Susan M. Love - Dr. Susan Loves Breast Book

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Copyright 2015 by Susan Love

Illustrations by Marcia Williams

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Library of Congress Cataloging-in-Publication Data is available for this book.

ISBN 978-0-7382-1822-9 (e-book)

Sixth edition 2015

Published as a Merloyd Lawrence Book by Da Capo Press

A Member of the Perseus Books Group

www.dacapopress.com

Note: The information in this book is true and complete to the best of our knowledge. This book is intended only as an informative guide for those wishing to know more about health issues. In no way is this book intended to replace, countermand, or conflict with the advice given to you by your own physician. The ultimate decision concerning care should be made between you and your doctor. We strongly recommend you follow his or her advice. Information in this book is general and is offered with no guarantees on the part of the authors or Da Capo Press. The authors and publisher disclaim all liability in connection with the use of this book. The names and identifying details of people associated with certain events described in this book have been changed. Any similarity to actual persons is coincidental.

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Editorial production by Marrathon Production Services. www.marrathon.net

Book design by Jane Raese

Set in 12-point Whitman

10 9 8 7 6 5 4 3 2 1

To the Schwab women,

Helen, Pat, Peggy, and Connie,

all who experienced breast cancer.

May the disease end with you.

Contents

Every five years I sit down to completely revamp the Breast Book. This year was more difficult than most as I struggled with chemo brain caused by the treatment I received for acute myeloid leukemia in 2012. Thank God for caffeine and all the help I had from family, colleagues, and friends, both online and off.

Breast cancer has become immensely complicated since I wrote the first edition. It has been critically important to read everything I can get my hands on and even more to touch base with friends and acquaintances who are in the thick of research and patient care. Their generous support is what makes this book valuable. Drafts of the sixth edition were read and commented on by Judi Hirschfield-Bartek, Sherry Goldman, Shelly Hwang, Ben Anderson, Eric Halvorson, Craig Henderson, Lisa Weissmann, Irene Gage, Susan Pierce, Robin Showaller, Brian Lwenda, Silvia Formenti, Annette Stanton, Sara Sukumar, Delphine Lee, Ginny Mason, and Shubhada Dhage.

The other important experts are the women who have shared their experiences with me. This includes not only the survivors I have met and talked to over the past years but also my Facebook friends, who always responded right away when I would post an urgent request for real-life stories to illustrate a point. I promised anonymity, but you know who you are.

I appreciate all the help, and any errors are mine alone.

Then there are the people in my life who facilitate the work and pitch in when needed. My major activity currently is the Dr. Susan Love Research Foundation, and the team there has been terrific. Our wonderful board of directors: Meribeth Brand, Kate McLean, Helene Brown, Melissa Wayne, Natalie Hagan, Karen Duvall, and Bill Greene. Their continual support is critical to our mission. I want to specifically name Heather Ortner, who has taken over the reins as CEO of the Dr. Susan Love Research Foundation and allowed me to do what I do best as the chief visionary officer. The Army of Women and HOW team of Leah Wilcox, Amaka Obedigwe, and Allison Ottenbacher, along with all of our terrific supportive staff, including Steve Ginnegar, Stephanie Twerdahl, Michelle Woodhill, Marla Schevker, Von Simmons, and, most significantly, Kristel Butcher, my wonderful assistant who keeps my calendar and makes sure I know where I am going. Tinh Nguyen has been indispensible in assisting with the research and filling in where and whenever needed.

It is remarkable to me that we have had the same core team working on this book since the first edition. Karen Lindsey continues to be a great cowriter even when her questions asking for clarification drive me crazyshe is always right. My terrific sister, Elizabeth Love, pitched in to help with the writing, fresh from translating the fifth edition into Spanish. Merloyd Lawrence is the wonderful, patient editor who makes sure it all falls together and makes sense. I am also very grateful to Christine Marra, who did a terrific job seeing the manuscript through the editing and production process. Then there is Marcia Williams, whose artwork is such a help in demonstrating the concepts I am trying to explain. I point her in a direction, and she always gets it and always comes back with something even better than I had expected. Sadly my agent, Sydney Kramer, died this year at the age of ninety-nine; he never wavered in his enthusiasm for this book through all of the editions. And Jill Kneerims gentle guidance and cheerleading make sure I stay on track.

This book and these acknowledgments have tracked my life over the past twenty-five years. The first edition was conceived before my daughter, who nonetheless beat it to being born. She is now engaged and living and working in Waltham, Massachusetts. And my dear wife, Helen, has put up with Dr. Susan Loves GD Breast Book over the more than thirty-two years of our lives together. To her I owe all my love and gratitude. You are the wind beneath my sails. And to all the women with breast cancer who share their stories with me online and in person, it is for you that I continue to do this work!

As I finish up this sixth and probably last edition I have to pause and reflect on what has happened in the twenty-five years since the first book was published. We have witnessed many changes in the treatment and understanding of breast cancer; some of them were subtle and others revolutionary.

In each new edition of the book my introduction reviewed recent discoveries in breast cancer treatments. Over the years we have witnessed a slow revolution in the way breast cancer is approached, and it is a good example of how scientific research and medicine evolve.

In my first edition I explained what was then a new paradigmthat the most lethal part of breast cancer was the cells that may have spread into other parts of the body before diagnosis. At that time the addition of hormone therapy and then chemotherapy to the initial treatment of the disease was an exciting result of this new way of thinking. It also established the limitations of extensive surgery as the sole approach. The result has been a definite improvement in overall survival for many women with breast cancer.