Breast cancer

The first symptom, or subjective sign, of breast cancer is typically a lump that feels different from the surrounding breast tissue. According to the The Merck Manual, more than 80% of breast cancer cases are discovered when the woman feels a lump. According to the American Cancer Society, the first medical sign, or objective indication of breast cancer as detected by a physician, is discovered by mammogram. Lumps found in lymph nodes located in the armpits[8] can also indicate breast cancer.
Indications of breast cancer other than a lump may include changes in breast size or shape, skin dimpling, nipple inversion, or spontaneous single-nipple discharge. Pain ("mastodynia") is an unreliable tool in determining the presence or absence of breast cancer, but may be indicative of other breast health issues.
When breast cancer cells invade the dermal lymphatics—small lymph vessels in the skin of the breast—its presentation can resemble skin inflammation and thus is known as inflammatory breast cancer (IBC). Symptoms of inflammatory breast cancer include pain, swelling, warmth and redness throughout the breast, as well as an orange-peel texture to the skin referred to as peau d'orange.
Another reported symptom complex of breast cancer is Paget's disease of the breast. This syndrome presents as eczematoid skin changes such as redness and mild flaking of the nipple skin. As Paget's advances, symptoms may include tingling, itching, increased sensitivity, burning, and pain. There may also be discharge from the nipple. Approximately half of women diagnosed with Paget's also have a lump in the breast.
Occasionally, breast cancer presents as metastatic disease, that is, cancer that has spread beyond the original organ. Metastatic breast cancer will cause symptoms that depend on the location of metastasis. Common sites of metastasis include bone, liver, lung and brain. Unexplained weight loss can occasionally herald an occult breast cancer, as can symptoms of fevers or chills. Bone or joint pains can sometimes be manifestations of metastatic breast cancer, as can jaundice or neurological symptoms. These symptoms are "non-specific", meaning they can also be manifestations of many other illnesses.
Most symptoms of breast disorder do not turn out to represent underlying breast cancer. Benign breast diseases such as mastitis and fibroadenoma of the breast are more common causes of breast disorder symptoms. The appearance of a new symptom should be taken seriously by both patients and their doctors, because of the possibility of an underlying breast cancer at almost any age.

Causes

The primary risk factors that have been identified are sex, age, childbearing, hormones, a high-fat diet, alcohol intake, obesity, and environmental factors such as tobacco use, radiation and shiftwork.
No etiology is known for 95% of breast cancer cases, while approximately 5% of new breast cancers are attributable to hereditary syndromes. In particular, carriers of the breast cancer susceptibility genes, BRCA1 and BRCA2, are at a 30-40% increased risk for breast and ovarian cancer, depending on in which portion of the protein the mutation occurs.
Personal history of breast cancer: A woman who had breast cancer in one breast has an increased risk of getting cancer in her other breast.
Family history: A woman's risk of breast cancer is higher if her mother, sister, or daughter had breast cancer. The risk is higher if her family member got breast cancer before age 40. Having other relatives with breast cancer (in either her mother's or father's family) may also increase a woman's risk.
Certain breast changes: Some women have cells in the breast that look abnormal under a microscope. Having certain types of abnormal cells (atypical hyperplasia and lobular carcinoma in situ [LCIS]) increases the risk of breast cancer.
Race: Breast cancer is diagnosed more often in Caucasian women than Latina, Asian, or African American women.
No physical activity: Women who are physically inactive throughout life may have an increased risk of breast cancer. Being active may help decrease risk by preventing weight gain and obesity.
Antiperspirant use: British scientists found that aluminum, a common ingredient added to antiperspirants to stop the skin from sweating, may be linked to breast cancer. Deposits of aluminum in high concentration near the underarm have been found in outer breast tissue in patients who used antiperspirants. Researchers believe the aluminum is being absorbed from antiperspirant sprays and roll-ons since aluminum is not normally found in the human body.
Pork consumption: People who eat an average of just over one ounce of pork daily have a significantly higher risk for cancer.
Processed meat consumption: The sodium, nitrates and nitrites in processed meats may irritate cells and initiate DNA changes that can lead to cancer. The risk is even higher when these foods are cooked at high temperatures for extended periods. High-heat grilling and pan-frying generates heterocyclic amines (HCAs), which are known carcinogens.
Tamoxifen may interact unfavorably with certain antidepressants when used for prevention of breast cancer recurrence.

Inteligent Exercise Part2

Although there are pilates-style studios and classes springing up across the country, Moira cautions people to research before they begin a program. "Because the method of exercise is very much knowledge-based, requiring a deep understanding of body mechanics and technique, I recommend that people begin one-on-one or in small group sessions with a certified instructor."

Moira and partner-husband Lindsay Merrithew are so committed to preserving and promoting the integrity of the exercise system that they've developed a resource centre of sorts. In addition to their two studios, where you can participate in private and group sessions, they also offer comprehensive training and certification. And if you're having difficulty finding a certified instructor, they encourage you to contact them for assistance.

In the meantime, to help you get started in the comfort of your own home, STOTT PILATES has produced several instructional videos, ranging in level of difficulty and described as "a godsend for all those keen to try exercise based on the teachings of Joseph Pilates but unable to find or afford an instructor in their area." And, if you're really serious, STOTT PILATES can provide you with the related resistance equipment, which they manufacture and sell to fitness enthusiasts and professionals all over the world.

"When I think about how I used to do sit-ups. I used to throw myself down on a mat, do 75 sit-ups and I'd be working my hip flexors instead of my abdominals, thank you very much," recalls John. "This is much different. You actually spend time learning how to exercise effectively."

And if you're still not convinced, take it from renowned ballet dancer Karen Kain, one of Stott's first clients: "Within the first week I could see a difference, not only in my strength and flexibility, but in how much better my back felt."

The First Lady of Pilates Part2

CBI: What do you define as your company's mission?

MS: STOTT is both an educational organization and an equipment manufacturer. We started the company 12 years ago before pilates had become a household word, and our goal has always been to provide high-quality exercise training equipment and support for people who want to get involved. People frequently don't know where to start, and we believe it's important to educate them not only about Pilates, in general, but also about how it's evolved – today, there are a variety of different approaches. That's why we refer to our program as STOTT PILATES, because, while it's based on pilates, we've done a great deal of research to refine our system of exercise.

CBI: What groups are currently certifying Pilates instructors? And are instructors still hard to find?

MS: There are a large number of people, groups, and associations that certify pilates instructors, but the educational level and quality varies dramatically. Some certification programs involve as little as 15 hours of training and don't require a practical examination; they make use of a written test to gauge the competency of instructors. We're finding that many of these people come to us later when they realize they need to know more. We have a training and certification center in Toronto, licensed training facilities in the U.S., and also offer instruction in other parts of North America and Europe. To give you a sense of what we do: our mat class instructor training is a 30-hour program; our reformer curriculum is a 60-hour (or six-weekend) program; and our advanced course, in which people learn about the use of other equipment, such as the Cadillac, chair, and barrels, is a 72-hour program. Only after a person successfully completes all of them can they become a fully certified Stott instructor. We also offer a 24-hour program for instructors who will be working with injured or special population clients. There's currently a huge demand for pilates instructors, but, unfortunately, there still aren't a large number of good, highly qualified instructors.

CBI: Do you still do any teaching yourself? Do you number many of pilates' celebrity practitioners among your clients?

MS: I've held onto a few clients, but, as our company's program director, do very little teaching today. I'm much more involved in teaching instructors and instructor-trainers; I do presentations at industry events and for fitness industry organizations; and I've also been very much involved in the production of the 21 videos that we've completed – 14 of which were for instructors. In terms of celebrities: The Cleveland Indians baseball franchise are big buyers of our equipment, and the Princess of Brunei recently purchased some of our units for her palace. Other clients include Lucy Lawless, better known as 'Zena, The Warrior Princess,' British actor/ comedian John Cleese, rock star Rod Stewart, Cirque du Soleil and a number of professional dancers.

– BAM

Inteligent Exercise Part1

Out of the Dance World... and Into the Mainstream
Don't let the lithe bodies, deep breathing and soft music lull you into thinking exercise based on the teachings of late fitness guru Joseph Pilates (Puh-lah-teez) is just for dancers. It's not. The fact is people from all walks of life, all around the world, are committing themselves to what some are calling a "deeper," more "intelligent" approach to fitness. "I don't come from a dance background, I'm an aging white guy," says John Ford, who suffered muscle tension and joint pain before embarking on a program at the STOTT PILATES Studio in Toronto. "My shoulders used to be hunched up around my ears. Now they're where they should be," says the 48-year-old union representative, adding, "I don't have the knee problems I had before, my posture is better and I'm looking forward to running and roller blading again." Although the method of conditioning has been around since the 1920s, until fairly recently it was a well-kept secret by dancers who used it to help rehabilitate from injury and enhance performance. As people like John discover its benefits, however, it is becoming more widely known and appreciated. "People are developing a more measured, holistic approach to fitness," says Moira Merrithew, a former professional dancer and program director of the STOTT PILATES Studio. "They still want to look fit and toned, but they also want to enjoy the process and to feel more vital and aware of their bodies." In the mid '80s, after hanging up her pointe shoes to nurse an injured foot, Moira discovered the neuro-muscular technique through the Dancer in Transition Resource Centre which offered her a grant to study at Joseph Pilates' studio in New York City. "Learning the intricacies of the method not only helped me to rehabilitate and achieve an optimal level of fitness personally, it inspired me to share the technique with others," says the soft-spoken 38-year-old.	Just as Yoga has evolved over the years to reflect the knowledge and styles of certain experts or gurus – Iyengar and Kudalini being examples – so has exercise based on Joseph Pilates' method. "By taking the teachings of Joseph Pilates and updating them to include what we now know about the body, we can offer a highly effective and safe exercise regime," says Moira. Moira's contemporary approach, known as STOTT PILATES, preserves the essence of Joseph Pilates' original "mind-body" teachings but enhances them with modern biomechanical knowledge and input from such health professionals as physical therapists and chiropractors. Unlike the original method, it incorporates the modern concepts of core stability and neutral postural alignment – restoring the natural curves of the spine – as integral to developing total fitness. As certified instructor Syl Klotz will attest, STOTT PILATES is a mindful yet dynamic workout that can be customized easily to suit the needs and objectives of each participant. Its repertoire of more than 500 challenging moves are based on the principal that by systematically and methodically developing a strong and flexible torso, the whole body can be balanced, aligned and conditioned for optimal performance. "It's the perfect complement to cardiovascular exercise such as power walking, aerobics or cycling," adds Syl. Done regularly – either on a mat or using specially-designed resistance equipment – the posture-improving regime promises muscular strength, flexibility and endurance, without the bulk. And unlike traditional weight training or aerobics programs, an emphasis on movement quality versus quantity makes STOTT PILATES more "work-in" than work-out, leaving participants feeling refreshed, not exhausted. "After only my first session, I felt a combination of strength and peace," says Lydia Stone, who first heard about the method of exercise through a dancer friend. "It makes you feel strong, stretched and invigorated," says the 39-year-old magazine editor and mother of two. "I can't wait to go back."

The First Lady of Pilates Part1

Moira Merrithew has mastered the moves as published in Club Business International magazine
STOTT PILATES, based in Toronto, was founded in 1987 by the husband/wife team of Lindsay Merrithew and Moira Merrithew, and produces a wide range of equipment, manuals, videos, etc., all predicated on the principals of Joseph H. Pilates. Merrithew serves as the president of STOTT PILATES, while Merrithew is the program director of the STOTT PILATES Studio and International Certification Center, which has certified more than 1,000 instructors in the STOTT PILATES techniques. For the many other thousands who have participated in STOTT classes or made use of her educational videos, Moira Merrithew is one of the most visible embodiments of the pilates method. Recently, she spoke with CBI about pilates, her company, and a number of other topics. CBI: How did Joseph Pilates come to develop his theories of exercise? Moira Merrithew: Pilates had asthma as a child, which is thought to be one of the reasons for his strong emphasis on breathing. His approach was to incorporate Eastern and Western traditions – i.e., the Eastern emphasis on controlled breathing, controlled movements, and a highly focused attention, and the more Westernized approach, which tends to rely heavily on resistance. In Pilates' day, a lot of people were developing exercise techniques, and it's likely they all influenced each other. Interestingly, there's a patent dating back to the late 1880s that details an apparatus very similar to the reformer. CBI: Has there been any solid scientific research that documents the purported benefits of pilates? MS: There's been one small controlled study, which compared exercises performed on a reformer with ones utilizing weights and pulleys – that study concluded that the reformer delivered better benefits. There have also been some positive studies, not on pilates, specifically, but on the effects of torso stabilization, restoring the natural curves of the spine, and maintaining the pelvis in a neutral position, all of which are components of pilates-based exercise. But if you're looking for a major piece of scientific research about pilates specifically – it doesn't yet exist. CBI: Pilates is often referred to as a mind/body form of exercise. What does it offer from a psychological perspective? MS: Pilates helps the individual to look inward, primarily by emphasizing their breathing, which helps the mind to focus on what the body is doing. People who practice Pilates-based exercises report that their workouts leave them feeling more serene, invigorated, and self-aware.	CBI: Like so many other forms of exercise, pilates can obviously be practiced at home. Are there any advantages to pursuing it in a studio or club? MS: It's great if people have the discipline to work out at home, but the ideal is to have the instructor with you. There's no question that pilates is best practiced in a personal-training type of environment, and that students with enjoy the best results when they have access to all of the equipment. It's important to understand that, while people tend to rave about the reformer, and while it's crucial to a pilates-based workout, it's only one part of the program. The work that's done on the mat and other equipment is also very beneficial and important. Actually, the ideal training scenario would be to complement your club workout by also working out at home. CBI: How can pilates best be applied in a club setting? MS: A lot of the clubs that have been successful with pilates-based programs began with a good, solid, personal training program and worked their way into pilates-based exercise. Many of them have retrofitted a squash court or some other preexisting space to create a pilates center. The beauty of this approach is that it attracts people of every age and fitness level, and, as a result, can open up markets that, previously, may not have been well-served. We also think that pilates can become an important profit center. If you look back at personal training, you realize that, for many years it wasn't taken all that seriously, but then club owners began to realize that there was a lot of money to be made with it. It's the same with pilates-style programming. Currently, about 50% of all pilates-based instruction is done in a one-on-one environment. We strongly believe that, as with personal training, the success of any pilates-based program ultimately rests with instructors – they're the people who drive this trend. CBI: If you were to give a beginning pilates student some advice, what would it be? MS: Students should understand that pilates is a process, with the main goal being postural correction and enhancement of athletic performance; muscle toning is a byproduct. Students should also be aware of the fact that pilates-based training never has to stop – their bodies will continue to change, and they'll never hit a limit. A good instructor will always be able to take them a little bit further. CBI: Are there any grievances or dangers that can legitimately be laid at the foot of pilates? MS: Because pilates is so instructor driven it's really important that prospective instructors be carefully screened. The quality of instructors can vary dramatically. Another thing that's important is to match the member's special circumstances, if any, with an instructor who's experienced in that particular area.