Posts tagged with "US News & World Report"

Boobie trap? Today, more breast cancer survivors are saying no to reconstruction

February 3, 2021

When journalist Catherine Guthrie learned that she would need to have a mastectomy following a breast cancer diagnosis, she was shocked by what seemed like a cursory explanation from her surgeon about what would happen next, reports U.S. News & World Report.

That included removing both of her breasts, adding implants, and moving a muscle from her back to her chest to make the results look more natural. It didn’t feel right to her. She went home, thought about it and decided to “go flat.”

“I feel great about it. I love my body. I love the freedom I have in my body. I love that I have full mobility and strength in my body. I’m as flexible and strong now 10, 11 years later as I was then,” said Guthrie, who already had back issues and had been concerned about how the surgery would impact that. “I absolutely have zero regrets.”

Guthrie’s choice mirrors a growing trend: A new study found that a majority of breast cancer patients—74% —who had opted to “go flat” were satisfied with the outcome.

The study, from University of California, Los Angeles (UCLA) Jonsson Comprehensive Cancer Center, also found that 22% of women who responded to the survey had experienced what they refer to as “flat denial,” which is where the surgeon either did not initially offer this choice, didn’t support the patient’s decision, or intentionally left extra skin in case the patient changed her mind.

Women were more likely to be satisfied with their results if they felt they had surgeon support for their decision, the survey found.

“There may be many reasons why a woman decides not to have reconstruction,” said senior study author Dr. Deanna Attai, an associate clinical professor of surgery at UCLA’s David Geffen School of Medicine.

“I think we have to do a better job of going into these discussions with an open mind, letting patients know that you have the option to not undergo reconstruction and we’ll do our best to close everything as neatly and flatly as possible,” she told US News,

Attai said she initially became interested in doing the survey because earlier research that suggested women who opted to not have reconstruction had a poorer quality of life didn’t match up with what she was seeing in patient communities.

“There just seemed to be a disconnect between what I was reading in the surgical literature and what I was seeing online, because these patients seemed to be very happy with their decision,” Attai said. “They were in the online space and organizing support groups and advocacy organizations to help educate others about the option to go flat and to provide information and support to each other.”

For the study, Attai’s team included patient advocates. They were concerned that an existing commonly administered survey showed bias toward reconstruction, so they developed an entirely new survey.

“We worked closely with the patient advocates to make sure that we were asking the questions in a way that made sense to them. We wanted to make sure that we got to some of the real issues, not only with satisfaction, but quality of life and comfort with their decision and satisfaction with their decision,” Attai said.

Attai said she had not seen the concept of flat denial discussed in previous research.

“This is a concept coming from patients. This is what the patients are experiencing. It’s not made its way into the validated survey tool. So for all of those reasons, we decided to do our own survey and we got what we got,” Attai said.

Among the limitations of the study is that this survey was distributed to the going-flat community. This may not represent all women, Attai said.

“It’s obviously very individual, but I was a little bit surprised to find that so many women were happy with their decision,” Attai said.

Although Guthrie always felt comfortable with her choice, she also still had feelings of loss. She writes more about her experiences in a book, Flat: Reclaiming My Body from Breast Cancer.

Not offering all the options puts the onus on a woman to come up with her own surgical treatment plan while she’s dealing with a traumatic diagnosis, Guthrie said. “Women can’t make an informed choice if they’re not given all of the choices,” Guthrie said.

It’s important for patients to feel connected to their providers, said Susan Brown, senior director of health information and publications for Susan G. Komen. If someone feels like she wants to consider going flat and is not getting support from her surgeons, it may be time for a second opinion, Brown said.

“One of the first things that stood out [about the study] was how important information is to patients before they try to make a decision or before they’re faced with a decision,” Brown said. “The second is how important physician support is for acknowledging, understanding and really respecting a patient’s wishes so that the provider or the patient can partner in making decisions because it looks like when that happens, then patients are more satisfied with the decision that they’ve ultimately made.”

Mastectomies have been increasing in recent years for a variety of reasons, Brown said. Not having reconstruction isn’t new, but it isn’t always something that’s been discussed as openly, she said.

Patients who are exploring their options can call the 1-877-Go-Komen helpline, she suggested.

” The study was published online recently in the Annals of Surgical Oncology. Attai is now working with surgeons and patient advocates to develop a new survey tool.

The American Cancer Society has more on alternatives to breast reconstruction.

Research contact: @usnews

Supreme Court declines to take up Pennsylvania absentee ballot case

November 17, 2020

Even with “friends” on the high court such as Justices Amy Coney Barrett, Brett M. Kavanaugh, and Neil M. Gorsuch, President Donald Trump learned on November 16 that he would not be able to block all absentee ballots that arrived in Pennsylvania after Election Day.

Indeed, the Supreme Court on Monday declined to take up a case challenging Pennsylvania’s absentee ballot receipt deadline, a few days after Republican efforts were dealt a blow in a lower court regarding late-arriving ballots, US News &World Report says.

Republicans had asked the high court to block all absentee ballots that arrived after Election Day. The justices previously upheld a Pennsylvania Supreme Court ruling for ballots to count that arrived up to three days after the election as long as they were postmarked by November 3.

Trump’s campaign and Republicans have waged scores of legal battles in Pennsylvania and around the country, although many of those cases have so far been unsuccessful in lower courts. Last Friday, November 13, the 3rd U.S. Circuit Court of Appeals rejected a GOP effort to block more than 9,000 late-arriving absentee ballots in Pennsylvania. The panel of three judges pointed out the “unprecedented challenges” facing the U.S. due to the coronavirus.

Most of the litigation from Trump’s team contests small batches of ballots that won’t be able to erase Biden’s lead in key battleground states where he’s ahead by thousands of votes. Biden currently has about 68,000 more votes than Trump in Pennsylvania, according to US News.

Since a winner was projected more than a week ago, Trump has refused to concede to President-elect Joe Biden, who flipped five states to win the White House and unseat an incumbent president.

Conservative justices had left the door open to revisiting Pennsylvania’s case post-election. Last week, Justice Samuel Alito had ordered the state to segregate the absentee ballots arriving after Election Day in the event that the late-arriving ballots are reviewed later by the high court. Prior to Election Day, Pennsylvania instructed elections officials to separate the ballots with the possibility of a court challenge.

If the high court were to eventually decide to take up the case and rule against ballots arriving after Election Day, the number of invalidated ballots would still be too small to overturn the state’s results. The president-elect also leads with 306 electoral votes compared to Trump’s 232.

Research contact: @usnews

Judiciary Committee delays confirmation vote on Barr amid doubts by Dems

January 30, 2019

A scheduled Senate Judiciary Committee vote on the nomination of William Barr to be U.S. attorney general has been delayed by a week, to February 5, as Democrats on the panel continue to worry that he will cut the Russia inquiry short—or fail to release Special Counsel Robert Mueller’s full report to the Congress and the American people.

According to coverage by U.S. News & World Report, such delays—known as holdovers—are not uncommon. However, this one comes during a “pronounced partisan divide” over seating Barr, coming just one day after Acting Attorney General Matt Whitaker told the media that the Mueller “investigation is, I think, close to being completed.”

Barr came under intense scrutiny from Democrats late last year, the news outlet said, when he sent an unsolicited memo to the Justice Department expressing doubts about the legitimacy of any inquiry into whether President Donald Trump committed obstruction of justice.

During the hearing, Barr has avowed, “…it is in the best interest of everyone—the president, Congress, and the American people—that this matter be resolved by allowing the special counsel to complete his work.”

However, to date, he has not promised to make the full report available when it is completed. Instead, Barr has pledged, “to provide as much transparency as I can consistent with the law”—a statement that brings little comfort to the opposition party.

Research contact: @alneuhauser

Put down the coffee: Workers are using caffeine and sugar to combat stress

March 23, 2018

There is an epidemic of stress nationwide today, with the vast majority of U.S. workers—80%, according to the American Institute of Stress—experiencing on-the-job tension and anxiety.

What they are doing about it, U.S. News reports—chugging coffees (34%) and handfuls of candy, downing alcoholic drinks, resorting to prescription and recreational drugs, and acting out—may exacerbate the problem rather than help to solve it.

In a poll of 751 adult American workers sponsored by The Marlin Company, conducted by The Harris Poll, and cited by the institute, fully 25% of respondents admitted that job-related stress makes them feel like screaming, and 14% said that their stress levels have made them feel like hitting a coworker.

Thus, it is no surprise that 10% of respondents expressed fear that someone they know at work actually could turn violent, with another 18% reporting that they had experienced a threat or verbal intimidation within the past year.

Now, a survey sponsored by Salt Lake City-based Bridge has found that the pressures are growing worse, instead of being ameliorated. The study has found that the 24/7 culture of many companies may be adding to the stress.

Only 33% of the 1,000 U.S. office workers who participated in the study said they are encouraged by their employer to take paid time off, and only 11% are encouraged to take mental health days as part of their sick leave. Most (78% of workers) were convinced that working more hours would be crucial to getting ahead and about 50% reported feeling like they have to engage in workplace politics.

However, U.S. News cautions, be careful what you wish for—and what methods you use to relieve the stress that is generated along the path to achievement. Even coffee, which has some proven health benefits, can cause unpleasant symptoms like headaches and irritability if you drink too much of it, according to the Mayo Clinic.

And Harvard Medical School has warned that, if you eat too much added sugar—in the form of those M&Ms or candy bars—it boosts your risk of dying from heart disease. Plus it goes without saying that alcohol and drugs do not mix well with work.

Instead, experts advise, take paid time off, even if it is not encouraged by your company; unplug and de-stress for a few minutes every hour, exercise for anxiety relief—and plan ahead. Starting the day worried and disorganized can only set you up for more stress; while planning your calendar will enhance feelings of control and competence.

Research contact: info@getbridge.com