue bull’s eye, which is now in six countries. Groups on the West Coast substitute the more “powerful” purple loop. In Canada, BCA Ottawa has turned the loop upside down, for the tears shed at diagnosis and lined it with black, to remember women who have died. San Francisco’s BCA has a white-on-black button that reads “Cancer Sucks.”

For those who, like Barbara Brenner, see the pink ribbon as a red herring—and the 44,000 women dying of breast cancer each year can ill afford the distraction—the decline of the pink ribbon comes none too soon. “We have to question our willingness as cancer organizations to get into bed with people whose ultimate goal is profit, not health,” Brenner says. And her point—that corporate benevolence is linked with the appearance of care rather than active solutions—is supported by history. After all, homelessness was the darling corporate cause once, in the years before welfare reform.

Reprinted from MAMM, June/July 1998

The Merry Month of May

May is the 3rd anniversary of my discovering I have breast cancer so I end up having my annual check up and mammogram in May. Nervous time as you can well imagine!! I finished my mammogram, seeing Dr. Dahlia Sataloff, my surgeon and Dr. David Mintzer, my medical oncologist. Luckily, everything is okay. My mammogram was the same as last year- no change is very good!! All doctors are happy and so am I.

I urge everyone to get a baseline mammogram if you have never had one and get annual check ups and mammograms. Early detection helped me to discover a lobular invasive tumor that was small enough that I did not need chemotherapy but just a lumpectomy and radiation. I am taking Tamoxifen for the recommended 5 years.

Now I try not to think about it for another year!

In The Midddle of the NIght

For the last week, I have been getting up in the middle of the night. Nothing is really on my mind- nothing that I wake up thinking about. I am just up. Anywhere between 3- 5 AM. Unusual for me. I am a sleeper and, though I do not go to bed early, I like to sleep late. Finally this week, I realized that my anxiety (which is what wakes me up between 3- 5 AM) is about the annual mammogram I am scheduled for on May 5.

This is the third year since my diagnosis and treatment for lobular cancer in my right breast. I had radiation for 8 weeks at Lankenau Hospital with Dr Marisa Weiss after surgery at Pennsylvania Hopsital with Dr Dahlia Sataloff. My oncologist is Dr David Mintzer at Pennsylvania Hospital. May is my check up month and I have appointments later in the month with Sataloff and Mintzer.

No doubt that I am nervous about the test. My body tells me so by waking me up. But mammograms save lives, find cancer early and are necessary for good health.I just hope all is well and they find nothing. Then I can sleep through the night for another year!

Carpe Diem Brown


Diem Brown, who died in mid November at the age 32, wasn’t just a reality TV star. She was a very real, very inspiring face of cancer for many people. At the age of 23,  she announced in her first appearance on an MTV reality show that she had ovarian cancer.

Between her honesty throughout her seven seasons of MTV’s The Challenge and her openness through blogs, social media, YouTube, and the like, she will be remembered for her strength and as well as her willingness to inform people of her experience by taking them on her cancer journey with her. She became an advocate for cancer patients and established Medgift, an online gift registry enabling those with medical troubles to seek financial help as well as physical and emotional support.

I did not know about her before she died but I was struck that this woman got ovarian cancer at a very young age, fought such a personal valiant battle for nine years as well as did so much good for others. Right before she died, she tweeted, “My doctors are seemingly giving up but I won’t & can’t rollover. Whatever option I have to LIVE. I’m grabbing!”

Not only was she beautiful, she was brave and caring. She’s my hero!

An Uplifting Project



October is Breast Cancer Awareness Month. The chance of a woman having invasive breast cancer during her life is about 1 in 8. Ashkenazi Jews have an even higher incidence of breast cancer than the general population. But breast cancer is no longer an automatic death sentence. With early diagnosis and new treatments, there are now more than 2.8 million breast cancer survivors in the United States.

The recent recommendations based on a population-based study published in Proceedings of the National Academy Sciences urge all Jewish women of Ashkenazi descent to be tested for mutations on the BRCA 1 and 2 genes that are associated with a higher risk of breast cancer. Leading oncologist Prof. Tamar Peretz, Interim Director General of Hadassah Medical Organization and Director of Hadassah’s Sharett Institute of Oncology in Israel, rejects universal testing:

“Jewish women without a family history of breast and ovarian cancer should not feel pressured to undergo the BRCA test for breast and ovarian cancer. The implications of the BRCA test are complex. Many women will get results without being able to discuss them with a qualified clinician. I fear that without using discretion in administering this test, and without coupling it with genetic counseling by an experienced health professional, the search for BRCA gene mutations can harm more lives than it saves.”

“As for the recommendation by certain scientists that Jewish Ashkenazi women be tested by age 30, we know that many Jewish women aren’t married by age 30, and if they are, few have completed their childbearing years. Prophylactic removal of a woman’s ovaries and breasts can have a devastating impact on her life. We have not yet determined that the psychological burden of knowing outweighs the risk of discovering this gene later.”

“Jewish women without family histories should make use of other examination modalities, in addition to avoiding obesity and heavy drinking, two factors linked with breast cancer.”

Hadassah Medical Organization was the first to conduct the BRCA tests on Jewish women, along with the National Institutes of Health (NIH), in 1995, confirming that postulated prevalence of the gene mutation in the Ashkenazi community, which includes approximately three million women living in the United States. In all, one in forty Jewish women and men carry a mutation on one of the BRCA genes, as compared to one in 345 men and women in the general population.

Hadassah has a new initiative called the Uplift Project: Supporting Breast Cancer from A to DD. People submit decorated bras. Learn more about it: The Uplift Project

October is Breast Cancer Awareness Month!

October is Breast Cancer Awareness Month, which is an annual campaign to increase awareness of the disease. While most people are aware of breast cancer, many forget to take the steps to have a plan to detect the disease in its early stages and encourage others to do the same. We have made a lot of progress but still have a long way to go and need your help!

Think Pink, Live Green is a way of living that aims to help women reduce their risk of breast cancer or the disease coming back in survivors. It’s also a way for women living with advanced disease to make the healthiest choices possible. One of the most important involves sleep!


Here is an article by Dr. Marisa Weiss from

Researchers are discovering that sleeping problems can cause weight gain, and being overweight can cause sleeping problems. It’s a vicious cycle. That’s why both getting enough Zs and maintaining a healthy weight are important to your overall health — plus they also help reduce the risk of breast cancer and speed recovery after treatment for the disease.

Those of us with breast cancer, now or in the past, often have sleep troubles. Plus, many of us were already overweight before diagnosis and then gained more weight through and beyond breast cancer treatment. Big surgeries and being under anesthesia for a long time cause pain, disrupt our body’s normal schedule, and decondition our muscle, heart, and lung function. Steroids during and after chemo can make us hungrier and put on more weight. Chemo can change our taste buds and make us crave high-calorie comfort foods. Plus, eating can temporarily soothe the uncomfortable emotions that go along with a breast cancer diagnosis: uncertainty, anxiety, anger, and depression. These are all very mean side effects of an already very upsetting situation.

But we’re not alone: two-thirds of American adult women are considered overweight or obese. This statistic goes hand in hand with the decline in sleep in America. In the last 50 years, the average daily time we sleep has dropped by 1.5 to 2 hours. A recent study found that more than 30% of participants said they got less than 6 hours sleep per night. Sometimes that’s by choice, but usually not. Another large study found that about 1 in 5 people suffer from a sleep disturbance (such as a newborn baby waking them up or constant jet lag). Nearly 1 in 10 had a medical sleep disorder such as insomnia or obstructive sleep apnea.

As with any cycle, you probably wonder which came first: being overweight or sleeping problems? It’s one of those chicken and egg questions. While researchers keep working to figure out the relationship between lack of sleep and being overweight, one thing is clear: Not sleeping enough may stop you from losing weight even if you’re eating right and exercising regularly. This is because our sleep patterns affect our metabolic system, which regulates the production of energy that fuels all of our body functions. Metabolic upset can lead to a host of other health problems.

Breaking the cycle

To lose weight, sleep time may matter more than gym time. Studies have shown that people who get enough sleep tend to have stable weight and stable blood sugar levels. The magic number for sleep seems to be 7 to 8 hours nightly. Still, many of us function even better with more than 8.

Let’s see how sleep and weight issues interact, how they may affect you, and how to break the cycle.

Sleep issues and appetite

Research shows there’s a fairly consistent relationship between sleeping less than 6 or 7 hours per night and the risk of being overweight or obese. A very large study of older people found that men and women who got by on about 5 hours of sleep per night tended to gain more weight than those who got 7 to 8 hours of sleep. People who got less than 4 hours sleep per night had a 40% greater risk of becoming obese compared to the healthy sleepers. A Swedish study found that “short sleepers” were more likely to be obese (and to have many poor health and lifestyle habits) than people who slept 6 to 9 hours per night.

Why does this happen? Eating too much causes weight gain, and lack of sleep turns out to play a role in our eating habits.

If you’re awake longer, you have more chances to eat. But why, when, and how much we eat are partly controlled by hormones that regulate how our bodies use energy, also known as metabolism. Sleep loss affects the hormones that control appetite. One hormone, ghrelin, increases appetite and makes us feel hungry. Another hormone, leptin, decreases our appetite and makes us feel full. The less sleep you get, the less normal these hormone levels are. Your body makes more ghrelin and less leptin. This means you’re more likely to feel hungry and eat more, which could lead to extra pounds.

Also, sleep deprivation creates changes in the brain that lead us to crave high-calorie, high-fat foods — and make us less able to stop ourselves from eating them. Sleep loss also seems to trigger emotional eating in people (especially women) prone to munch during stressful times.

Sleep and metabolism

So we know a lack of sleep upsets metabolism. When your metabolism is upset, it also messes up your circadian rhythms — the body’s internal schedule for when you’re supposed to eat, sleep, and be active.

One of your internal clock’s functions is to regulate insulin (which controls blood sugar levels and how much fat you store), growth and stress hormones, and immune system actions (particularly inflammation). Inflammation is your body’s response to a threat. Signs of inflammation include swelling, warmth, redness, and pain. All these symptoms mean your body is trying to fix anything that’s damaged or trying to get rid of something harmful, such as a virus or bacterium.

Insulin resistance means your body stops responding to insulin the way it should. To learn more about insulin resistance, read one of my earlier Think Pink, Live Green columns, The Ins and Outs of Insulin Resistance.

Not getting enough sleep can also have a bad effect on insulin regulation and increases the risk of diabetes. A study that allowed healthy young adults only 4 hours of sleep per night for just one week found that some of the participants’ insulin and blood sugar levels were similar to the levels of people with diabetes.

Still, the biggest concern is developing metabolic syndrome, a group of risk factors for heart disease and cancer that includes high blood pressure, blood sugar, and cholesterol levels. Studies have found that people who don’t get enough sleep had a higher risk of developing metabolic syndrome. And guess what? These metabolic problems can disturb your sleep — another vicious circle. Yikes, this stuff is complicated.

Sleep apnea

Even if you always go to bed on time, you may not be able to sleep well due to obstructive sleep apnea. Sleep apnea is a fairly common medical condition. While you’re sleeping, the airway in your throat collapses or becomes blocked. You may even briefly stop breathing, which then wakes you up. Apnea is more common in overweight people, and most extremely obese people suffer from it. Like any sleep disorder, sleep apnea can cause metabolic changes, raising the risk of being overweight even if you’re currently at a healthy weight. This creates another unhealthy feedback loop (less sleep, more hunger; more hunger, more food, and so on). People with sleep apnea, especially if they are also obese, tend to have more metabolic problems, including diabetes.

The breast cancer connection

When it comes to the risk of developing breast cancer, there doesn’t seem to be a link between sleep and the disease. But there is a connection between aging and breast cancer risk: the older you are, the higher the risk. Aging involves all the wear and tear of living, as well as environmental exposures. Sleep is when you repair a lot of these everyday stresses and strains to your system. With or without breast cancer — but especially if you’ve had the disease — sleep quality can play a big role in how well you feel, function, heal, and recover.

Sleeping problems have been found to show up before and after breast cancer surgery, and most chemotherapy patients have temporary sleep issues. Many women who’ve had chemotherapy have ongoing sleep problems, especially if they are very overweight.

If you’re a regular reader of this column, you know that overweight and obese women have a higher risk of developing breast cancer in the first place. They also have a higher risk of the breast cancer coming back (recurrence), especially if they carry extra fat in their midsection. This is partly because the extra fat cells make a lot of extra hormones that can lead to extra breast cell growth. The extra hormones include estrogen, insulin growth factors, prostaglandins, and others. When you have higher levels of these hormones in your blood over time, the risk of cancer is increased. Extra weight also is connected to inflammation, which puts stress and strain on your immune system and breast cells. A lot of new research shows a link between weight-related inflammation and breast cancer risk.

Rest for success

Thankfully, better sleep promotes weight loss and vice-versa. If you’re struggling to get good sleep and stick to a healthy weight, here are some tips to get back on track:

  • Make time in your schedule for 7 to 8 hours of sleep nightly — no excuses!
  • Retrain your body’s internal clock. Start and stick to a regular schedule of eating, exercising, and sleeping.
  • Figure out the cause of your sleep issues. Often changing or shifting a habit, activity, or behavior can make a big difference.
  • Break the caffeine cycle. Drink fewer caffeinated beverages such as coffee, tea, soda, and energy drinks. I’ve had to cut back to only one caffeine beverage per day, which I have to drink before noon. Drinking coffee or soda all day to boost your energy will likely make it harder to fall and stay asleep at night. Plus, if you’re fan of sugary, caffeinated drinks, they can add pounds.
  • Keep your bedroom dark and avoid using electronic devices such as cell phones, tablets, and video games right before your go to bed. Light — especially the blue light given off by computer screens and energy-efficient light bulbs — suppresses an important hormone called melatonin. Melatonin helps regulate sleep. Some researchers think normal melatonin levels also can help maintain normal cell growth and that low levels of melatonin may contribute to the risk of developing cancer. If you work a night shift or must use devices after dark, buy a special blue-light filter.
  • Get treatment for sleep problems with a medical cause:
    • If you have obstructive sleep apnea or severe snoring, talk to your doctor. Experts recommend treating the apnea first, before dealing with any related extra weight. That way, you’ll be rested enough to start exercising. Your doctor may prescribe a CPAP (continuous positive airway pressure) machine to help you breathe at night.
    • If you have breast cancer-treatment-related insomnia or sleep disturbance, try some of the tips in my column Sleep Well: Turn In, Tune Out, and Unplug. Complementary medicine techniques such as meditation, yoga, and acupuncture might also help. Check out the section on Complementary and Holistic Medicine for more information.
  • Avoid widely prescribed hypnotic sleeping medicines, especially after a breast cancer diagnosis. This class of medicines includes Ambien (chemical name: zolpidem), Halcion (chemical name: triazolam), Sonata (chemical name: zaleplon), and Lunesta (chemical name: eszopiclone). A very large study published in 2012 found that users of hypnotic sleeping medicines (especially people who took them often) had a much higher risk of death or being diagnosed with cancer than non-users. Also, each of these medicines can have many problematic side effects. For example, Ambien and Halcion have been associated with walking, eating, and even driving while asleep. The U.S. Food and Drug Administration recently halved the recommended dose of Lunesta because that medicine can make it difficult to drive and may affect memory and coordination the day after taking it. All of these medicines may be habit-forming and cause withdrawal symptoms if stopped suddenly.
  • Cognitive behavioral therapy, a special type of counseling that doesn’t use medicine and focuses on changing one’s thoughts, may help with sleep.
  • Try some of the diet and exercise tips in the Lower Your Risk Besides burning calories, exercise also promotes better sleep. But remember, work out at least 3 hours before bedtime or you’ll be too revved up to sleep.

Have you ever had problems sleeping? What did you do to get more sleep?



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