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segment, click here.

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JAN 15, 2010 |NYTimes.com
How to Live Well Beyond Breast Cancer
By Tara Parker-Pope

Most books about breast cancer are focused on a woman’s immediate crisis, helping them learn more about the disease and make urgent treatment decisions. But what happens to women after all the decisions are made, the treatment is finished and life is supposed to go back to normal?

The American Cancer Society estimates there are some 2.5 million breast cancer survivors in the United States, and for most of them, life never goes back to what it used to be, said Dr. Marisa C. Weiss, a breast oncologist and founder of the nonprofit information Web site BreastCancer.org.

A 12-year-old book gets updated to catch up to the news and needs of women after breast cancer treatment.

Dr. Weiss is the co-author of a new book, “Living Well Beyond Breast Cancer: A Survivor’s Guide for When Treatment Ends and the Rest of Your Life Begins.’’ The book, written with her mother, Ellen Weiss, was originally published in 1998 as “Living Beyond Breast Cancer.” The updated version reflects not only the dramatic changes in breast cancer treatment and advice over the past 12 years but also addresses a range of issues now more commonly faced by women after treatment, like “chemo” brain and sleep problems. In addition, the book reflects the personal experience of Ellen Weiss, who learned she had breast cancer five years ago. Dr. Weiss said her mother was doing well and “was able to provide deeper and more useful insights into the experience of surviving breast cancer.”

For the Friday “Well Bookshelf” series, I recently spoke to Dr. Weiss about her new book and why women need more information about life after breast cancer. Here is our conversation.

Q.
There are so many books now about breast cancer. Why did you decide to write this book?
A.
More and more women are surviving breast cancer because of advances in early detection and treatment. They want to know how to move on with their lives. The whole point of diagnosing breast cancer and treating it effectively, it’s not to give treatment. It’s to give them back a life worth living that’s meaningful, that’s fun, where they’re contributing. We want to make sure that women have all the information they need to get past their treatment, move on with their lives and overcome or manage a lot of the lingering issues.

Q.
People often talk about getting back to “normal” life. Is that possible after breast cancer?
A.
It used to be when we talked about women getting past breast cancer, we talked about how long would it be to return to normal. They never go back to where they were. Their lives are transformed by this experience. What’s realistic is they get to a new normal. Life won’t look the same as it did, but with time they can reestablish a sense of normalcy and feel much more like themselves again.

Q.
Why did you change the title to “Living Well Beyond Breast Cancer”?
A.
Because people don’t want to just be living beyond breast cancer. They don’t need to just live. They want to live well. And they want to live well beyond this disease. When the C.D.C. (Centers for Disease Control and Prevention) and SEER (Surveillance Epidemiology and End Results) issue survivorship data, they usually give five year survivorship. Women are like: “Five years? Tell me my chance of living 10 years, 15 years, 25 years.” They say, “I have a 5-year-old kid. I want to see her walk down the aisle 20 years from now.”

Q.
Does this book have treatment advice for a woman newly diagnosed with breast cancer?
A.
The book picks up where your primary treatment drops off. After surgery, radiation, chemotherapy, that’s where women start to ask themselves: When this is over, what do I do next? Do I ever see these doctors again? How do I move beyond it? There are a lot of treatments ongoing. Hormonal therapy like tamoxifen or aromatase inhibitors, those go on for five years. Herceptin goes on for a full year. For anybody who is living with metastatic disease, they are on continuous treatment. So we have information in the book about ongoing therapies.

Q.
What’s one of the most common questions women ask after breast cancer treatment ends?
A.
One thing women don’t anticipate is that at the end of treatment, instead of feeling jubilant and completely relieved and happy, they often feel depressed and anxious and worried and isolated. They were in this continuous whirlwind tour of the medical system, and then all of a sudden they are abandoned and there is separation anxiety when they no longer see their doctors on a regular basis for treatment. Everybody expects they will get back to normal right away and go back to a full time job, go back to their prior expectations and performance. That’s not always realistic. There is a reality check of being different than you were and not having active sympathy since treatment is over.

Q.
What are some of the other common experiences of women after breast cancer treatment?
A.
Another big side effect is fatigue. There are hot flashes from premature menopause and side effects of ongoing hormonal therapies. Another one is difficulty with cognition. People call it “chemo” brain or mind fog – that’s also a big issue. Difficulty sleeping. Waking up with anxiety, hot flashes, restlessness – you no longer feel as rested during the day. And especially for any young woman who goes through this, they also struggle with body image issues.

Q.
Did you talk about “chemo” brain in the first edition of the book?
A.
There was some information, but it was really small. We know now that women really suffer from not being able to perform as well as they used to. More women get chemotherapy and are taking ongoing therapies. These things can affect their cognitive ability and ability to multitask. A woman today is on the cellphone, the BlackBerry, on the computer, kids are calling her and she’s meeting a deadline for work. The need to multitask constantly is so much more today than it used to be. It’s not a surprise that this issue should be much bigger today than it was even 12 years go.

Q.
Do you ever hear from women who say that the new normal after breast cancer is better than the old normal before their diagnosis?
A.
Many people have transformational experiences where they feel like: “I know what really matters to me. My priorities have been reordered. I know who my friends are, I know who I want to spend time with. I’m going to make sure I travel more.’’ They realize how precious life is and that life is your greatest gift. The whole reason you subject yourself to chemo, radiation, surgery and all this rough stuff is to get back to a life you find worth living. On the other side, people say, “I’ve worked hard to get to this point, I’m not going to take anything for granted.” I hear a lot of times women say: “My life is better than it ever was before. My relationship is stronger with my husband,” or “I’m getting out of a dysfunctional relationship.’’

To view the article on the NY Times website click here.

SEPT 26, 2008 |NBC10.com
High School Students Get Candid
About Breast Health
Book By Mother-Daughter Team
Answers Questions, Alleviates Fears

A mother-daughter team has co-authored a book that is encouraging girls to start talking about breast health, and on Friday they brought their message in person to Friend Central High School. Watch Video Dr. Marisa Weiss is a renowned breast cancer oncologist. She and her daughter Isabel Friedman wrote "Taking Care of Your Girls: A Breast Health Guide."

The book's purpose, they said, is to help girls open up about their fears and ask when they have questions.

"Young girls weren't getting the answers they needed to resolve their anxieties," Friedman said. " … So from that we started writing this book together."

The book, and Friday's assembly, covered an array of topics, ranging from size, to breast shape to myths.

Most importantly, the students learned monitoring one's breast health should not begin at middle age. What a person does right now impacts her risk of breast cancer later in life, Weiss said.

"It's perfect timing, during the years 8 to 18," Weiss said. "That's when you can make the biggest differences (because) that's when you're actually laying down the foundation of your future breast health. That's when habits get set in place, lifelong habits, what you eat, what you do drink, physical activity, your weight."

Weiss said nine of 10 breast cancers could be attributed to a woman's lifestyle, a message well received by 16-year-old Olivia Gillison, who said she learned about the potential dangers of plastics during the assembly.

"I didn't realize plastics were so unhealthy for us, like heating up our food in plastics and everything," Gillison said.

Phoebe Harris, 17, said she learned that no two breasts are the same, and there is no such thing as "normal" when talking about size and shape.

"It was fun, there was a lot of joking. It's usually a pretty uncomfortable subject, but they made it fun," Harris said.

To watch the video on the NBC10 website click here.

SEPT 5, 2008 | AMAZON READER REVIEW
You go girls! I was watching a sitcom many years ago, and the lead female character, played by Jamie Lee Curtis, referred to her breasts as "the girls." The lead male said in admiration "Those aren't the girls. They are the women's auxiliary!" I have no idea why that line stuck in my head. Maybe because I was jealous of Jamie Lee Curtis's perfect bust.

Women and girls have always had mixed feelings about their breasts, and very little notion of how to care for them. Taking Care of Your "Girls" is a book long overdue. Written by a mother and her college-aged daughter, it is full of good advice, funny stories, diagrams and many, many quotes from girls and women.

I like the message that everyone should be at peace in their own skin; that there isn't a perfect way to look. I'm still jealous of Jamie Lee Curtis's figure, but I'm comfortable with myself. I'm handing this book to my teenage daughter when she gets home from high school. Anyone with "girls" will appreciate it.

SEPT 3, 2008 | GOOD MORNING AMERICA
Growing up can be hard. One of the most difficult parts is taking care of a changing body. Dr. Marisa Weiss and Isabel Friedman want to help girls get through it and wrote "Taking Care of Your Girls," a "health guide" for growing girls.

GOOD MORNING AMERICA
To watch the interview with Robin Roberts click here.
To read the review on the ABC website click here.

SEPT 3, 2008 | CAPESSA
Thanks so much for writing Taking Care of Your “Girls,” especially for including your daughter in the process. Reading about it in the WSJ the other day flooded me with memories of the time I was 14 and was absolutely convinced I was going to die of breast cancer upon discovering a strange discharge in my breast. It was one of those situations where too much information was actually not enough information and I freaked out. If only I had had your book!

Amber Scott, Capessa Managing Editor

SEPT 3, 2008 | HEALTH.COM
As sophisticated as teenage girls are becoming (and I should know, I have two of them), it turns out they don’t know much about a topic close to their hearts: breasts. When Breastcancer.org—together with Lankenau Hospital in Philadelphia—surveyed more than 3,000 girls, they discovered that:

• More than 30% of girls perceived a normal change
in their breasts to be a sign of breast cancer

• More than 20% thought breast cancer was caused by infection, tanning, drug use, stress, or breast injury—
all of which are breast cancer myths

So Marisa C. Weiss, MD, the founder of Breastcancer.org, and her 18-year-old daughter, Isabel Friedman, wrote Taking Care of Your Girls, a book about breast health for teenagers; it comes out this week.

This is exactly the kind of book I’d like my daughters to read and that I wish I’d had growing up. All I knew about breasts back then was that, for the longest time, I didn’t have any. That both depressed and alarmed me. Had I done something wrong? Was some kind of disease stunting my boobs’ growth?

Those kinds of questions apparently still plague teen girls, no matter how savvy they may be on other topics. “Girls today are smart, but they just don’t know a lot about their breasts or how to keep them healthy,” says Dr. Weiss. “There are adult books and websites on breast cancer, and some puberty books with breast chapters, but nothing written for the modern-day sophisticated girl who is an information seeker.”

Dr. Weiss, who is a breast oncologist, also was concerned about the impact of all the pink-ribbon breast cancer press. Even her own daughter had worries: “I worried about breast cancer until my mother explained that the risks for young girls are very low,” says coauthor Isabel Friedman. “But I have a mom who is an oncologist and most girls don’t.”

That’s why she and her mom filled their book with down-to-earth medical information and illustrations, and quotes from real girls on everything from finding the right bra and the embarrassment of puffy nipples, to the truth about augmentation and (perhaps most useful) how to deal with boys who like to tease.

Friedman also talks frankly about “rackne,” her lingo for chest zits, and how she struggled with stretch marks when her breasts first grew.

Having these candid and knowledgeable guides to “boobdom” makes the journey through it authentic and illuminating. I even learned something I didn’t know—that yeast infections can show up as white spots on your breast skin.

If I’d had this book lo those many years ago, I would have felt a whole lot better about myself. And I would have known what to say when that snot-faced kid in eighth grade said, “Hey Krueger, Halloween is over. Time to take off your sunken chest.”

HEALTH
Poked & Prodded, Boob Blog
Taking Care of Your Girls: Lessons in Teen Boob Health
By Anne Krueger

SEPT 2, 2008 | WALL STREET JOURNAL
Two years ago, when she was nine, Jamie Margulies noticed a lump on the left side of her chest, behind her nipple. She was scared, since her mom had recently been diagnosed with breast cancer. "I thought that since she had breast cancer, I would definitely get it," says Jamie, a 6th-grader who lives in Gladwyne, Pa.

To reassure her daughter, Jamie's mother took her to see her oncologist. The doctor examined her and set her mind at rest: The lump was not a cancer, but a breast bud -- a sign that her breasts were starting to grow.

"That made me feel a lot better," Jamie says.

Her doctor, Marisa Weiss, says she has witnessed a growing fear of breast cancer among young girls, as information about the disease permeates the media. She also has noticed that girls are either uninformed or misinformed about breast health.

"They are still young girls, without the dialogue skills to ask the questions, air their concerns and replace the myths with facts," says Dr. Weiss, director of breast radiation oncology at Lankenau Hospital in Wynnewood, Pa., and founder of Breastcancer.org, a nonprofit educational organization.

Together with her teenage daughter, Isabel Friedman, Dr. Weiss co-wrote a new book "Taking Care of Your 'Girls' ", which hits stores today. Written for girls and teenagers, it offers information on topics such as breast development and size, choosing a bra, how to stand up to teasing and what healthy foods to eat during this time of growth. Throughout the book, Ms. Friedman, who is 18, gives advice and tells stories from a peer-to-peer perspective.

Dr. Miriam Schechter, a pediatrician at the Children's Hospital at Montefiore Medical Center in New York, says she's seeing more awareness of breast cancer among teens and their mothers. "It's not just that there is breast cancer in their families, but you hear about it in the press and among Hollywood stars," she says, adding that it's important to discuss the topic with girls when they begin to form breasts, to allay their fears.

Dr. Weiss's book is an extension of an educational program that she and her daughter have been presenting in schools to girls in grades 5 through 12 and their mothers. At the start of each assembly, Ms. Friedman tells the girls how, when she was 11, she and her younger cousin drew pictures of the many types of breasts they saw at the beach in journals. She says she shares the drawings with the students and talks about how every woman's breasts are different.

Dr. Weiss then gives the girls medical information. She explains that breast cancer is exceedingly rare in girls under 20 and that only one in 10 cases of breast cancer is thought to be due to an inherited genetic abnormality. She describes the steps girls can take to reduce the risk of getting the disease, such as keeping a healthy weight, exercising and not smoking. She also advises them to maintain a healthy diet, including limiting consumption of red meat and fried foods.

It's especially important that girls receive this information at ages eight to 18, she says. "That's when they are using food, water, beverages and the air they breathe as building blocks for breast tissue. They are laying down the foundation for future breast health."

In April, Dr. Weiss and her daughter spoke to about 180 girls at Atlanta Girls' School. Joan Countryman, the then head of school, says the assembly filled a need: "The information that parents and teachers have to help them figure out the kinds of conversations that may be helpful to girls is pretty sparse."

Ms. Countryman says the girls were "firing off questions." They asked Dr. Weiss if deodorant gives you breast cancer (it doesn't), whether sleeping on your side makes your breasts grow unevenly (nope), if stretch marks will go away (most likely), and what bra to wear jogging (one with ample support). They also wanted to know if they would get breast cancer if their mom has it. (Not necessarily, Dr. Weiss told them.) "She calmed their fears," Ms. Countryman says.

Information about breast health and breast cancer can be found at www.breastcancer.org, and people can ask their own questions here.

Recently, Jamie Margulies attended one of Dr. Weiss's assemblies. Now, she says, she tries to avoid chemicals in her food by drinking organic milk, eating organic fruit and avoiding diet sodas. And she's less scared of the changes in her body. "I think it would help every girl if she knew the stages of what was going to happen," she says. "Then she wouldn't be too worried."

in the HEALTH JOURNAL
Girl Talk: Early Education
Eases Fears of Breast Cancer
By Elizabeth Bernstein
Page D1

AUG 28, 2008 | MIAMI HERALD
Boobs. All girls have them, and you should know how to take care of yours - no matter how old you are.

While important topics like breast cancer might not affect you now, you can start taking preventative steps. The book "Taking care of your 'girls': A breast health guide for girls, teens and in-betweens" by Marisa C. Weiss, a breast-docter and her daughter, Isabel Friedman ($15.95, Three Rivers Press) is a great resource if you have questions about your "girls."

It tackles important health issues, like breast cancer, but can also help answer some of your everyday questions and anxieties (we all have them!): what kind of first bra should you get, how to get rid of stretch marks, when will they stop growing, will the size of my breasts even out, and so on. It's helpful to get a doctor's perspective, but it's also comforting to have the voice of a peer in Isabel, a recent high school grad.

in HYPE
Girl Talk
By Sally Dadisman
McClatchy-Tribune News Service

This article was also published in the Belleville News-Democrat, Belleville IL and Kansas City Star, Kansas City, MO

AUG 25, 2008 | PUBLISHERS WEEKLY
An oncologist and founder of BreastCancer.org, Weiss and her 18-year-old daughter have surveyed 3,000 mothers and their daughters to produce this chatty but informative book on breast health for girls and adolescents. The text covers everything from getting the first bra to risk factors for breast cancer (which, the authors note, is nearly nonexistent in teens), and is peppered with questions posed by girls of all ages, ranging from when to start regular breast exams to why breasts sometimes feel painful or tender. Reassuring their readers that breasts come in all shapes and sizes, the mother-daughter duo deals with body image, teasing and bullying, surgery for breast reduction or enhancement and how to do a breast self-exam. Although they stress that for girls most lumps and pains are harmless and normal signs of growth, the message that early care of the breasts is vital rings clear. In a chapter called “Think Pink Live Green,” the authors arm girls with choices they can make for their own breast health future, including eating organic foods, avoiding drinking and smoking, exercising and keeping weight in check. This empowering book will be an excellent impetus for honest conversations about breast health and development.