Prostate Cancer Symptoms Tips What is prostate cancer symptoms? We have tips about prostate cancer symptoms

Unfortunately, Type 2 diabetes is not an equal opportunity offender. Although the disease does do a number on women and their overall health, it is men who reap the worst repercussions as a result of having diabetes and unstable blood sugar levels.

Starting with the head and working down to the feet, you can see vision is acutely affected by diabetes due to high and uncontrolled blood sugar levels. There are several conditions that appear to advance more rapidly in diabetic men than diabetic women. One is retinopathy, which is a vision disorder as a direct result of diabetes. Retinopathy is the enlargement, breakage, or leaking of tiny blood vessels in the eye, which can spill blood into the eyeball and threaten vision. Once this condition sets in, men tend to progress into blindness faster than women.

The brain is more susceptible to disaster too. The likelihood of stroke or strokes are higher for men. Adding high cholesterol and elevated triglycerides, or fat in the blood, to this problem only makes it more probable. Let's not forget high blood pressure. It goes hand in hand with obesity, cholesterol and low activity.

Traveling to the heart we see the increased opportunity for health issues. Since men are more prone to heart disease, it goes without saying they need to focus more attention on keeping this area as healthy and fit as possible. In fact, studies show if a man is diagnosed with Type 2 diabetes before the age of 60, they are two and a half times more likely to suffer from a heart attack than non-diabetic men of the same age.

When you get to the midsection, things get serious. For a man, it comes down to impotence. There is a direct correlation between out of control blood sugar levels and erectile dysfunction (ED). The condition can appear even in the early stages of diabetes, but the chances of acquiring it, dramatically increase as you age. Since the causes are due to impaired blood flow, nerve damage and muscle function, it is imperative to keep these areas in check through proper diet and exercise. Also, maintaining a healthy weight is ideal for making sure this doesn't become an issue.

Lastly, it all comes down to circulation. Men seem to have a much higher rate of limb amputation due to poor circulation, than women. In fact, statistically, men are between two and three times more likely to need amputation of their feet or legs as a result of circulation restriction and/or nerve damage. This is where getting up and moving around can benefit. Any form of activity up to and including exercise will keep this debilitating action at bay.
Men... keeping yourself healthy and controlling your blood sugar through..

• stress-reduction techniques,
• a balanced diet, and
• regular exercise,

It is the best bet to reduce or avoid these complications of Type 2 diabetes.

Men with diabetes face several health concerns, including increased risk of heart attacks and strokes and impotence (not being able to have or keep an erection).

Above the age of 50, the likelihood of having difficulties with an erection occurs in approximately 50-60% of men with diabetes. In men over 70, 90% have erectile dysfunction problems (link to diabetes and ED page)

Diagnosed and controlled, diabetes can be successfully managed to minimise its impact on health and well being. You can prevent or delay diabetes complications like damage to eye sight and nerve damage to fingers and toes. However many men do not realise they suffer from the disease. Around one third of the men with diabetes are not aware of their illness.

Diabetes Signs and Symptoms

If you find yourself with any of the following symptoms, it is important you visit your doctor or health practitioner and get tested for diabetes:

o feeling tired
o frequent urination (especially at night)
o being very thirsty
o weight loss
o blurry eyesight
o recurring skin, gum, or bladder infections
o sores that heal slowly
o dry, itchy skin
o loss of feeling or tingling in your feet

Type 1 and Type 2 Diabetes

There are different kinds of diabetes:

o Type 1 diabetes is usually first diagnosed in children, teenagers, or young adults.
o Type 2 diabetes is the most common form of diabetes. People can develop it at any age, but it is often diagnosed in later life and is commonly found in men who are over weight and do little exercise.

What is Diabetes?

Most of the food we eat is turned into glucose (sugar) for our bodies to use for energy. The pancreas makes insulin, which helps sugar get into the cells. When you have diabetes, your body either doesn't make enough insulin or can't use the insulin it does make. This causes sugar to build up in your blood. Over the years, high blood sugar leads to problems like heart disease, stroke, blindness, kidney disease, nerve problems, gum infections, and amputations.

Diabetes-Related Problems in Men

Men with diabetes suffer more from some diabetes-related health problems than women. The American Diabetes Association reports that:

o In people who develop diabetes before the age of 30, men develop retinopathy (a vision disorder that can lead to blindness) more quickly than women.

o Having the main symptoms of peripheral vascular disease (pain in the thigh, calf, or buttocks during exercise) is linked to a two- to three-fold increased risk of coronary heart disease, stroke, or cardiac failure in men with diabetes.

o Amputation rates from diabetes-related problems are 1.4 to 2.7 times higher in men than women with diabetes.

"Beer Pot" Belly Equals High Diabetes Risk

Overall obesity, measured by high body mass index (BMI) and a "beer pot" belly, measured by a large waist circumference, both accurately predict the risk of type 2 diabetes in men, but abdominal obesity appears to be the better predictor, new research shows.*

Both BMI and waist circumference are useful for assessing health but waist circumference can indicate a strong risk for diabetes whether or not a man is considered overweight or obese according to his BMI, researchers said.

As waist circumference increased, so did the risk of developing diabetes, with the risk in men with the highest waist circumference (up to 158 centimetres) increasing by 12 times.

The study findings also suggest that the currently recommended cut-off for high waist circumference of 102 cm (40 inches) for men may need to be lowered to 95 cm.

Many of the men who developed type 2 diabetes had measurements lower than the cut-off and the risk associated with the waist circumference increased at a much lower level than previously thought.

Sleeping Too Much Or Too Little Increases Diabetes Risk

Men who sleep too much or too little are at an increased risk of developing Type 2 diabetes, according to a study by the New England Research Institutes in collaboration with Yale School of Medicine researchers.

Six to eight hours of sleep was found to be most healthy.

In contrast, men who reported they slept between five and six hours per night were twice as likely to develop diabetes and men who slept more than eight hours per night were three times as likely to develop diabetes. Previous data have shown similar results in women.

The elevated risks remained after adjustment for age, hypertension, smoking status, self-rated health status and education.

Too little sleep appears to produce metabolic disturbances like decreased carbohydrate tolerance, insulin resistance, and lower levels of the hormone leptin leading to obesity. The mechanisms by which long sleep duration increase diabetes risk requires further investigation.

You Can Delay or Prevent Type 2 Diabetes

When you take steps to prevent diabetes, you also lower your risk for heart disease, stroke, kidney disease, blindness, and amputation.

Small changes in your lifestyle can make a difference.

They include:

o Getting 30 minutes of physical activity five days a week and losing 5 to 7 percent of your body weight.
o To help you lose weight, choose low-fat foods and foods high in fiber.
o Cut down on fat and cholesterol by having low-fat dairy products, lean cuts of meat, fish, poultry, fruits, and vegetables.
o Limit foods high in salt and sugar.
Know Your Risks That Can Lead to Type 2 Diabetes
It's important to find out early if you have type 2 diabetes or if you are at risk of developing it. To find out if you're at risk, check off each item that applies to you.
o I am overweight or obese. (Obesity is measured with a body mass index (BMI), which shows the relationship of weight to height.)
o I have a parent, brother, or sister with diabetes.
o My family background is African American, American Indian, Asian American, Latino, Maori or Pacific Islander.
o I have high blood pressure.
o My cholesterol is not normal. My HDL or "good" cholesterol is less than 50 or my triglycerides are 250 or higher.
o I am not very active. I exercise less than three times each week.

Heart valve disease occurs when there is an existing problem with one of your heart valves. It is a necessity for the public to be aware of the consequences of this disease. In the worst case scenario, this condition may cause the untimely death of a person. Therefore, an early detection and a prompt treatment may avert further consequences taking place. The functions, causes, symptoms, diagnoses, and even the treatments are important information concerning heart valve diseases.

The heart consists of a few structures that are put together to pump blood to the entire body. There are several parts within the three layers of outer structures of the heart. The upper and the lower chambers are commonly known as the atria and ventricles. They are the major parts of the heart. The lateral classifications of the heart, the right and the left portions, are not the only structures that comprise the heart. In-between these chambers there are heart valves.

The valves are also seen prior to the pulmonary vein and subsequent to the pulmonary artery before reaching the left atrium. The mitral valve can be found in-between the left atrium and the left ventricle. It has two leaflets that actually flail as the valves open and close. At the other side, the tricuspid valve is found between the right atrium and the right ventricle, and it has three leaflets. The basis for the names of the valves comes from their structure.

The function of these heart valves is to provide a one-way stream of blood inside the heart. The one-way stream of blood is very important to maintain the normal function of the heart. The valve provides the blood a passageway before leaving each chamber by opening its leaflets. Inversely, it prevents the blood from flowing backwards by closing its flaps subsequent to the flow of blood through it. The relaxation and the contraction of the heart tissue triggers the open-and-close mechanism of the valves which control the flow of blood.

When the purpose of the heart valves diminishes, due to bacteria or other conditions, the functions of the heart are also disrupted. The malfunctions are classified into two classifications: regurgitation and stenosis. Regurgitation is the flow of blood with a backward direction, and stenosis is the narrowing of the heart valves.

As the heart valve disease occurs, many manifestations can take place. The actual condition of the disease doesn't necessarily reflect on the manifestations. It can occur abruptly depending on the duration of the disease progression. The development of this condition may vary from one person to another. Some patients may have a longer disease process. The symptoms may mimic other conditions such as heart failure.

It is always easier to prevent a disease than to cure a disease. This is especially true for this disease because the treatment comprises an expensive multifaceted approach that entails administration of medications and surgical procedures. Preventing the incidence of heart valve disease is the immediate treatment for a sore throat by using potent antibiotics. This intervention is performed to avert the occurrence of rheumatic fever that eventually can lead to valvular heart diseases. Maintaining a healthy heart diet will also prevent the prevalence of this disease. The early recognition of the symptoms is a very good secondary preventive measure to avoid further complications.

There are two types of heart valve disease--heart disease resulting from narrowed heart valves, and heart disease resulting from leaky heart valves. Each of them stems from several different causes, ranging from birth defects, to bacterial infection, to aging.

Congential Heart Valve Disease

Congenital heart valve is the most common, and can result in inflexible or narrowed, or floppy, valves, or irregular valve flaps. Congenital heart valve disease is often diagnosed within a few days of a baby's birth, but if the defect is minor, may not be discovered until much later. Heart valve disease can be very hard to diagnose because some forms of it do not produce symptoms.
Some people, however, acquire heart valve disease because of complications from another disease such as heart muscle disease, coronary artery disease and heart attack. A child who has suffered from a rheumatic heart disease because of a simple strep throat will likely to have a valvular disease when he or she reaches adulthood.

Heart valve disease, however, can also develop as a complication from some other illness; children who have had rheumatic fever following an untreated case of strep throat have a greater than fifty percent chance of developing scarring on their heart valves. A heart with scarred valves has to work harder than one with smooth ones, and as the years mount, the extra strain on the heart can lead to rheumatic heart disease.

Endiocarditis

Another form of heart valve disease which can result from infection is endiocarditis. Endiocarditis develops when bacteria enters the bloodstream during surgery or dental procedures, causing inflammation of the heart and scarring both its valves and leaflets. In the case of endiocarditis, the scarred leaflets will allow blood entering the heart to back up, or "regurgitate," diminishing the blood volume within the heart and the amount of blood and oxygen which reaches the body's other organs.
The elderly are susceptible to heart valve disease resulting from calcification, or calcium deposit buildup, along the valves.

Testing For Heart Valve Disease

Echocardiograms and MRIs are the tests best suited to diagnose heart valve disease. Either one will give the cardiologist a good look at abnormalities both in the main chambers of the heart and all its smaller structures including the valves.

The symptoms of skin cancer are the easiest symptoms to detect. This is because cancer of the skin usually manifests itself in abnormal skin growths that are in plain sight. Although these may sometimes look like a simple sore or a pimple, when it fails to heal over time, this can immediately alert the patient that something is wrong. Also, most cancerous skin growths often ooze some fluid, bleed, and crust or scab over, which are more telltale signs that it is more than just a simple growth. These, however, are usually painless, which is why some people still fail to report their case, leading to delayed treatments.

If you see a new growth on the skin that looks abnormal or does not seem to heal or go away, these should be reported to a doctor. Although many skin growths such as moles are nothing to worry about, it is still best to seek the advice of a medical professional. When a growth is cancerous, however, you can usually tell over time as they often change in size or color.

Symptoms of the Most Dangerous Type of Skin Cancer

The most dangerous type of skin cancer is malignant melanoma. This usually forms on the trunk or on the legs. Although these don't get constantly exposed to the sun, these areas usually get rare but very intense exposure to the sun, such as when a person spends an excessive amount of time at the beach without applying skin protection products. However, melanomas can also form from an existing mole or freckle, so it is sometimes difficult to identify as well. Keep in mind that when a freckle-like spot on the skin is multi-colored and combines shades of brown, black, red, white, and blue, then it could be a melanoma, not a freckle, which is just light to dark brown in color. Melanomas also have an irregular or uneven border, while a freckle usually have clear-cut borders.

Diagnosing Skin Cancer

Experienced doctors who are trained in diagnosing skin cancer can often recognize its symptoms with one look. To get an idea of the full extent of the disease, however, a complete examination of the entire skin surface will still be needed. Once some symptoms are spotted, a specialist will do a biopsy to determine whether cancer cells are indeed present in the skin cells. This is the surest way to diagnose whether the disease is present or not and to determine its specific type.

In a biopsy, a doctor will take cells or tissues from your skin and analyze them under a microscope. There are two types of biopsy: excisional and incisional. Excisional, which obtains a wider margin of tissue around the affected area, is more effective in diagnosing malignant melanoma. Incisional biopsy removes only a small sample of the growth. This is more common and can usually identify other forms of the disease.

Surgery may be an option for many men with prostate cancer. In some prostate cancer cases, a radical prostatectomy, removal of the prostate gland, is needed.

Penn is a national leader in surgical treatment of prostate cancer and its surgeons are at the forefront of developing and using new minimally invasive surgical techniques. Benefits of minimally invasive surgical techniques include:

• Smaller incisions/less scarring
• Significantly less pain
• Less blood loss
• Shorter recovery time
• Faster return to normal daily activities

Radical prostatectomy

A radical prostatectomy is complete removal of the prostate gland, surrounding tissue and seminal vesicles. A prostatectomy can be performed via traditional surgery, or robotic-assisted surgery.

Traditional prostatectomy

Traditional prostatectomy involves removing the prostate and surrounding tissues through an incision in the body. Nearby lymph nodes may be removed at the same time.

The surgical incision can be made either though the abdomen or through the perineum, the area between the scrotum and the anus.

Robotic-assisted prostatectomy

One of the most innovative treatments for prostate cancer is robotic-assisted laparoscopic prostatectomy – removal of the prostate gland via computer-assisted surgery.

Laparoscopic robotic-assisted prostatectomy is the complete removal of the prostate using long, narrow instruments that are introduced through very small skin incisions. To perform the procedure, six tiny incisions are made in the patient's abdomen and the laparoscopic instruments are carefully inserted and attached to the robot.

Robotic prostatectomy offers similar and sometimes better outcomes than traditional prostate cancer surgery. The margins obtained around the prostate are just as precise, if not more so, than with open surgery. This leads to cancer cure rates equal to traditional surgery. Better precision also means better nerve sparing, thereby maximizing the chances of preserving sexual and urinary function.

While these technological advantages are significant, a surgeon's skill and experience remain the most important elements for achieving good outcomes. Penn has one of the most experienced robotic-assisted surgery teams in the world, with full-time surgeons dedicated to robotic-assisted prostatectomies. It’s their experience, understanding of the body and prostate cancer, and dexterity of the robot’s tools that helped rank Penn’s urology the highest in the Philadelphia region, and among the nation’s best.

Most men who have robotic-assisted prostatectomies return to work in two to three weeks and can resume activities such as golf and weightlifting in about three weeks.

Cryosurgery

Cryosurgery is a treatment currently offered through clinical trial studies. Cryosurgery is the application of extreme cold to destroy tumors and cancer cells. Cryosurgery may be an option to treat prostate cancer if other treatment options are not successful.

Learn More About Prostate Cancer Treatment at Penn

If you or a loved one has been diagnosed with prostate cancer or an abnormal PSA, you're probably wondering what to do next. Look to Penn's Abramson Cancer Center for the most advanced cancer program in the region - for full insight on all your options.

Our team will:

• Help you understand your PSA levels and guide you towards the next steps you should take
• Ensure you have the most accurate diagnosis using advanced diagnostics
• Offer you the most advanced surgical and radiation treatment options – all in one place
• Answer your questions about the potential side effects of all your options
• Provide an unbiased opinion on your best treatment option

Call 800-789-PENN (7366) to schedule a consultation with a Penn prostate cancer specialist.

Or, learn more about prostate cancer treatment, side effects of prostate cancer, and other prostate cancer information by watching a five-part video series about prostate cancer.

Today’s woman is more knowledgeable and conscientious than ever about the risks of breast cancer.  This is especially true for women over 40 years of age, who have crossed the threshold of increased risk of breast cancer.

Age is so important to the development of breast cancer that about 76% of women who develop it have no other risk factors other than age.  However, all women, regardless of age or race, need to acknowledge the risk of developing it.  All women are at risk.

<b>Risk Factors</b>

Women who have never smoked a day in their entire lives can develop breast cancer.  Women who have been always been health conscious can also develop it.  In fact, nearly one woman out of eleven will experience breast cancer.  A staggering statistic by anybody’s standards!

An estimated 211,000 new cases of breast cancer was diagnosed this past year.  Even with the increased awareness programs, early detection through annual mammography screening and instruction for self-examination, breast cancer remains a leading cause of death for women.

Breast cancer, like other forms of cancer, is a disease of the cells.  In all, there are about fifteen different types of breast cancer.  Some are more serious than others, but the one common factor each shares is that neither the cause nor the cure has been found.

<b>There are four recognized developmental stages of breast cancer:</b>

(1.) State 0: Cancer cells are present in either the lining of the milk glands (lobules), or in the tubes (ducts) that link the milk glands to the nipple.  No cancer cells have spread to the nearby fatty tissue.
(2.) Stage 1: Cancer has spread to nearby fatty tissue in the breast.  Tumor size is about 1” or under; no cancer cells are present in surrounding lymph nodes.
(3.) Stage 2: Size of tumor is 1” to 2” in diameter; cancer cells may have also spread to nearby lymph nodes.
(4.) Stage 3: Cancer is locally advanced.  Tumors are approximately 2” or larger in diameter, or tumors of any size have spread to lymph nodes under the arm or in the chest (above or below the collarbone).
(5.) Stage 4: Metastatic, advanced breast cancer.  The cancer has spread from the breast and lymph nodes to other parts of the body.

Early detection of breast cancer remains a woman’s best chance of survival, and women of all ages should take advantage of all the resources available.

<b>Every woman should:</b>

1.) Become educated about the risk factors associated with breast cancer.
2.) Become knowledgeable about the types, stages, and symptoms of breast cancer.
3.) Learn the correct procedure for self-examination tests, and perform them routinely.

Long-term use of oral contraceptives, early menstruation, late first full-term pregnancy, exposure to high doses of radiation – puberty through childbearing years, and inherited genetic mutation can all increase a woman’s risk of acquiring breast cancer.

<b>Women 40 years of age and older should also:</b>

1.) Have an annual mammography screening.
2.) Become educated about increased age-related risks associated with breast cancer.

Recent studies confirm that risk of breast cancer in midlife increases with regular consumption of alcohol, hormone replacement therapy, weight, and body mass distribution.

During self-examination, look for a lump or thickening in the breast, a discharge from the nipple, scaliness on the skin or around the nipple, a change in shape, color, or texture, and dimpling or puckering.

If you detect a lump, don’t panic.  About 85-percent of all lumps turn out to be nonmalignant.  Make an appointment with your doctor for a more thorough examination, and tests.

Treatment for breast cancer today is often less radical than in years past, and chances for survival much better when the tumor is discovered early.

Chemotherapy is a word that strikes fear into most of our hearts.  We've seen the movies and heard such horrible stories about undergoing this difficult treatment for a disease that could very well kill us.  I underwent chemo for breast cancer and know that, in some cases, the cancer isn't hard … it isn't painful … it doesn't make us sick.  That's the case for most of us who have breast cancer, but don't have distant metastases.  But then, they say we need to do chemo and we know we'll feel that.

Although chemo drugs haven't changed that much, and they're still terribly hard on our bodies, the management drugs have changed a lot.  Chemotherapy, for many of us, isn't the show-stopper we thought it would be.  Of course, each of us is different and the chemo drugs affect each of us in different ways, but, for the most part, chemo is definitely doable.  

My breast cancer was Stage IIIa, with a 5.8 cm tumor, 8 of 10 lymph nodes positive, and I was only 39 years old.  That bought me a ticket for the chemo ride.  And I was scared out of my wits.  But, I found an online breast cancer support group, at WebMD, and those women told me everything to expect and more.  I went through four rounds of adriamycin and cytoxan.  Both of them are some pretty stout breast cancer chemo drugs.  After that, I did a controversial treatment that involved extremely high doses of cytoxan, taxol, and cisplatin, so I learned quite a bit about surviving chemotherapy.

First of all, I would highly recommend getting a port.  This is a line that goes into a vein in your chest, the entrance to which sits just under your skin, right below your collarbone.  It requires a quick surgery to put it in but, if you're having a mastectomy for your breast cancer, you can get the chemo port put in at the same time.  If you choose not to do that, you'll have to get your chemo treatments through your veins and chemo is really hard on your veins.  This means that you will, most likely, have to endure multiple attempts for them to find a vein, as time goes by.  With the port, it's already in a vein, so all they have to do is stick the needle into the port to access it.  If you find this uncomfortable, there is a cream they can give you called Emla cream.  One of the first things I learned was to tell them the moment I was uncomfortable.  It's all fixable.  You'll put the Emla cream on a bit before you have to have your port accessed and it'll numb your skin.

Most breast cancer chemotherapy drugs will cause your hair to fall out.  This is because chemo kills the rapidly dividing cells in your body.  Your mucous areas and hair follicles are affected for this reason.  That's why you may have nausea or develop mouth or throat sores.  Again, all this sounds scary, but is totally manageable.  Since you will probably be losing your hair, which can be quite traumatic, I would advise going wig or hat shopping before you even get your first chemo.  Take a girlfriend with you and be adventurous.  Try on different styles, and even colors.  If you've always wanted to be a blonde, now's your chance!  Make a day of it and have fun with it.  Goodness knows, you have to look for that silver lining every chance you get.  Also, make sure to have your nausea med prescription filled before you go so you'll have it waiting for you if you need it at home.  You may be pretty tired, afterward, so don't wait till then to get those meds.

On your first chemo day, they will probably give you some steroids, intravenously or through your port, to help with the nausea.  This may make you hungry; it sure did for me!  But, I would recommend you don't eat your favorite food on chemo day.  Chemo is manageable, but after you're all done, you may find that you have associations.  For example, I used to love the cucumber melon fragrance when I was going through chemo.  I had cucumber melon everything!  But, to this day, the smell of cucumber melon makes my stomach do a little somersault because it reminds me of such an unpleasant time in my life.  The same can happen with food.  I still can't look a chicken burrito in the eye!  But, I'm sure glad I didn't eat a taco because I would've hated for that to be ruined for me!

Many breast cancer chemo drugs are hard on your bladder, so be sure to drink, drink, drink.  If you don't feel like drinking water, then broth, jello, or even popsicles will help.  Since you've gotten your nausea meds all filled in advance, be sure to take them as prescribed, whether you think you need them or not.  Chemo nausea isn't just any kind of nausea and it's much easier to stay ahead of it than to try to fix it once it occurs.  If you do happen to get nauseated, and I can't stress this enough, call your doctor!!!  There are many, many nausea meds and you do not have to feel sick just because you're doing chemo.  Once they find the right drug for you, it will be so much easier.  So, do not suffer this in silence!  The same applies for if you get sores in your mouth or throat.

You will be tired from this treatment.  Most of us get more tired as the treatments progress because they make our white blood cell counts drop really low.  Because of this, it's a good idea to keep some Purell, or something similar, with you all the time for use when you've had to touch, for example, public restroom door handles.  Your risk of infection will be much higher during this time.

If you lose your hair, it will typically happen in 10-14 days after your first chemo treatment.  If you have long hair, you might want to cut it short in preparation.  I know I felt so out of control of everything, during that time.  When your hair comes out, it lets go quickly and in large clumps, getting all over your pillow and clogging your drain.  For many women, that is more traumatic than even losing a breast.  So, I figured that was the one thing I could control about this whole breast cancer thing … when my hair came out.  I cut it really short, beforehand and, when it started to let go, I had my husband get the clippers and shave my head.  My daughter helped and we did a little Mohawk and stripe action first!

That was my way of shaking my fist at this cancer … it might take my breasts, and it might take my hair for a while, but I beat it to the punch!  It was my way of saying, "You cannot take my spirit!"  You can do the same thing.  Your breast cancer does not define you.  It is but a speed bump in the course of your life.  Strap on your gloves and step into the ring.  This chemo is your biggest punch.  Your spirit is your own and that breast cancer can't touch it!