12 Weeks is a Long Time to Wait for Breast Cancer Chemotherapy

FIRST PERSON | How long a wait is too long when it comes to treatment of breast cancer? A report published in the Dec. 19 issue of JNCI, Journal of the National Cancer Institute, states that after examining records from 6,622 women, the average time for a woman to wait for adjuvant chemotherapy (chemo given after surgery) for breast cancer is 12 weeks. After my surgery, I waited four weeks before chemotherapy began.

Reconstruction delays

A main cause for delays in starting chemotherapy after surgery was immediate reconstruction. Flap surgeries allow for immediate breast reconstruction. This type of surgery requires a long recuperation period. Chemotherapy impedes healing. All incisions must be healed and all drains removed before chemotherapy can start.

I chose breast implants for reconstruction. This process was partially started during my mastectomy — consider it partially immediate reconstruction. A tissue expander was put in after they removed my breast. Recovery time is significantly less than with flap surgery. I still had some stitches in when chemo started.

Testing and imaging delays

Testing such as 21-gene reverse-transcription polymerase chain reaction assay testing and MRIs increased the time frame from lumpectomy or mastectomy to the start of chemotherapy. Some doctors use post-surgical MRIs to determine if clear margins were reached. If they are unhappy with the results of the MRI, a second surgery may be required, thus increasing the time before chemo can start.

My oncologist did not feel that any further testing other than a MUGA scan was necessary following my mastectomy. The MUGA scan was performed in order to check heart function before starting on treatment with a monoclonal antibody. Even though I had to go through this imaging, it did not delay the start of chemotherapy.

Other delays

One of the biggest causes of delays in starting chemotherapy treatment in minority women was access to health insurance. Black women who received Medicaid had the longest wait between surgery and the start of chemotherapy when compared to white women with private insurance. This is something that needs to change. When dealing with breast cancer, the faster and more aggressively it is treated, the better the prognosis for survival. There is no reason a woman should have to wait for treatment just because the government is paying for the chemotherapy.

Twelve weeks is too long to wait to start chemotherapy after surgery. Imaging should not have an impact on how long a person waits for chemo. Waiting too long, especially with aggressive forms of breast cancer could be the difference between life and death. I had imaging and started chemo just four weeks after my mastectomy. My outcome might have been very different had I been forced to wait an additional eight weeks before I started chemotherapy.

Lynda Altman was diagnosed with breast cancer in November 2011. She writes a series for Yahoo! Shine called “My battle with breast cancer.”

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Firefighters ambushed by gunman while responding to house fire

Residence near shooting and fire in Webster evacuated. (Max Schulte/Rochester Democrat&Chronicle via Twitter)

A gunman set a trap and shot and killed two firefighters responding to an early morning blaze in Webster, N.Y., police officials said. Two other firefighters were also shot and both are listed in guarded condition at a local hospital.

"It does appear that it was a trap that was set for first responders, but the cause or reasons we don't have at this time," said Webster Police Chief Gerald Pickering as he described  the scene where shots were fired at West Webster firefighters when they arrived at 5:35 a.m. to battle the blaze along Lake Road. Webster is about 10 miles east of Rochester.

The apparent gunman was found dead at the scene, but it’s unclear if he was killed by  a self-inflicted gunshot or if it was from a weapon from police officers who were chasing him.

The victims were Mike Chiapperini, also a lieutenant and public information officer with the local police department, and Tomasz Kaczowka, Pickering said.

Chiapperini was described by Pickering as a lifelong firefighter who started with the department's explorer program and had about 20 years of experience. Kaczowka was a younger firefighter and was also a 911 dispatcher, he said.

West Webster firefighters Joseph Hofsetter and Theodore Scardino were seriously injured and are at Strong Memorial Hospital with gunshot wounds, a hospital spokeswoman said.  Scardino  has  injuries to his chest and lungs. Hofsetter was injured in the pelvis, the spokeswoman said at a media briefing.

An off-duty police officer from nearby Greece, N.Y.  John Ritter was also injured by shrapnel during the shooting, Pickering said.

Pickering said that one of the firefighters who survived made his way across a bridge to get to safety. The other three did not make it across, Pickering said. Police arrived and rescued the other three firefighters, but two were fatally shot, Pickering said.

"These are volunteers who get up in the middle of the night to fight fires. They don't expect to be shot and killed," a tearful Pickering said at the press conference.

The morning scene was described as chaotic as police and firefighters dealt with an immense blaze as well as gunshots,  local news station WHAM-TV  reports.

“I’m not aware of anything like this happening in Webster, obviously not a firefighter being fired upon,” Webster Fire Marshal Rob Boutillier told the Democrat and Chronicle.  Pickering described Webster as resort lakeside community that is quiet and usually peaceful.

There at least four houses that have been damaged by the fire along Lake Road, WHAM-TV reported. Firefighters had to leave the scene and stop battling the blazes while police secured the scene. They continue to battle the blaze.

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New Zealand level series thanks to Guptill century

EAST LONDON, South Africa (Reuters) – A brilliant, unbeaten century from opener Martin Guptill led New Zealand to an eight-wicket victory off the final ball against South Africa in the second T20 international on Sunday.

Chasing 169 for victory in 19 overs at Buffalo Park, Guptill helped erase the memory of Friday’s embarrassing capitulation to 86 all out in Durban with a stunning batting display as the tourists reached their target for the loss of just two wickets to level the series 1-1.

Requiring 39 from the final four overs and 11 off the last, Guptill was on 97 and needing four for victory when Rory Kleinveldt bowled the final delivery – a low full toss which was eased away through extra cover.

Guptill’s unbeaten 101 was just the third T20 international century by a New Zealander, the first two belonging to captain Brendon McCullum who was almost anonymous with 17 from 15 balls during a second-wicket partnership of 73 with Guptill.

The right-handed opener was similarly dominant during an opening stand of 76 with Rob Nicol (25) as he drove the Proteas attack impeccably straight and displayed the skills – and patience – so obviously missing from the New Zealand batsman in Durban.

Captain Faf du Plessis led from the front once again as South Africa posted a competitive 165-5 in 19 overs after losing the toss and being asked to bat first.

Du Plessis paced his innings to perfection on a tricky pitch to reach 63 from 43 balls with eight fours and a six in a match reduced to 19 overs per side following a 52-minute floodlight failure.

The deciding match takes place in Port Elizabeth on Wednesday.

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Quentin Tarantino unchains America’s tormented past in “Django”

LOS ANGELES (Reuters) – Twenty years after Quentin Tarantino unveiled his first film “Reservoir Dogs,” the director has turned his eye to America’s slavery history, spinning a blood-filled retribution tale in his trademark style for “Django Unchained.”

Tarantino, 49, has become synonymous with violence and dark humor, taking on the Nazis in “Inglourious Basterds” and mobsters in “Pulp Fiction.”

In “Django Unchained,” to be released in U.S. theaters on Christmas Day, he fuses a spaghetti Western cowboy action adventure with a racially charged revenge tale set in the 19th century, before the abolition of slavery in the United States.

Jamie Foxx stars as a slave whose freedom is bought by a former dentist, played by Christoph Waltz. The two set off as bounty hunters, rounding up robbers and cattle rustlers before turning their attention to brutal plantation owners in America’s Deep South.

Tarantino is well-versed in delivering violence. But the director said he faced “a lot of trepidation” about filming the slavery scenes. He has already come under fire from some critics for the frequent use in the film of the “N-word” – a racial slur directed at blacks.

The director said he was initially hesitant to ask black actors to play slaves who are shackled and whipped, and even considered filming outside of the United States.

But a dinner with veteran Oscar-winning actor Sidney Poitier, whom Tarantino called a “father figure,” changed his mind after Poitier urged him to not “be afraid” of his film.

“This movie is a deep, deep, deep American story, and it needed to be made by an American, and it needed to star Americans. … Lots of the movies dealing with this issue have usually had Brits playing Southerners and it creates this arm’s-distance quality,” Tarantino said.

Much of the film’s more graphic slavery scenes, such as gladiator-style fights to the death and being encased naked in a metal hot box in the heat of the Southern sun, are drawn from real accounts.

“We were shooting on hallowed ground. This was the ground of our ancestors. … Their blood was in the grass, there’s still bits of flesh embedded in the bark,” Tarantino said.

The film has received good reviews from critics and is expected to add Oscar nominations in January to its five Golden Globe nods.

With the exception of Waltz, who plays eccentric German bounty hunter Dr. King Schultz, the majority of the main players are not only American but from the South.

“It seemed sacred to us, and we couldn’t help but channel those emotions, everybody on the crew and on the set. … Those were very moving days,” Tarantino said.

‘DESPICABLE’ CHARACTERS

Tarantino reunited with Waltz, who won an Oscar in 2010 for his role as a menacing Nazi officer in “Inglourious Basterds,” and long-time collaborator Samuel L. Jackson, who plays slave housekeeper Stephen, a character who Tarantino described as “the most despicable black (character)” in movie history.

“Stephen might be frankly the most fascinating character in the whole piece, and it was important to deal with that whole upstairs-downstairs aspect of the Antebellum South,” he said.

The role that has people talking is Leonardo DiCaprio‘s first villainous turn as a racist plantation owner – a stark contrast from his Hollywood heartthrob “Titanic” days and roles as eccentric Americans in “The Aviator” and “J. Edgar.”

Asked how he felt to be the first director to make DiCaprio a villain, Tarantino laughed, saying he felt “pretty darn good about it.” He commended DiCaprio for turning into a “Southern-fried Caligula,” referring to the tyrannical ancient Roman emperor.

“I saw him as a petulant boy emperor. … He has nothing but hedonistic hobbies and vices to indulge him, and it’s almost as if he’s rotting from the inside,” Tarantino said.

The film’s female lead, Django’s wife Broomhilda played by Kerry Washington, moves away from Tarantino’s fierce screen women such as Uma Thurman in “Kill Bill” and Diane Kruger in “Inglourious Basterds.”

Tarantino said Broomhilda was meant to be the “princess in exile.” He said he was “annoyed” when he was asked by a friend why Broomhilda did not exact revenge on her abusers in the same way as Thurman’s “Kill Bill” character. The film, he said, is “Django’s story.”

“It invokes … that odyssey that Django goes on and gives the black slave narrative the romantic dimensions of great opera or great folklore tales,” Tarantino said.

(Editing by Jill Serjeant, Patricia Reaney and Will Dunham)

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Top Comments: Mashable Readers React to Instagram’s Terms of Service

Monday, Dec. 17: Instagram Updates TOS

Readers had varying reactions to Instagram‘s updates. Some felt that they were fair: If you don’t like the terms of service, argued some users, you have the option not to use the service. Others were far more outraged.

Click here to view this gallery.

[More from Mashable: Why xkcd Is Wrong About Instagram]

This week, the top comments on Mashable brought into focus both the state of the world around us and the constantly changing nature of our virtual lives. Our readers launched into debate when Instagram appeared to be making drastic changes to its privacy policy. Based on the wording of Instagram’s new Terms of Service, photographers worried that they may no longer own the rights to their own work, and that their photos could be used in advertising. As Mashable‘s Chris Taylor put it, the TOS as they stood early this week basically “signed your life away.”

Over the course of the week, we saw new privacy settings for Instagram users revealed, officially commented upon (while remaining unchanged) and then finally rescinded and apologized for.

[More from Mashable: Instagram Updates Its Terms of Service Based on User Feedback]

The Instagram controversy proved that users are, in fact, paying attention to the often glossed-over Terms of Service established by their favorite apps, and that a company’s response to public outcry has the potential to make or break their service.

Mashable‘s senior tech analyst, Christina Warren, compared Instagram’s actions to Netflix’s in the summer of 2011. Outraged users proved they weren’t bluffing about abandoning Instagram: Celebrities and power users threatened to quit the network, and downloads of rival apps such as Flickr and Aviary soared in the days surrounding the controversy. What was your take on this week’s events, involving photo-sharing and users’ right to ownership?

Even more commented upon, though less debated, were two Mashable stories that examined social media backlash in the wake of a tragedy. In the days following the horrific shooting at Sandy Hook Elementary in Newtown, Connecticut, we found ourselves contemplating, both online and off, the horrific nature of the event. Unsurprisingly, the two most-commented-upon stories this week both centered on Sandy Hook’s impact on the social web. Our commenters sounded off on the offensive tweets sent during Obama’s Newtown speech, as well as on the viral post, “I Am Adam Lanza’s Mother.”

Other stories our commenters flocked to this week included a viral video of a golden eagle snatching a baby (later proved to be a hoax), the hacking of the Westboro Baptist Church by hacktivist group Anonymous and the appalling revelation that Facebook’s interns make more money than all of us. We also prepared for the end of the world as brought forth by the Mayan Apocalypse — which never did happen.

What were your favorite moments on Mashable this week? You can be part of the discussion by signing up with one of your social networks, and joining the conversation on our site. Next week, your voice could be featured in the Top Comments.

Happy holidays to our community!

Image courtesy of flickr, Marc Wathieu

This story originally published on Mashable here.

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Former President George H.W. Bush remains hospitalized

(Reuters) – Former President George H.W. Bush, who has been hospitalized for a month undergoing treatment for bronchitis, may not be released from a Houston hospital in time to celebrate Christmas at home as doctors had hoped.

Bush, 88, remained in stable condition and doctors were optimistic he would make a full recovery, George Kovacik, a spokesman at Methodist Hospital, said in an emailed statement on Sunday.

But doctors were being “extra cautious” with his care and no discharge date had been set, the statement said. Earlier this month, Kovacik said doctors expected Bush would be able to spend Christmas at home with his family.

“His doctors feel he should build up his energy before going home,” the statement said.

Bush, the 41st president and a Republican, took office in 1989 and served one term in the White House. The father of former President George W. Bush, he also is a former congressman, U.N. ambassador, CIA director and vice president for two terms under Ronald Reagan.

(Reporting by Kevin Gray; Editing by Daniel Trotta and Vicki Allen)

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NRA’s defiant LaPierre dismisses critics of school gun plan

LaPierre speaks at Friday's press conference. (Getty)

Two days after suggesting a "good guy with a gun" be stationed at every school in the country in response to the deadly shootings in Newtown, Conn., National Rifle Association executive vice president Wayne LaPierre blasted critics of his plan.

In an interview broadcast on Sunday's "Meet The Press," LaPierre reiterated the statements he made Friday at a press conference in Washington, when he said the answer to preventing shootings like the one at Sandy Hook Elementary Sch00l is armed security in every school--in effect, protecting children with guns.

“If it’s crazy to call for putting police in and securing our schools to protect our children, then call me crazy," LaPierre said. “I think the American people think it’s crazy not to do it."

At one point during the often contentious exchange, host David Gregory held up a high-capacity magazine clip that carries 30 bullets, asking if the NRA would support a federal limit on the capacity of such clips.

"Isn't it just possible that we could reduce the carnage in a situation like Newtown?" Gregory asked.

"I don't believe that's going to make one difference," LaPierre responded.

"You're telling me that it's not a matter of common sense that if you don't have an ability to shoot off 30 rounds without reloading, that, just possibly, you could reduce the loss of life?" Gregory asked.

"I don't buy your argument for a minute," LaPierre said. "There are so many different ways to evade that, even if you had that."

“Is there no new gun regulation you would support?” an exasperated Gregory asked. LaPierre refused to answer.

At Friday's press conference, LaPierre--who did not take questions from reporters--argued that had someone at the school been armed, "innocent lives might have been spared."

"The only thing that stops a bad guy with a gun is a good guy with a gun," he said.

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3-day trip becomes 3-week ordeal for 2 Jamaicans

SAN JUAN, Puerto Rico (AP) — It was supposed to be a three-day fishing trip at most. It turned into a three-week ordeal, drifting under an intense sun for hundreds of miles in the Caribbean in a small boat with a broken motor.

The two Jamaican fishermen survived by eating raw fish they caught and drinking water from melted ice they had brought to preserve their catch. The Colombian navy finally plucked them from the sea a week ago and delivered them home Saturday after treating them for severe dehydration, malnutrition and hypothermia.

Everton Gregory, 54, and John Sobah, 58, recounted their story in a telephone interview from Jamaica, while the boat owner and the men’s employer also provided details.

The men set off from Jamaica’s southeastern coast on Nov. 20. The water was glassy, the wind was calm and their boat was laden with 14 buckets of ice, 16 gallons of water and several bags of cereal, bread and fruit.

They headed to Finger Bank, a nearby sand spit 8-miles-long (13-kilometers) that is known for its abundance of fish like wahoo, tuna and mahi mahi. The owner of the 28-foot (8-meter) boat said she usually joins them on fishing trips, but she couldn’t go that afternoon.

After spending a couple of days around Finger Bank, the two men set off for home with their catch. But the boat’s engine soon died. The water was too deep to use the anchor and the current too strong to use the oars, so the boat slowly drifted away from Jamaica.

At first, the men got by on sipping the water and eating the food they brought with them. But days turned into weeks, and they began to eat the fish they had caught and drink the melted ice that had kept it fresh.

Gregory and Sobah kept eating raw fish and used a tarp to try to collect water, but the rain clouds remained at a distance.

Back home, friends and family called police and used their own boats to search the area where the men were last seen. The two fishermen work for the Florida-based nonprofit group Food for the Poor, which chartered a plane to search along Jamaica’s coast.

Marva Espuet, the owner of the boat, said she knew she had packed it with more food and water than needed for a three-day trip, but the thought provided little relief.

“If I had gone, there would have been two boats going,” said the 52-year-old woman, a longtime friend of both fishermen.

With searches proving fruitless, Sobah’s niece grew frantic, recalled Nakhle Hado, a fishing manager for Food for the Poor who helped lead the search. She “begged me that she wanted John back for Christmas,” Hado said.

Hado said some people believed the two men would never be found, but he and others didn’t give up. “My gut was telling me that they were still alive,” he said.

Hado said he had trained Gregory and Sobah on how to survive at sea.

“In case something happens, they don’t have to think twice. They know how to react,” he said. “It’s very important, their mental state.”

Gregory and Sobah finally ran out of fresh water and went several days without drink. A healthy human being can die from dehydration anywhere from three to five days without water.

Then on Dec. 12, a Colombian navy helicopter patrolling off the coast of that South American country spotted the men near Lack of Sleep cay, more than 500 miles (800 kilometers) from where they started. It took two days for a navy vessel to reach them because of bad weather. The men were hospitalized for several days at the Colombian island of San Andres before boarding a plane back home to Jamaica.

“It feels good,” Sobah told the AP in a brief phone interview after arriving.

Gregory said he had lost hope, but Sobah tried to keep him positive that they would be rescued. “I just had that belief,” Sobah said. “I believe in the Creator.”

Yet it is Gregory who plans to keep fishing despite the ordeal because he needs the job.

Sobah said he’s done. “I’m not going to go fishing again. No way.”

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“Hobbit” fever beats Tom Cruise at box office

(Reuters) – The big-budget “Hobbit” fantasy movie ruled movie box office charts for a second straight weekend, fending off Hollywood heavyweight Tom Cruise in new crime drama “Jack Reacher.”

“The Hobbit: An Unexpected Journey” hauled in nearly $ 37 million from theaters in the United States and Canada, according to studio estimates of Friday-through-Sunday ticket sales. The film is the first of three movies based on the classic J.R.R. Tolkien novel about a world of dwarfs, elves and dragons in the fictitious Middle Earth.

In second place, Cruise’s “Jack Reacher” about the investigation into a sniper shooting brought in just short of $ 17 million at U.S. and Canadian theaters. Distributor Paramount Pictures postponed a premiere of the film after the fatal school shooting in Newtown, Connecticut, sparked new scrutiny of violent movies.

Adult comedy “This is 40,” starring Paul Rudd and Leslie Mann as a middle-aged couple, brought in $ 12 million, finishing in third place.

“The Hobbit” was distributed by Time Warner Inc’s Warner Bros. studio. Paramount Pictures, a unit of Viacom Inc, released “Jack Reacher.” Comcast Corp’s Universal Pictures distributed “This is 40.”

(Reporting By Lisa Richwine and Andrea Burzynski)

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Massive PC, Console Game Discounts Ring in Holiday Season

Black Friday, the day right after Thanksgiving, is normally the day associated with electronics sales. And while the proponents of “Cyber Monday” and “Small Business Saturday” have tried to get in on the action, it’s still common knowledge that Thanksgiving weekend is the best time to upgrade your PC or console game arsenal. Right?

Not according to online game retailers. Discounts of up to 80 percent off a game’s retail price are taking place across the web, especially in online stores which offer games in the form of digital downloads (which cost nothing to make extra copies of). Here’s a look at just a few of the sales going on right now, for Windows and Linux PCs, Macs, game consoles, and mobile devices.

Steam (Windows, Linux, Mac)

The annual Steam Holiday Sale is under way, and it’s not just blowing hot air. Complete collections of every Steam game from publishers including Valve are on sale for around the price of one retail title, and individual games can be bought from each bundle for only a few dollars. Each day new sales are available, and most of them are massive, percentage-wise. They’re tied to a personal Steam account (which will always be linked to the original name they were created with), but can be bought as gifts for others.

Also check out: Amazon.com’s PC download sales, many of which are fulfilled through Steam and are discounted about as much. Amazon’s lineup also includes many casual games, of the “$ 10 store discount rack” variety.

Humble Indie Bundle 7 (Windows, Linux, Mac)

The Humble Bundle crew has been offering cross-platform, name-your-own-price bundles of indie games for several years now, and their seventh numbered offering is timed right for the holiday season. Bundles are giftable, the games can be played on Steam, and you can choose how much of your purchase price goes to game developers and how much goes to select charities.

PlayStation Network (PS3, PSP, Vita)

Console gamers aren’t being left out. The PSN Holiday Essentials sale is putting “more than 40 titles” on sale over the next three weeks, with a new selection available every week and even lower prices available to PlayStation Plus members.

Also check out: The Xbox Live Countdown to 2013 sale, with a “Daily Deal” every day until the end of the year.

Other sales

Game publishers SEGA and Square-Enix are discounting many of their most popular titles. SEGA’s holiday sale includes PSN, Xbox Live, Android and iOS titles, with most of its mobile games selling for $ 0.99. Meanwhile, the Square-Enix Winter of Mobile sale page lists huge discounts on iPhone and iPad games, while Android Police blogger Jeremiah Rice has put together a list of which Square-Enix Android games are on sale.

Jared Spurbeck is an open-source software enthusiast, who uses an Android phone and an Ubuntu laptop PC. He has been writing about technology and electronics since 2008.
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