By Lisa Rapaport, Reuters Health

Women with early-stage breast cancer may have fewer treatment complications and lower costs when they don’t get a mastectomy followed by reconstructive surgery, a U.S. study suggests. In recent years, reconstruction following a mastectomy has become more widely available, contributing to a sharp increase in the number of women who opt for this treatment even when less aggressive alternatives may be just as effective, researchers note in the Journal of the National Cancer Institute.

With early-stage tumours that haven’t spread to distant parts of the body, survival odds are similar for a mastectomy or a lumpectomy paired with radiation, previous studies have found. In the current study, researchers found the risk of complications with a mastectomy followed by reconstruction was almost twice that of lumpectomy.

“The vast majority of women with early breast cancer can undergo breast conserving therapy followed by whole breast irradiation which allows for preservation of the breast,” said lead study author Dr. Benjamin Smith, a researcher at the University of Texas MD Anderson Cancer Center in Houston. “Our data illuminate that this treatment strategy may very well be easier on patients from a complication perspective and still allow them to preserve their body image,” Smith added by email.

Most of these patients have surgery – either a lumpectomy that removes malignant tissue while sparing the rest of the breast or a mastectomy that removes the entire breast. After surgery, they may also get chemotherapy or radiation to destroy any remaining abnormal cells and reduce the risk of cancer coming back.

To assess complications and costs, researchers analysed data on patients diagnosed from 2000 to 2011. The study included 44,344 women under 65 with employer-based health insurance and 60,867 women at least 66 years old with coverage through Medicare. Researchers looked for complications such as infections, fluid build-up, blood clots, lumps of dead tissue or pain in the breast, inflammation in the lungs, rib fractures, implant removals or graft failures.

After two years, 30 percent of the younger women experienced complications with a lumpectomy followed by whole breast radiation, compared with 54 percent among those who underwent mastectomy paired with reconstruction. With a mastectomy alone, the complication rate was 25 percent.

For older women, 38 percent had complications with a lumpectomy and radiation, compared with 66 percent for a mastectomy and reconstruction and 37 percent for a mastectomy alone. Compared to the lumpectomy and radiation, complication costs were roughly $9,000 higher for the younger women who got a mastectomy with reconstruction and $2,000 higher for the older women.

Within two years of diagnosis, the total cost of treatment with a mastectomy plus reconstructive surgery was $88,000 for the younger women, $22,000 more expensive than a lumpectomy with whole breast radiation. In the older group, the mastectomy with reconstruction was $36,000, which was $2,000 more than the lumpectomy and whole breast radiation.

One limitation of the study is that the costs come from just 2010 and 2011, the authors note. Because insurance coverage varies, the study doesn’t show what individual patients may pay out-of-pocket for their care. Doctors may recommend a mastectomy when cancer cells remain after a lumpectomy, or for women who want to avoid radiation or repeated mammograms, Smith noted.

“Not all patients are eligible for breast conserving surgery; for patients requiring a mastectomy, reconstruction allows women to have a breast mound which may be important to them,” Anees Chagpar, director of the breast centre at Smilow Cancer Hospital at Yale-New Haven in Connecticut, said by email. Chagpar wasn’t involved in the study.

Early stage breast cancer also includes a lot of women with very different situations, noted Dr. Lisa Schneider, a plastic surgeon at the Institute for Advanced Reconstruction in Shrewsbury, New Jersey, who wasn’t involved in the study.

“Someone with a strong family predisposition who is deeply fearful of breast cancer and has seen their mother die of cancer may make a very different choice than someone who has young children... or an elderly parent they need to care for and needs to get back to work as soon as possible,” Schneider said by email.

SOURCE: Journal of the National Cancer Institute, online September 27, 2016.

~ Wash Day Chronicles: Shampoos ~

Very few things are more traumatizing for a woman with thick hair than wash day. The best part of the entire process is the feeling of water hitting your scalp. For those few moments, all cares and worries are replaced by sensations of pure euphoria as you allow the water to create ripples of comfort down your body. Yes, it’s an amazing feeling, but what happens when it’s time to actively engage in washes, rinsing and various moisturizing techniques? Pain! You get pain in your arms because of the effort it takes to keep your limbs elevated for that long performing the strenuous activity. In addition to the painful process, there are common discrepancies of how often one should wash and what products should be used.

One of the most commonly asked questions within the textured hair community is how often you should wash your hair. The answer to that question depends mainly on the individual, taking into consideration factors like environment and skin type. For example, because you’re reading this article, your environment more than likely is tropical with intense bouts of heat and dryness – thanks to the very active hurricane season. More than likely, your perspiration has been on the rise, which in turn, causes a build-up of dirt and oils along the surface of your scalp. This causes the pores in your scalp to clog and must be cleansed on a more constant basis than someone in colder climates. Weekly cleanses are suggested. Yes, it’s true; you can wash your hair every week without the fear of hair loss or dryness.

Thanks to old wives tales, we’ve been taught to believe that water rots the hair and is bad for it. Imagine, water is the life source of everything on earth, it creates moisture and hydrates – and hydration is exactly what textured hair needs in order to thrive and be styled. Why would washing and cleaning your hair be bad? However, this leads to queries of why people who have weekly washes still have dry hair and dandruff. The answer to that question lies in their haircare products and in some cases the technique. Shampoo and conditioner are two of the essential hair care products anyone can use. While moisturizers and hair care treatments vary based on the user, you can bet everyone uses shampoo and conditioner. That makes shampoo and conditioner the universal constant of all hair care regimens. The problem would essentially come from products not suited for constant use or designed for textured hair.

Okay, so let’s say I believe this; what products do I use? Would you believe I genuinely don’t know? Well, that’s only partly true. Like most situations involving hair care, the products you use are supposed to be individually tailored to your situation. There are helpful generalizations, for example, it is a common misconception that oily, silicone-heavy coating conditioners and greases are best for textured hair. In addition to the heavy products, it is assumed that harsh shampoos with stripping properties, designed to remove the heavy products, would be best. Both situations are untrue and will hinder moisture of the scalp and hair fibres. Frequent use will definitely strip your hair of moisture; that’s why avoiding conditioner will immediately cause evident dryness. The idea behind using these products is to create squeaky-clean hair, but it’s not necessary for textured hair. Don’t misconstrue that statement to mean your hair shouldn’t be clean, and that heavy with oils and moisturizers is better. Milder shampoos and sometimes co-washes, which do not involve the use of any shampoo, can get the job done without stripping the hair.

It is essential for textured hair to receive as much moisture as possible without oversaturation of the fibres. Inadequate moisturizers and pomades, or “grease” as our mothers call it, can create a false sense of moisture in that they weigh the hair down without actually infusing moisture. These products will make hair look shiny immediately, but won’t actually help in the process. Therefore, if we look at the use of poor shampoos stripping the moisture from your hair, in addition to conditioners and other products only adding to the look of moisture rather than infusing it, we can see how hair washing could have developed a bad reputation.

Shampoos mainly known for their cleaning abilities comprise 40 to 70 percent water and have a slightly higher pH than conditioners to lift hair cuticles and remove dirt and product build-up. They also contain a variation of cleansing ingredients like sulphates and surfactants, which remove dirt and products; foam boosters to increase lather; and conditioning agents to add some moisture to the hair follicles. There is no one shampoo which is perfect for every type of hair, which is why it is imperative for you to understand what you hair needs. There are three main types of shampoos: moisturizing, clarifying and chelating. Choosing the types of shampoos which best suit you don’t always fall into one category and you may have to use two or all three types of shampoo.

Moisturizing shampoos tend to be sulphate-free and are best for weekly uses and gently cleansing hair without robbing it of moisture. Clarifying shampoos are used, perhaps once a month, in order to properly remove the build-up of hair products, like greases and gels, but are not suggested for weekly use. Chelating and clarifying shampoos are often confused as they have the same basic function, however, chelating shampoos work on a deeper level. Chelators work by affecting the hair’s bonding structure and help to prevent damage caused by hair being washed in areas with hard water. Chelating may be necessary for you depending on how hard your water is, but that in itself is hard to determine unless you look into it on your own.

I could go on about the different types of shampoos and how to use them, which I will, but you will have to stay tuned for the next edition as I give more breakdowns and eventually dive into conditioners and moisturizers. Yay! Fun!

If you have questions about your hair care regimen, or if you’d like to leave me a comment, feel free to send your email to Health & Beauty coordinator Claudienne Peterson at

Journey to understanding hair loss

It feels great to be back! My friends don’t care to listen to me babble about hair as much as I do, so it’s pleasant to trap others. I’m joking of course, or am I? So sorry today’s topic seems so serious as this is something no woman ever wants to talk about, but quite a few seem to be experiencing currently – hair loss. Even typing the words make me cringe.

~ It’s possible at the all new Dident Dentist ~

My fellow islanders, I would love to introduce a brand new dental clinic on St. Maarten called Dident Dentist! This is a lovely team of professionals in various aspects of the dental industry and their major goal is to help you get your teeth and gums healthy with as little pain as possible!

When I first heard about this brand new, state-of-the-art clinic, what caught my ears was the whole aim of having a pain-free dental experience no matter what the problem was. First of all, the team is super welcoming and truly cares about your experience; they really want you to have a good one.

New dental techniques used in Holland will be introduced in the coming months.

3D scanner – This makes it possible to have a good fitting zirconium crown within an hour.

Lasers – This instantly kills all the bacteria around the teeth and gum, quite deep in the gum.

Laughing gas – This is used for extreme situations. “We always talk through what the fear is, because often I find ‘try it, come with me’ if there is anything you feel, just raise your right arm, we’ll have a rinse, we’ll have a talk. The same goes with children, we’ll have fun; I’ll make a little face painting as reward, or toys as reward. Or even with the mirror, we count the teeth. I would like them to have a nice association with the dentist, it’s very important.”

General anaesthesia – With a new electric aneastheticum applicator, it’s a painless way to deliver anaesthetics – an anaesthetic that applies not too much pressure upon the gum. Not like a needle that goes in and fills up the liquid, it goes in and slowly disperses the anaesthetic in the mouth. It’s very gentle, and we also have gel that we can use before we put the needle in. We don’t have to go through the fear of one prick by a long needle; we can have a much more soft approach by soft penetrating local anaesthetic going into the soft tissue in your mouth.

Dental Hygienist Lien De Graaf
Lien De Graaf was born in the Netherlands. The married mother of three became a qualified dental hygienist, receiving her diploma at Vrije Universiteit Amsterdam. She also studied dental hygiene at Guy’s Hospital, London. She has more than 25 years of work experience overseas in private clinics, hospital medical services, laser and orthodontic clinics. She has done volunteer dental work overseas in Nepal and has volunteered dental health education programs at various local schools and involved with fundraisings and charities. Her hobbies include sailing, scuba diving, trekking, oil-painting and travelling. Her motto is “Never give up, life is short, give it a try.”

Why you really need to see a dentist
-Plaque is not entirely removed from the surface of the teeth regardless of how rigorous (although not recommended) the teeth are brushed every day.
-While not treated, the bacterial growth progresses downward between the teeth and gum. This is called a pocket. Once this process is ongoing, the gum starts to get inflamed so the bond between gum and teeth gets destroyed. Now it’s “boogy woogy” time for the germs. One of the first warning signs of gum disease is bleeding by brushing teeth, although this won’t happen when somebody smokes, but there is still a disease. Eighty percent of the human population have this problem, but it can be stopped by good treatment.
-Bacteria will penetrate deeply along the teeth’s surfaces while destroying soft tissues responsible for holding the teeth in their position.
-The end of this process is a long period of a foul odour (and possibly taste in the mornings especially) and then finally losing your teeth.

I was so impressed with visiting this beautiful clinic, meeting the wonderful team, interviewing the very delightful Lien, and getting comfortable, that I decided to make an appointment for my very own first visit to their clinic. I now have faith in having a really good dental experience. You should go and visit too!

Dental hygiene treatments are focused on the following issues:
1. Prevention: Dident provides you with health education. Expect to see them soon contributing to the community and visiting the elementary schools on St. Maarten.
2. Treatments for children
3. Regular cleaning
4. Deep laser cleaning: This is for those severe cases of the growth of bacterial pockets alongside the teeth (where bad smell and sometimes loose teeth are the case); the laser treatment is really effective as it sterilizes the space between the teeth and gums. This is not painful at all or intrusive because the impulses are too short to be recognized by the nerves. Lasers are very precise and make the difference between ad broom and a pencil.
5. Maintenance of existing structures in the mouth
6. Making anxious patients feel comfortable; 65% of patients are afraid of the dentist. This is where laughing gas (nitrox gas) comes into play; in most situations, it takes away fear.
7. Teeth whitening: At Dident this is precisely applied gel on the surface of the tooth avoiding the gum line, then it is blasted with laser-light to safely intensify the whitening process.

Dident Dentist is located on One Niger Road, 1(level 3) Cupecoy, Lowlands. Contact 524-5090 or Visit The building is situated at the opposite of Porto Cupecoy at the roundabout.

By Tijon

“I know [a fragrance] will be a success when a man falls in love with a woman who is wearing it.” ~Jean-Paul Guerlain

Scientists are increasingly confirming what aroma therapists and perfumers have always believed – that fragrance affects psychology. By measuring brain wave activity and heart rate, researchers have proved that certain scents such as lavender and chamomile are calming, while others like neroli and bergamot are stimulating.

In one test, computer keyboard operators typed 14 per cent more strokes per hour with a hint of citrus or cedar in the air, and made 21 per cent fewer errors. Current studies designed to pinpoint the specific mood effects of fragrances are focusing on a method of psychological evaluation called “mood profiling” which helps identify which fragrances make us feel best.

Perfume history:
In 1630 Tulips from Turkey, the spring-blooming perennials were first introduced in France by botanists. This led to a tulip perfume that became all the rage in Paris. The Dutch took things a step further and proclaimed this new flower their national symbol. Tulips come in a variety of colors except pure blue (if it looks blue, it is actually considered a violet hue).

Our sense of smell:
It has been believed since 1920 that the human nose could discern about 10,000 odors. A new study now claims humans can discern over one trillion odors. Women can generally smell scents more acutely than men, but of course, dogs beat us all.

Fragrance fact:
Fragrances will be more intense on people with a high fat, spicy diet. The scent of the fragrance doesn’t change, but the scent of your skin does. Most of us forget that our skin is an excretory organ. Spicy foods spice up the oils secreted through the pores of your skin; so spicy skin, different fragrance.

Fragrance tip:
How to choose a perfume? Like many sensory experiences, our reaction to smell is an instinctual process. Trust yourself, and learn which scent family – floral, fresh, woody, etc. – you are most innately drawn to. If you observe which fragrances you like most upon first sniff, over time, you will likely start to see a pattern.

Earthy scents are the physical manifestation and grounding force from which all elements are founded. Its raw, organic, often untamed character encompasses the vastness of air, fluidity of water and the spirit of fire, while remaining true to its primitive foundation. Its landscapes are a mosaic of history and authenticity. Popular in this category is amber, vetiver, patchouli and sandalwood.

How can I tell if my fragrance is overpowering?
Ask a friend. Since we can’t smell the fragrance we’re wearing after a while, we have to rely on the opinions of friends and family. If you regularly receive compliments, that’s probably the surest sign that you’re wearing the right fragrance. On the other hand, if people ask which fragrance you’re wearing but make no other comment, beware!

Oil spotlight: Galbanum.
In Christian Biblical history, when Jesus was born, the three Magi brought gifts of frankincense oil, myrrh oil and gold. There are some reports that the third gift, gold, may have been changed in translation and may actually have been another fragrant and expensive oil, galbanum. Indigenous to Northern Iran, it is a small plant whose oil is used as a base note in perfumes.

Law of random numbers:
If you dial a wrong number, you never get a busy signal, someone always answers.

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