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HEALTH & WELLNESS

Coping with fewer hours of daylight

Daylight saving time comes to
an end each fall, at a time when
the hours of available sunlight
already are beginning to decline.
Some people are more accustomed to darkness than others.
Norwegians, Swedes and people
living in Alaska and the upper
reaches of Canada near or above
the Arctic Circle may go through
a period when winters can be
especially dark. Fairbanks, Alaska, gets just three hours and
42 minutes of sunlight on the
winter solstice. Those in Barrow,
Alaska, will endure a period of

67 days of darkness, according
to Alaska.org. Residents of Seattle, which is even further north
than cities such as Fargo, North
Dakota, or Portland, Maine, deal
with more darkness than those
living outside the city may know.
Although much of the rest of
North America doesn’t experience such profound periods of
darkness, when the darkness of
fall and winter arrives, it can
be difficult to maintain a positive outlook. Borrowing some
of the coping mechanisms relied
on in northern latitudes can help

many people to see the dark in a
different light.
· Be aware of SAD. Seasonal
affective disorder, or SAD, is
defined by the Mayo Clinic as a
type of depression that’s related
to changes in seasons, beginning and ending at about the
same times each year. Symptoms
tend to start in the fall and continue into the winter, sapping
energy and making a person feel
moody. As with other types of
depression, SAD can get worse
and lead to severe problems if
left untreated. Light treatment,

Determining
breast cancer stage

When receiving treatment
for breast cancer, women will
learn about cancer staging.
According to the nonprofit
organization Breastcancer.org,
determining the stage of the
cancer helps patients and their
doctors figure out the prognosis, develop a treatment plan
and even decide if clinical trials
are a valid option.
Typically expressed as a
number on a scale of 0 through
IV, breast cancer stage is determined after careful consideration of a host of factors. The
staging system, sometimes
referred to as the TNM system,
is overseen by the American
Joint Committee on Cancer
and ensures that all instances
of breast cancer are described
in a uniform way. This helps to
compare treatment results and
gives doctors and patients a
better understanding of breast
cancer and the ways to treat it.
Breastcancer.org notes that
the TNM system was updated
in 2018, but before then was
based on three clinical characteristics:
· T: the size of the tumor and
whether or not it has grown
into nearby tissue
· N: whether the cancer is
present in the lymph nodes
· M: whether the cancer has
metastasized, or spread to others parts of the body beyond

the breast
While each of those factors
is still considered when determining breast cancer stage,
starting in 2018, the AJCC
added additional characteristics to its staging guidelines,
which make staging more complex but also more accurate.
· Tumor grade: This is a
measurement of how much the
cancer cells look like normal
cells.
· Estrogen- and progesterone-receptor status: This indicates if the cancer cells have
receptors for the hormones
estrogen and progesterone.
If cancer cells are deemed
estrogen-receptor-positive,
then they may receive signals
from estrogen that promote
their growth. Similarly, those
deemed progesterone-receptorpositive may receive signals
from progesterone that could
promote their growth. Testing
for hormone receptors, which
roughly two out of three breast
cancers are positive for, helps
doctors determine if the cancer will respond to hormonal
therapy or other treatments.
Hormone-receptor-positive
cancers may be treatable with
medications that reduce hormone production or block
hormones from supporting the
growth and function of cancer
cells.

· HER2 status: This helps
doctors determine if the cancer cells are making too much
of the HER2 protein. HER2
proteins are receptors on breast
cells made by the HER2 gene.
In about 25 percent of breast
cancers, the HER2 gene makes
too many copies of itself, and
these extra genes ultimately
make breast cells grow and
divide in ways that are uncontrollable. HER2-positive breast
cancers are more likely to
spread and return than those
that are HER2-negative.
· Oncotype DX score: The
oncotype DX score helps doctors determine a woman’s
risk of early-stage, estrogenreceptor positive breast cancer
recurring and how likely she
is to benefit from post-surgery
chemotherapy. In addition, the
score helps doctors figure out if
a woman is at risk of ductal carcinoma in situ recurring and/or
at risk for a new invasive cancer
developing in the same breast.
The score also helps doctors
figure out if such women will
benefit from radiation therapy
or DCIS surgery.
Determining breast cancer
stage is a complex process, but
one that can help doctors develop the most effective course of
treatment. More information is
available at www.breastcancer.
org.

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talk therapy and medication can
help people who are susceptible
to SAD.
· Make daylight hours count.
Spend time outdoors while the
sun is bright in the sky. Make an
effort to switch your schedule
if work interferes with getting
outdoors, even if all that can be
managed is an outdoor walk at
lunch. Sit by a bright window
and soak up rays when possible.
· Celebrate winter activities.
Go skiing, snowboarding, outdoor ice skating, or snowshoeing. Look forward to winter for

what can be done, rather than
what can’t.
· Socialize more often. Instead
of holing up indoors alone, frequent the places that become
indoor gathering spots for locals.
These can include coffee houses,
breweries, restaurants, or even
the local church. Plan more
social occasions with friends
and families so everyone can
collectively shoo away the winter
blues.
· Exercise more. Use the darker hours as an excuse to exercise
more, be it at the gym or outside.

The Mayo Clinic says that exercise and other types of physical
activity can relieve anxiety and
depression, lifting an individual’s
mood as a result.
· Light a fire. Set the kindling
ablaze in a fire pit, fireplace or
woodburning stove, or just light
a handful of candles. Flames can
be soothing and less harsh on
the eyes than artificial light.
Fall and winter darkness
does not have to send a person
into the doldrums if he or she
embraces the right attitude.

Understanding
osteoarthritis

The most common chronic
condition of the joints in both
the United States and Canada,
osteoarthritis affects roughly 30
million people in just those two
countries alone.
While osteoarthritis, or OA,
can affect people of all ages,
it’s most common in men and
women over the age of 65.
Understanding osteoarthritis
and how to prevent and manage the disease can help men
and women over the age of 50
reduce their risk and live more
comfortably even if they develop OA.
What is osteoarthritis?
According to the Arthritis
Foundation, healthy joints are
covered by cartilage, a flexible
connective tissue that covers
the end of each bone. Cartilage
facilitates motion of the joints
and serves as a cushion between
the bones. When a person has
OA, cartilage breaks down,
causing swelling and pain and
affecting the mobility of the
joint. Over time, OA can worsen and cause bones to break
down and develop bone spurs,
which form when bones meet
each other in the joints. OA can
even advance to a point where
cartilage wears away and bone
rubs against bone, creating even
more pain while damaging the
joints even further.
What causes
osteoarthritis?
Once considered a byproduct
of the wear and tear the human
body naturally endures over a
lifetime, OA is now viewed as
a disease, notes the AF. The
following are some potential
causes of OA.
· Genes: The AF notes
that certain genetic traits can
increase a person’s likelihood
of developing OA. Collagen is a
protein that makes up cartilage,
and, while rare, a genetic defect
that affects the body’s production of cartilage can lead to OA
occurring in people as young as
20 years old. Researchers have
also noted that the gene FAAH
is more commonly found in
people with OA of the knee

than in people who don’t have
the disease. FAAH has been
previously linked with pain sensitivity.
· Weight: Being overweight
increases a person’s risk for a
host of ailments and diseases,
and OA can be counted among
them. Extra weight puts additional pressure on hips and
joints, and over time those extra
pounds can cause cartilage to
break down more quickly than
it would if the body was not carrying extra weight.
· Injury: Men and women
who have suffered injuries to
their joints may be at greater
risk of developing OA than
those with no such injury history.
· Overuse: Overuse of joints,
tendons and ligaments can
accelerate the breakdown of cartilage and increase a person’s risk
of developing OA. Cartilage also
can break down more quickly in
the bodies of athletes and people
whose careers require them to
stand for extended periods of
time, bend over frequently and/
or lift heavy items.
· Preexisting conditions:
Conditions such as rheumatoid
arthritis, hemochromatosis and

acromegaly may also contribute to the development of OA
among people diagnosed with
such disorders.
Prevention and
management of oa
Men and women who maintain healthy weights and exercise regularly and appropriately
may be able to prevent the onset
of OA. Appropriate exercises
include strength training that
focuses on building muscles
around the joints, even if those
joints are already affected by
OA. Strong muscles around the
joints can reduce the pain associated with OA, while range-ofmotion exercises can improve
flexibility of the joints and
reduce stiffness. Aerobic exercise also helps men and women
maintain healthy weights while
facilitating weight loss for those
who are already overweight.
Those already diagnosed
with OA should speak with their
physicians before beginning
an exercise regimen, and such
conversations can also include
discussions about the various
medications that can be used to
reduce symptoms of OA.
More information about OA
is available at www.arthritis.org.

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