Two genes, BRCA1 and BRCA2, if mutated are known to dramatically increase a woman’s risk of developing breast and ovarian cancer. Men can also carry these genes, and if they have a gene mutation, which also puts them at risk for developing breast and other cancers, though their breast cancer risk is not nearly as much as in women. These mutations are so-called germline mutations, that is, they are acquired at conception from either their mother or father. If a parent has a BRCA gene mutation, each child has a 50 percent likelihood of acquiring that mutation. Each year, a group called the National Comprehensive Cancer Network, reviews the latest research and develops the guidelines of who should be tested for these gene mutations. Current guidelines recommend screenings for:

• women and men who have a strong family history of breast and/or ovarian cancer on either the maternal or paternal side of their family
• women and men who developed breast cancer, particularly bilateral breast cancer, at a young age (under age 50)
• women who developed ovarian cancer at a young age
• women who have men in the family with breast cancer

The screening is a simple blood test, but it is expensive (around $4,000) and, due to patent restrictions, is performed by only one lab in the United States. For that reason, we must conserve resources and only test those individuals who meet the testing criteria.

Individuals who carry the BRCA1 gene mutation have a 60% to 85% chance of developing breast cancer and an approximately 40% chance of developing ovarian cancer. Those with the BRCA2 gene have 40% to 60% chance of developing breast cancer and about a 20% chance of developing ovarian cancer. After learning you have one of these gene mutations, there are several decisions to make.

At a minimum, women with BRCA gene mutations should undergo aggressive surveillance.  This typically consists of an annual mammogram and breast MRI starting at age 25. This allows us to detect breast cancers sooner, if it does develop, at an early and more treatable stage. Like Ms. Jolie, some patients choose the risk-reduction bilateral mastectomy and breast reconstruction, which reduces their risk of developing breast cancer by 93%. However, there is no data currently that compares the mortality rate of those who choose bilateral mastectomy versus those who opt for aggressive screening.

Unfortunately, we currently do not have reliable surveillance methods for early diagnosis of ovarian cancer that are as effective as mammograms and breast MRI are for breast cancer. For women who have the BRCA1 or BRCA2 gene mutation, we do recommend removal of their ovaries and fallopian tubes after they are done having children, typically between the ages of 35 and 40.

If you feel you may be at an increased risk for carrying one of these genes, it’s important to discuss your family history with your healthcare provider. He or she can recommend a course of action. For those who find they have either the BRCA1 and BRCA2 gene, the University of Michigan Comprehensive Cancer Center has a wealth of resources to help you understand your options.

Additional Resources:

• Breast and Ovarian Cancer Risk Evaluation
• Gynecologic Care for Breast Cancer Patients and BRCA Gene Mutation Carriers
• Blog post: Cancer risk and genetic testing for BRCA1 and BRCA2 (by Kara Milliron, MS, CGC)
• CNN Opinion Article: When Removing Breasts is Not the Answer (by Sara Hawley, MD)

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Mark Pearlman, MD, is vice chair and service chief in the Department of Obstetrics and Gynecology at the University of Michigan Von Voigtlander Women’s Hospital. He also holds an appointment as professor in the Department of Surgery and is associate chief of clinical affairs for the University of Michigan Hospitals and Health Centers. Dr. Pearlman is a member of the surgical staff of U-M’s Breast Care Center, with particular expertise in the management of gynecologic care for women with increased genetic risks for breast and ovarian cancer, gynecologic care of women with breast cancer, as well as the management of benign breast disease.

The University of Michigan’s Women’s Von Voigtlander Women’s Hospital is a leader women’s health care.  Consistently ranked among the America’s top gynecology programs by U.S. News & World Report, U-M is committed to unsurpassed patient care.

The University of Michigan Comprehensive Cancer Center’s 1,000 doctors, nurses, care givers and researchers are united by one thought: to deliver the highest quality, compassionate care while working to conquer cancer through innovation and collaboration. The center is among the top-ranked national cancer programs, and #1 in Michigan for cancer patient care. Seventeen multidisciplinary clinics offer one-stop access to teams of specialists for personalized treatment plans, part of the ideal patient care experience. Patients also benefit through access to promising new cancer therapies.

Being aware of your new body is just one of the many benefits of prenatal yoga, which is why I encourage pregnant women to try it.

I talk to all of my patients about the benefits of exercise and prenatal yoga, so if this is a conversation that you haven’t had yet with your healthcare provider, it is one you want to have. You should talk to your doctor or midwife before you start yoga or any type of exercise class during pregnancy.

Why prenatal yoga?
There are numerous studies about the benefits of prenatal yoga. Possible benefits include improving sleep, reducing stress and anxiety, and increasing the strength and flexibility of muscles.

Prenatal yoga usually includes different breathing techniques, gentle stretching, and a mindful approach that are all beneficial to you throughout your pregnancy and even during labor.

Yoga can help you achieve the mental relaxation that helps limit fear of the labor process, and provides inner peace in the moment.

Listen to your body

It is important to be realistic about your goals and how active you were before pregnancy. Whether you rarely exercise or workout often, it is important to stay hydrated, stay cool, and listen to your body.

For my patients who are already athletic and exercise regularly before pregnancy, I remind them that pregnancy is NOT the time to push past the pain; if it is uncomfortable, stop.

Adapt your exercise/yoga to your changing body

Women who already practice yoga sometimes ask about continuing in their current classes.  That might work for your first trimester, but you will want to look for a new class that is appropriate for your changing body and needs. Pregnancy is not ergonomic and as your back and your balance shift, so will your yoga practices.

One of my favorite prenatal yoga videos shows three pregnant women (each representing a different trimester) and although they are doing the same yoga poses, they each make modifications for that stage of their pregnancy.

Choosing a yoga instructor

Do your research. Make sure you find an instructor who is trained in prenatal yoga and let her know if you have any previous yoga experience.

Pregnant women should never do bikram yoga, also known as hot yoga, because it is practiced in a “hot” room. It is NOT safe for pregnant women, because it raises your core body temperature.

It is fine to have prenatal yoga be your introduction to yoga. You don’t need experience to get started!  Another added benefit of starting prenatal yoga is that making time for a prenatal yoga class and scheduling that time for yourself is a great skill for your new schedule as a mother.  My patients tell me that prenatal yoga makes them feel better, and often they continue that commitment to exercise after their babies are born.

Related blog posts:

• Prenatal exercise: Listen to your body

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Carrie Bell, MD, is an OBGYN at University of Michigan Von Voigtlander Women’s Hospital and Assistant Professor of Obstetrics and Gynecology. Dr. Bell sees patients at U-M’s East Ann Arbor clinic.

University of Michigan Von Voigtlander Women’s Hospital opened in December 2011, offering women a state-of-the-art place to welcome their babies to the world in the most caring and comfortable way possible.  From private rooms to birthing tubs, each feature was designed around mom and baby’s every need.  Learn more at www.UofMhealth.org/birthcenter.

During your pregnancy, spend time learning about breastfeeding.

• Talk to other expectant or new moms.  Expectant moms are welcome at our monthly Breastfeeding Moms Network group.  Women attend for a variety of reasons. Some women have questions, some new moms look forward to spending time with other moms, and some who have had very positive breastfeeding experiences come to support other women.

• Take a class.  U-M’s Briarwood Center for Women, Children, and Young Adults offers breastfeeding classes. I’ve also heard positive feedback from women who have taken other breastfeeding classes locally through organizations like Lamaze, Center for the Childbearing Year, and Women, Infants and Children (WIC).

• Find out if your insurance will pay for a breast pump. You don’t need to arrange for one this early, but it is one more piece of information you can get before your baby’s arrival.

After your child is born

• At University of Michigan Von Voigtlander Women’s Hospital your delivery nurse will be a great resource for helping you start breastfeeding after your baby’s arrival.

• Start breastfeeding within the first hour after your baby is born.  Research has shown the importance of getting a baby to the breast within the first hour. That is true for women with c-sections as well as women with vaginal deliveries.

• Skin to skin contact (kangaroo care) is beneficial for parents and their newborns for a number of reasons. Read more about the benefits of kangaroo care.

• If you feel you need additional help right away, ask your nurse.  At the University of Michigan we have a specially trained group of nurses who make up a breastfeeding support team that can offer additional assistance while you’re in the hospital.

When you and your baby go home from the hospital:

• Ask your childbirth provider for recommendations on lactation support.  At the U-M, each woman is given a packet of information before she leaves the hospital which includes information about breastfeeding resources.
• At University of Michigan, a visiting nurse checks in on each mom after you go home from the hospital.  The visiting nurse is another great resource to answer any breastfeeding questions.
• The University of Michigan Health System lactation consultants have a Lactation Help Line (734-232-7885).  Even if you call with an important question an hour or two after being discharged from the hospital, you won’t be the first new mom to do that. That is why we offer the line, to support moms and breastfeeding. The lactation help line is not limited only to U-M patients. We are happy to support any woman who has questions about breastfeeding.  Some women are reluctant to get help from a lactation consultant, because they think lactation consultants tell women what to do. We realize that breastfeeding is not possible for everyone. Our goal is to offer support so that women can decide what is best for them and their babies.

• U-M’s Briarwood Center for Women, Children, and Young Adults offers a Multidisciplinary Breastfeeding Support Clinic which is staffed by a lactation consultant as well as an OBGYN and pediatrician specializing in breastfeeding support.  Women can be self-referred, although you might want to check with your insurance to see if the visit is covered.

• You are always welcome at the Breastfeeding Moms Network group. It can be very helpful for new moms to talk to other moms.

I hope you take advantage of the available resources and get your questions answered. It can take some time to get breastfeeding well establish, but the benefits are well worth the effort. We look forward to supporting this new relationship with you and your baby.

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Carrie Pawlowski RN, BSN, IBCLC, is a lactation consultant at the University of Michigan Von Voigtlander Women’s Hospital.  Carrie works with mothers and babies at our birth center as well as in our multidisciplinary lactation clinic at U-M Briarwood Center for Women, Children and Young Adults.

University of Michigan Von Voigtlander Women’s Hospital opened in December 2011, offering women a state-of-the-art place to welcome their babies to the world in the most caring and comfortable way possible.  From private rooms to birthing tubs, each feature was designed around mom and baby’s every need.  Learn more at www.UofMhealth.org/birthcenter.

If you are planning a pregnancy, please remember the importance of prenatal vitamins, eating well, and regular activity.

It is difficult to predict from a prior experience how long it might take you to get pregnant.  Your increased age and changing medical history can be factors. Changes in a woman’s ovaries, uterus, and tubes can make it easier or harder to get pregnant for the second time.

Here are some factors that can impact your ability to conceive:

Is your menstrual cycle regular?

Having regular periods increases your chance of getting pregnant.  If you didn’t require medical assistance to get pregnant the first time, you can expect normal menstrual cycles to start within approximately three months after you stop breastfeeding.

If you are planning to try having a second child, talk to your gynecologist if your period isn’t regular and monthly about three months after you stop breastfeeding.

Is there anything you want to share about your first child’s birth?

Your gynecologist will ask you questions about your first pregnancy, labor and delivery. Did you have a c-section or a vaginal delivery? Did any infections occur after delivery? Your answers will help your gynecologist determine whether to refer you to a specialist.

Did you need fertility treatment for your first pregnancy?

If you had fertility treatments for your first pregnancy, your chance of getting pregnant without assistance – sometimes referred to as spontaneous pregnancy –  the second time is dependant on your reasons for fertility treatment previously. Feel free to call your fertility specialist, and ask if you should seek fertility treatment again based on your individual situation.

For example, if a couple used In Vitro Fertilization (IVF) for their first pregnancy because of blocked tubes, we would generally recommend another cycle of IVF to help the couple get pregnant with their second child.  If the couple still has embryos frozen from their first cycle, we would plan to use those embryos to help the couple get pregnant again.

The first time was easy, so why is it taking longer?

Perhaps you are one of the couples who did not have difficulty conceiving the first time, so you’re wondering why the second time isn’t as easy for you. Depending on your age and situation, you might want to seek the advice of your physician.  He or she will help you determine if it would be appropriate for you to get a consultation from a fertility specialist.

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Michael Lanham, M.D. received his Medical degree from the University of Michigan.  He completed his residency in Obstetrics and Gynecology, also at the University of Michigan.  His research interests include interpretation of ovarian reserve measures, fertility preservation, effective implementation of electronic medical records and improvements in clinical efficiency.

University of Michigan Center for Reproductive Medicine brings the expertise of infertility specialists and research scientists together to help each of our clients have access to the latest fertility therapies and technologies available through one convenient center.  We offer a full spectrum of assisted reproductive technology options, including IVF, fertility preservation, intrauterine insemination, donor insemination, and pre-implantation genetic diagnosis.

The diagnosis of MRKH, also known as vaginal agenesis, is often an unknown entity to the teenager and family and can cause them all to experience feelings of disbelief, grief and loss.

For a young woman facing this unexpected diagnosis, future fertility might not be the biggest immediate concern.  More likely she will initially struggle with understanding the consequences of the diagnosis and how this may affect her in relationships, dating and her future.

Parents tend to quickly realize that their daughter will not be able to carry her own children and what sadness that may cause her throughout her life (and them as well).  We always discuss with families that there are many ways to become a parent and that several options exist to help a woman achieve the goal of motherhood if that’s what she wants in her future.

There are several things we suggest for young women with MRKH and their families, to be able to live life to the fullest.

Don’t rush any decision making – Being born with MRKH is a lifelong journey, and a young woman should take her time considering her treatment choices regarding vaginal development. One common treatment called vaginal dilation is a method of gradually stretching the vagina, and is quite successful. It does take time, effort and commitment as it can take several months to develop the vagina. Surgery for vaginal development is another option with its own risks and benefits, and although some women assume that surgery is the quickest solution, it usually requires dilation and long term care too. There are several different surgical methods.  Be sure to talk through all of your options with your care team, and take as much time as you need to feel certain about your decision. The only person who can determine when it is the right time to address these issues is you!

Seek counseling – Parents and daughters have sometimes mixed feelings initially about meeting with our special counselors.  Talking about sexuality and sexual health is uncomfortable for most parents and teenagers and when a young woman is coping with MRKH it can be even more intimidating.  Counselors can help teens and families work through these conversations and are an important part of your care team. You can meet with them in private or with parents or partners. Your doctor can give you recommendations for counselors with experience with MRKH.

Respect privacy – We emphasize to parents that although MRKH affects the whole family, it is the daughter’s decision if, when, and with whom that information can be shared.  It is important for parents to find comfort and support by talking with a relative or friend, but we recommend that parents ask their daughter’s permission before discussing her health with anyone.

Also, while it’s important for teens to share experiences and struggles with peers, young women with MRKH should also really think about who they choose to confide in about their health.  In this age of social media, adolescents are not always protective enough of their friends’ privacy.  Unwanted sharing of personal information could be very hurtful to a young woman learning to cope with MRKH.  She should choose carefully which friends or family members she can trust to be supportive and to keep her personal information private.

Find support – For women with MRKH, and for their parents as well, talking to other people with similar circumstances can be powerful.  Ask your care team about support groups they recommend, or if there are other parents or resources they can connect you with.

For more information, or to learn about the Pediatric and Adolescent Gynecology clinic at University of Michigan C.S. Mott Children’s Hospital, call 734-763-6295.

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Elisabeth Quint, MD, received her medical degree at the University of Leiden in the Netherlands. She completed a residency in obstetrics and gynecology at the U-M Medical Center. Dr. Quint is co-director of the Pediatric and Adolescent Gynecology Clinic and a member of the Disorders of Sex Development care team at University of Michigan Health System.

The University of Michigan’s Women’s Von Voigtlander Women’s Hospital is a leader women’s health care.  Consistently ranked among the America’s top gynecology programs by U.S. News & World Report, U-M is committed to unsurpassed patient care.

Exercise is vital to the health of a pregnant woman, not only for her physical health, but also for her mental well-being. The numerous benefits of exercise include helping to maintain your body weight during pregnancy and helping to prevent and control gestational diabetes. Exercise is also powerful in preventing depression.

As your body changes during your pregnancy, some exercise choices are naturally less appealing.  Swimming is always a wonderful choice for exercise because there is little or no impact on your body.

As you get farther along in your pregnancy, you’ll notice that your balance is not as good. That is why sports that can cause you to fall (biking, skiing, horseback riding) are not recommended.  Also, be careful of sports that include physical contact like basketball and soccer.

Be Aware

There are so many benefits to exercise, but there are some issues to be aware of when you are pregnant.

• Avoid stretching to the point of resistance. Your body is producing hormones to relax ligaments, and it is easier to damage ligaments.
• Pregnant women tend to get dehydrated easier, so make sure you stay hydrated.
• Don’t power through a workout or a run. You need to be aware what your body is saying. 
• Even just walking is a good endurance exercise.

Exercise, in any form, is a way to increase all of the good things your body does. There are some issues that limit the amount of exercise that a woman can do during pregnancy, however. Talk to your healthcare provider about what is appropriate for you.

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Amy Tremper, MD, is an OBGYN at the University of Michigan Von Voigtlander Women’s Hospital.  Her areas of interest include exercise in women and OBGYN care for the physically handicapped. Prior to earning her medical degree, Dr. Tremper received a degree in physical therapy. Her outside interests include gardening, cooking, swimming and travel.

The birth center at the University of Michigan Von Voigtlander Women’s Hospital opened in December 2011, offering women a state-of-the-art place to welcome their baby to the world in the most caring and comfortable way possible.  From private rooms to birthing tubs, each feature was designed around mom and baby’s every need.  Learn more at www.UofMhealth.org/birthcenter.

In general, the more you know about your family’s health history, the more your medical team can start using those facts in evaluating your overall health and fertility picture.

There are many possible causes for decreased fertility, including endometriosis, fibroids, premature menopause, polycystic ovary syndrome, low sperm count, underlying conditions, and physical issues.  Some of these – hypothyroidism or polycystic ovary syndrome in particular – do tend to run in families.

Still, patterns of fertility in your family may not predict how easily you will conceive.

We know, for example, that fertility decreases with age. In general, older women have a lower chance of getting pregnant. By the time women are 30 years old, a quarter of them will have issues with fertility. If your mom or sister was trying to conceive around age 40 or later, that could have been the source of her difficulties.

There can also be some difficulty in determining your family history. Sometimes family members will not mention difficulty conceiving, or miscarriages, until they hear that another family member is having difficulties. Talking with family members can offer family members the ability to support you through your fertility journey, but the decision of when and how much to share with your family members is up to you.

While your family history is helpful for our medical team to be aware of, it can be difficult to interpret family history as it relates to an individual patient’s situation. That is why we always discuss and evaluate each individual patient or couple as unique, rather than depending on family history alone. Only with a consultation can we discover what blood tests and imaging studies might give us an answer for what might be going on. Even with all the testing we have to offer, approximately 25% of couples will have normal tests and no good explanation for their difficulty conceiving, even with a positive family history.

For more information or to make an appointment at the U-M Center for Reproductive Medicine, visit the Center for Reproductive Medicine website.

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Senait Fisseha, MD, JD, is the medical director for the University of Michigan Health System’s Center for Reproductive Medicine.  Her areas of specialty cover all aspects of infertility including: polycystic ovary syndrome, recurrent pregnancy loss, other endocrine disorders resulting in infertility; as well as assisted reproductive technologies such as IVF/ICSI, and gamete and embryo cryopreservation.

The University of Michigan Center for Reproductive Medicine uses a multidisciplinary approach that brings the expertise of endocrinology and infertility specialists, OB-GYN’s, urologists, lab technicians and research scientists together to help each of our clients have access to the latest expertise and technology available – through one convenient center.

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When to start your plan:

Usually I discuss the birth plan with my patients at the beginning of the third trimester.  Often it is the childbirth classes she takes that help a woman make decisions about the type of birth she wants. If a woman has not taken classes, I suggest other resources available online or at the library that will help her make choices regarding her baby’s birth.

Ask lots of questions:

Your prenatal care appointments are the best time to ask questions that will help you formulate your plan.  We have certain goals for each appointment during your pregnancy. Women may find it helpful to bring their questions to their visits in writing and to make sure they prioritize their questions, so their most important questions are answered first.

An extra person can be helpful:

Sometimes it helps to have a friend or family member present at your appointments so there is a second person hearing the same information. A friend or family member is especially important when you have to bring an older child to your appointments so that someone can stay with your child while you get your questions answered.

Put it on paper:

Some women like the ability to go online and point and click at a list to document their decisions, and other women prefer to write out their preferences in more detail. Either way, collecting your thoughts on paper will benefit you and the team of people caring for you and your baby.

Sharing your “game plan”:  When you arrive at the hospital, the entire medical team supporting you will have access to your birth plan . For example, if your nursing team knows you are interested in avoiding an epidural, they will work with you to use a number of childbirth support tools and often have a great knack for knowing when to suggest certain things like the birthing ball or the labor tub to help you along the way.

If there is anything you are worried about – just ask. I’m sure it won’t be the first time your doctor, midwife, or OB nurse has heard the question, and having an answer will hopefully be reassuring for you.

Ready for the Unexpected:

I can say on behalf of the nurse midwives, as well as the rest of the pregnancy and childbirth team at U-M, that your team here at the birth center is committed to helping you achieve the birth experience you hope to have.

As I’m sure you’re aware, there are circumstances that are beyond your control.  Remember, birth plans are not legal documents — they’re guidelines. The health and safety of a mother and her baby are always the priority.

Women can take comfort in knowing that if there are any unexpected complications, at a moment’s notice, you have access to everything. The delivery rooms may look like nice hotel suites, but at U-M you have all of the technology and medical staff you need for unexpected occurrences.

Having a plan and knowing what time of birth experience you want is valuable, but it should be reassuring to know that you are having your baby in a place where you and your baby have full access to a medical professionals, medical technology and the facilities to make the birth experience the best it can be for you and your baby.

Learn more about the University of Michigan Von Voigtlander Women’s Hospital and our pregnancy and childbirth resources: www.UofMhealth.org/birthcenter

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Jane Brigham, CNM, received her Master’s degree in Midwifery from the University of Philadelphia in 2002. She joined the U-M Nurse Midwifery practice in 2007. Jane loves to support women’s choices during both pregnancy and birth. Jane has three teenage boys and spends most of her free time attending their athletic events! Her clinics are at West Ann Arbor Health Center and at Brighton Health Center.

The birth center at the University of Michigan Von Voigtlander Women’s Hospital opened in December 2011, offering women a state-of-the-art place to welcome their baby to the world in the most caring and comfortable way possible.  From private rooms to birthing tubs, each feature was designed around mom and baby’s every need.  Learn more at www.UofMhealth.org/birthcenter.

Annette Schork, RN, BSN, OCN, CBCN, is one of four oncology registered nurses at the Cancer AnswerLine™

• Primary osteoporosis is the result of a normal physiologic process—usually aging and/or menopause.
• Secondary osteoporosis is due to bone loss from a medical condition or a treatment side effect.

Who is at risk for osteoporosis?

Talk with your doctor about your risk of osteoporosis. You may be at higher risk depending on your family history, diet and whether you have ever smoked. Older women (over 65) and older men (over 70) are generally at higher risk. White people also seem to have an increased risk.

Risk factors for secondary osteoporosis can be related to the type of cancer you had, your treatment, or the way your body responded to treatment. Specifically, risks may exist for survivors of certain types of cancers and treatments that could spread to the bone such as:

• Breast cancer
• Prostate cancer
• Multiple myeloma (cancer that occurs in the antibody-producing white blood cells)
• Other solid tumor types such as lung, testicular, ovarian and endometrial (uterine wall) cancers

Treatment for some cancers, such as breast or prostate cancer, can include blocking or eliminating certain hormones in your body. Blocking sex hormones (testosterone or estrogen) helps to slow the growth of cancer cells. However, the sex hormones also help protect the bones. If your body is deprived of these hormones, osteoporosis can develop. This does not mean that you should not receive this type of treatment, because it may be the most effective way to treat your type of cancer.

According to Dr. Catherine Van Poznak, a University of Michigan Comprehensive Cancer Center oncologist who specializes in breast cancer’s relationship to bone, “People with breast or prostate cancer who undergo treatments that block specific hormones may be at higher risk of thinning bones. Also, certain chemotherapy drugs used to treat these or other cancers may induce ovarian failure in younger women, causing bones to thin as a result of early menopause and estrogen deprivation. In addition, steroids may also accelerate bone loss in both men and women.”

Osteoporosis is treatable, but not curable. This means that once you know you have this condition, you should work with your health care team to develop ways to slow down any bone loss.

Symptoms of osteoporosis may include:

• Weight loss
• Stooped posture
• Curving of the upper back (Dowager’s hump)
• Bone tenderness
• Loss of one or two inches in height
• Bone break or fracture

An individual can have osteoporosis and not experience any symptoms. If you think you are at risk for osteoporosis, a bone mineral density screening (sometimes referred to as a DEXA scan) may be right for you. If it’s lower than normal or declines while you’re in treatment, there are medications called bisphosphonates you can take to strengthen your bones. Some examples of medications used to treat osteoporosis are Fosamax, Actonel, Boniva, and Reclast.

There are also lifestyle changes you can make to keep your bones as strong as they can be:

• Consider a vitamin D supplement. Vitamin D also plays a vital role in bone health and is often not as readily available in an average diet, unless you drink fortified milk or orange juice. Most people need between 400 IU and 800 IU per day.
• Add weight-bearing exercise to your routine. Gravity helps encourage bones to become denser at areas that support weight, so make sure you incorporate weight-bearing exercise into your workouts. Walking is an excellent option, particularly when carrying hand weights.
• Avoid tobacco and alcohol. Tobacco use and excessive alcohol consumption have both been associated with bone loss.
• Get your daily dose of calcium. Recommendations vary based on age, but most people need between 1000 mg and 1200 mg per day of calcium. Ideally, calcium is consumed as part of a well-balanced diet that includes dairy products rich in calcium. However, many people benefit from the use of supplements. Calcium is best absorbed in portions of 400 mg to 600 mg at a time, so plan to take it in divided doses throughout the day.

Have you experienced osteoporosis as a result of cancer or cancer treatment?  What have you done to strengthen your bones?  Feel free to leave a comment.

Additional Resources:

National Institutes of Health:  What Breast Cancer Survivors Need to Know About Osteoporosis

U-M Bone Deep:  Bone Health Resources

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The Cancer AnswerLine ™ is a dedicated phone line at the Comprehensive Cancer Center that is staffed by oncology nurses five days a week, 8 a.m. – 5:30 p.m. at 800-865-1125. They have a combined 105 years of experience helping patients and their families who have questions about cancer.

The University of Michigan Comprehensive Cancer Center’s 1,000 doctors, nurses, care givers and researchers are united by one thought: to deliver the highest quality, compassionate care while working to conquer cancer through innovation and collaboration. The center is among the top-ranked national cancer programs, and #1 in Michigan for cancer patient care. Seventeen multidisciplinary clinics offer one-stop access to teams of specialists for personalized treatment plans, part of the ideal patient care experience. Patients also benefit through access to promising new cancer therapies.

Maria Lyzen, right, and Ruth Freedman lead the Cancer Center’s Breast Cancer Advisory and Advocacy Committee.

The summit was organized through encouragement from the U-M Comprehensive Cancer Center’s breast cancer advocates. They feel the summit is a way to let the community know that the U-M breast cancer specialists are collaborative and multidisciplinary. Panel discussions and a mock tumor board will give the audience a first-hand look at how these leading oncologists work together on behalf of their patients. They will also give an update on the latest breast cancer research at Michigan and nationally, showing what has been learned and how vital research donations are to these research advances.

The summit will cover:

• cancer prevention
• screening
• treatment
• research, including clinical trials
• survivorship
• genetic risk

Special guest Maria Lyzen will discuss advocacy. Maria is a long-term breast cancer survivor involved in cancer research advocacy.

One novel feature of this community event promises to be riveting: presentation of an actual tumor board, where U-M doctors discuss two cases. The audience will see up close how specialists create a personalized treatment plan for each patient, and have the chance to interact in ‘real time’ to ask questions about how the specialists collaborate to reach their recommendations for treatment.

Survivorship issues will highlight the psychological and emotional aspects of survivorship, including depression and anxiety, and cover recent research impacting survivorship, such as the late effects of chemotherapy.

Other highlights include “Ask the Expert” stations, a vendor expo, strolling lunch, and gift tote bag.  The vendor expo goes beyond health education to showcase the range of support services available in our community. Attendees will have the chance to talk to representatives from the Mid-Michigan Affiliate of Susan G. Komen for the Cure and the American Cancer Society.

The summit is free and open to the public, but registration is required.

Saturday, April 20, 2013, 10 a.m. – 3 p.m.

Washtenaw Community College, Morris Lawrence Building

4800 E. Huron River Drive, Ann Arbor, MI 48105

RSVP: Visit www.mcancer.org/breastsummit  or call 734-998-7071

This event is sponsored by U-M Comprehensive Cancer Center Breast Oncology Program, U-M Comprehensive Cancer Center Community Outreach Program, Mid-Michigan Affiliate of Susan G. Komen for the Cure and U-M School of Public Health.

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The University of Michigan Comprehensive Cancer Center Community Outreach Program is committed to providing evidence-based health information, tailored programs and special events that educate the community about cancer prevention and early diagnosis.

The University of Michigan Comprehensive Cancer Center’s 1,000 doctors, nurses, care givers and researchers are united by one thought: to deliver the highest quality, compassionate care while working to conquer cancer through innovation and collaboration. The center is among the top-ranked national cancer programs, and #1 in Michigan for cancer patient care. Seventeen multidisciplinary clinics offer one-stop access to teams of specialists for personalized treatment plans, part of the ideal patient care experience. Patients also benefit through access to promising new cancer therapies.