1. Ice Bound Heather Tedeschi

2. Breast Cancer Statistics • 1 in 8 women are diagnosed with breast cancer • 2nd most commonly diagnosed cancer in women • 2nd highest death rate in women due to cancer • From 1999-2006, rates have decreased by 2% per year

3. Stages • 0: Abnormal cells that have not invaded breast tissue or grown outside the duct • 1: cancer cells have invaded breast tissue • Tumor is smaller than 2 cm • IIA: axillary lymph nodes only • Tumor is smaller than 2 cm &has spread to lymph nodes • Tumor is between 2 and 5 cm and not in lymph nodes • IIB: between 2 and 5 cm and in lymph nodes • Lager than 5 cm and not in lymph nodes

4. Stages • IIIA: same as II except cancer is in axillary lymph nodes that are attached to each other • IIIB: spread to chest wall or skin of the breast (inflammatory • Lymph nodes may be attached to other structures or near breastbone • IIIC: any size tumor that has spread to chest wall and or skin of breast (inflammatory)

5. Stages • IV: Spread to other organs (bones, lungs, liver, brain)

6. Summary • Active childhood • Medical school at age 23 • Married • Ad for a job at the South Pole after newly divorced

7. Summary • February 1999: last flight left the South Pole • March 1999: found a lump in her right breast • June 1999: reported the lump and attempted to draw fluid from the mass • June 22: Performed biopsy • July 10, 1999: airdrop by the U.S. Air Force • 3 days later, identity revealed to the New York Times • Radiation

8. Summary • July 22, 1999: Confirmation of breast cancer • July 24, 1999: started chemotherapy • Sept. 1999: tumor no longer responds to chemo • October 16, 1999: New York National Guard brings Jerri to Indiana University Hospital • April 2000: cancer free

9. Key Themes • Physician-patient communication • Coping with the possibility of dying • Social Support • Interests

10. Effects of Breast Cancer • Depression (Reich et al., 2008) • 2x more common • severity of cancer, level of physical impairment, and past history of depression • Depression goes untreated

11. Effects of Breast Cancer • Fatigue (Montgomery, 2009) • 90% of chemo or radiation patients • Patients who reported chemo or radiation scored higher on fatigue measure • Radiation treatment = sig. muscle weakness

12. Course of Treatment • Hormone Therapy • Lupron: IM injection every 3 mo. • Tamoxifen: daily pill • Chemotherapy • Kytril taken orally to prevent nausea • Surgery • Lumpectomy • Mastectomy • Radiation

13. Intervention • Quality of life • Galvao and Newton (2005): Exercise • Social support • Park et al. (2009): spousal support to increase BSE • Remien et al. (2005): social support to increase medication adherence

14. Participants • Breast cancer patients • Recruited from medical centers in central Texas • Stage 1-4 • Partner and friend

15. Procedures • Initial intake • Self-report: depression, anxiety, and fatigue • Social support group and no social support group • Education Session: Breast cancer and exercise • Once a week exercise sessions for 2 months • Self-report symptoms and 2 and 6 months • Newsletter

16. Questions?