Breast cancer survivor urges women to get regular screenings and mammograms, thanks local non-profit ‘The Rose’

The first time Ediana Quijada found a lump in her breast, she was laughed off and told “it was happening because of her period and nothing to worry about.”

It was far from nothing. After a six-year battle with metastatic breast cancer, the cheerful Houston native is happy to share her story with other young women, advising regular breast exams, early detection having made a key difference in many cases.

In the fall of 2012, 29-year-old Ediana was finishing her construction management internship at the University of Houston.

The internship did not offer health insurance but UH hosts free mammography screenings in October in honor of Breast Cancer Awareness month. However, when she told the nurses about her lump, they assured her, with a cursory glance, that she was too young to worry about cancer. She was sent away without a mammogram.

Reassured and a little abashed about being paranoid, she busied herself with assignments as the stresses of the semester took over. The second of four siblings (two sisters, one little brother), Ediana said she had no reason to suspect the worst because there was no history of cancer in her family.

But the lump wouldn’t stay quiet.


“I started feeling that the little lump was getting bigger and bigger,” Ediana said. “I could measure it; it was an inch now. Or is it in my head? Then I would calculate, my period must be coming, that’s why the lump’s getting big … and my breast is turning pink.”

A visit with her mother’s doctor in December confirmed the devastating news — a large mass in her breast. Could be a tumor. Clearly, the cancer had made good use of the two-month delay.

“I didn’t have insurance, so my mother took me to a walk-in clinic,” Eidana said. “The doctor said, ‘oh my God, why didn’t you come before?’”

A few hours and one $100-ultrasound later, she was advised to do a biopsy.

“The biopsy cost over $2,000, I thought ‘I can’t do that right now,’ and he (the doctor) referred me to The Rose,” Ediana said.

That first encounter with The Rose marked the beginning of Ediana’s long, painful but ultimately successful battle with breast cancer. A Houston-based nonprofit group, The Rose provides breast cancer screenings and treatment regardless of patients’ ability to pay. They began Ediana’s treatment by conducting another ultrasound, this one costing only $10.

A little monster inside your breast.

Ediana was paired with a patient navigator who helped her through the system and set up her appointments.

“It turns out I was Stage 3, Type C, which is borderline Stage 4,” said Ediana. “Very aggressive and very bad. They said, ‘it looks like you have a little monster inside’.”

Given the tumor’s massive size, treatment had to begin immediately. When three painful rounds of chemo (each lasting around eight months), one round of radiation and one surgery failed to eliminate the cancer, her doctors put Ediana on an–at the time–experimental drug called T-DM1.

“This

Read More →

Surgical protocol reduces opioid use for breast reconstruction patients

Breast cancer surgeries can be quite painful, so a team at Houston Methodist West Hospital has worked to develop pain management protocols that help some patients while reducing the use of narcotics.

Dr. Candy Arentz, a breast surgical oncologist, and Dr. Warren Ellsworth, a plastic surgeon, have been using an enhanced recovery after surgery (ERAS) protocol with non-narcotic medications and nerve blocks to lessen pain and the need for narcotics in reconstructive surgeries.


A DIEP flap reconstruction uses tissue and fat from the abdomen and other areas to reconstruct the breast after a lumpectomy or a mastectomy. Ellsworth said the reconstruction can be beneficial because it can look more natural than implants and can last the rest of a patient’s life. But it can be more painful because of the extra incisions. He recognizes that opioid overuse is an issue and said that is just one reason why he and Arentz are working to reduce opioid use.

“We have also, I would say, across the entire house of medicine known about this opioid overuse, opioid dependence and all these challenges that our narcotics impose on our patients, not only the basic side effects of narcotics like nausea, vomiting, constipation, but of course, the dependency,” Ellsworth said.

The ERAS protocol helps patients with pain starting the day before the surgery. “So it prepares their body for the surgery and the pain that could occur, and then we continue the pain control throughout the surgery and then of course postoperatively and have found a significant reduction in the use of narcotics because of this protocol,” Ellsworth said.

As Arentz and Ellsworth were coming up with the protocol, Ellsworth consulted with plastic surgeons at the University of Pennsylvania and Stanford University, modeling the Methodist West protocol after their programs. But according to Ellsworth, Methodist West is the first in the Houston area to make the non-narcotic protocols a priority with their patients in the area of DIEP flap reconstructions.

Ellsworth said starting ERAS required bringing in others in the hospital on board, including the head of anesthesiology so that anesthesiologists could administer nerve blocks, or long-lasting numbing injections into patients’ nerves, and the head of the ICU (intensive care unit) because the new protocols were a big change in pain management. Arentz said it required patient buy-in as well.

“It starts with our conversations in clinic and assuring the patients that they will have decreased pain afterwards than probably what they were expecting,” Arentz said, adding that the protocol is done without using IV medications, which is what most people expect when they are going to have surgery.

Arentz and Ellsworth had planned to start using ERAS in February or March, but COVID-19 shifted it back some. So they started in April. Ellsworth said that all

Read More →

MD Anderson’s hurricane checklist for breast cancer patients

Many Houston-area residents experienced at preparing for hurricane season have likely already stocked their home with basic supplies such as extra batteries, a first-aid kit, rain gear and a 7-day supply of non-perishable food and water among other essentials needed to weather a severe storm and its aftermath. But breast cancer patients should be aware to also have additional supplies on hand, especially as Texas continues to face new challenges created by the COVID-19 pandemic, making it more important than ever to plan ahead.



a person riding a wave on a surfboard in the water: In this file image, a GOES-16 GeoColor satellite image taken Saturday, Sept. 19, 2020, and provided by NOAA, shows Tropical Storm Beta, center, in the Gulf of Mexico. A hurricane watch is in effect Saturday for coastal Texas as Tropical Storm Beta gains strength. A storm surge watch and a tropical storm watch are also in effect for the area during an exceptionally busy Atlantic hurricane season. (NOAA via AP)


© Associated Press

In this file image, a GOES-16 GeoColor satellite image taken Saturday, Sept. 19, 2020, and provided by NOAA, shows Tropical Storm Beta, center, in the Gulf of Mexico. A hurricane watch is in effect Saturday for coastal Texas as Tropical Storm Beta gains strength. A storm surge watch and a tropical storm watch are also in effect for the area during an exceptionally busy Atlantic hurricane season. (NOAA via AP)


“Cancer patients are often at greater risk of contracting an infection. So, try to get everything you need early on, to avoid the last-minute crowds in stores,” Marian Von-Maszewski, M.D., associate medical director of Critical Care at MD Anderson said. “It’s almost impossible to maintain adequate social distancing in those situations. And that could prove to be more dangerous than the storm itself.”

Von-Maszewski shared recommended hurricane preparation measures for cancer patients in a recent article published by the MD Anderson Communication Department. First off, breast cancer patients are advised to include an adequate supply of face masks, gloves and hand sanitizer.

“Evacuation could pose a risk,” Von-Maszewski said. “Face masks will be especially important if patients have to stay in crowded shelters.”

Flood water and other standing water are also a potential source of infection and breast cancer patients are advised to add mosquito spray to guard against insect bites, and antibiotic cream and bandages to cover any open wounds to their hurricane supplies.

Plan ahead for a hurricane during the COVID-19 pandemic

Plan ahead and be sure to maintain at least a two-week supply of any current medications. Make a list of all your current medications and their dosages, and talk to your doctor about what to do if you have to miss a dose or treatment. In addition, prepare a dedicated cooler with ice packs or frozen water bottles for medications that need to be kept refrigerated. Research the location of the nearest emergency room and how to get there. Call your insurance company in advance to be sure which ones are covered by your policy. Remember to keep your car’s gas tank full, too, in case you need to seek medical attention or quickly evacuate.

Organize your medical information in one place

It’s possible you won’t immediately be able

Read More →

Finding breast cancer early through screening major tool for beating disease

Breast cancer is the second most common cancer diagnosis in the United States. Dr. Srinath Sundararajan, an oncologist and hematologist with Texas Oncology-Katy, says early detection saves lives and that screening is important, even during the pandemic.

“Delaying cancer screenings will lead to detecting cancer at a later stage, and definitely that leads to more aggressive disease, more lengthy treatment and an increased healthcare cost,” Sundararajan said. “Cancer when identified early, there is a better chance of it being a curable cancer and better chance of having less intensive treatment. Screening cancer and finding it early is the single most effective way of improving cancer survival rates.”

He explained that since the 1980s, advances in breast cancer treatments have improved mortality rates, but screening has played a major role because it allows patients to seek treatment earlier in the disease.


While Sundararajan said mammograms are the main breast cancer detection tool, women talking with their health care providers about how to do a proper self-breast exam can enhance their breast health awareness and act as another tool. He said they should look for unusual changes in their breasts, including lumps, changes in the contour of the nipple, skin color changes, puckering of the skin or a new nipple discharge that occurs without apparent reason. Women should seek immediate medical attention with their health care provider if any of these symptoms occur.

While the age that a woman should get her first mammogram depends on several factors such as family history, Sundararajan explained that a woman with average risk should have a discussion with her doctor when she is between 40 and 50 years old. He said the frequency for mammograms will vary based on the results of that first one. Women should certainly have mammograms from age 50 to age 75, Sundararajan said.

The pandemic has had a large impact on cancer. A study showed that diagnoses of breast, cervical and colon cancer were down about 90 percent at one point. Sundararajan said the numbers have improved but are still down overall by about 30 percent since before COVID-19.

“It doesn’t mean that cancer was not happening or that new cancer was not occurring during those times,” he said. “Those are all missed diagnoses, which would probably impact them later in the future. Once they’re diagnosed, they might be at a later stage.”

Sundararajan explained that 90 to 95 percent of patients whose breast cancer is detected early respond well to treatment and are still living five years later. Those survival rates decrease when the cancer is found later.

Sundararajan emphasized that it is safe to go out for cancer screenings. He said clinics, diagnostic offices and doctors’ offices are taking precautions so that people do not catch or spread the novel coronavirus. Many medical facilities require masks and temperature checks to enter and are

Read More →