(BPT) - As a commercial airline pilot with nearly 30 years of experience, Diane Sandoval, 50, is no stranger to making difficult decisions. However, she faced one of her toughest challenges not in the skies, but when she discovered a small lump in her left breast during a self-examination. Her worst fear was confirmed after a visit to her doctor when she was diagnosed with early-stage breast cancer.

Following an inconclusive mammogram and ultrasound, Sandoval learned she had several small tumors. She underwent a mastectomy to remove the tumors followed by breast reconstruction, putting her piloting career on pause.

The next big question was whether she should receive chemotherapy or not. Her physician recommended a genomic test — the Oncotype DX Breast Recurrence Score test. This tool has been proven to determine whether chemotherapy will be beneficial for individuals recently diagnosed with early-stage breast cancer. The test provides a personalized score based on the biology of the patient’s tumor that can help tailor treatment decisions for their individual cancer. Recent results from the largest breast cancer study ever conducted, called TAILORx, confirmed that the test clearly identified the 70 percent of women with early-stage breast cancer who receive no benefit from chemotherapy, as well as the remaining 30 percent of women for whom chemotherapy can be life-saving.

Sandoval is one of the nearly 1 million women who has put chemotherapy to the test with this genomic test. Her score confirmed that her risk of experiencing a breast cancer recurrence was low and she would not benefit from chemotherapy. As a result, she felt confident that she could forgo chemotherapy and its associated side effects. Subsequently, she was able to resume her career as a pilot and her active lifestyle.

She recently joined a campaign called “Put Chemo to the Test” to raise awareness of the Oncotype DX test and encourage women recently diagnosed with early-stage breast cancer to ask their doctor to order it before finalizing their treatment plan.

“I hope to help women with early-stage breast cancer better understand their treatment options by raising awareness of this test and how it can determine whether they are part of the majority of patients who may be spared chemotherapy and its well-known side effects or are among the important minority of patients who could receive life-saving benefit from chemotherapy,” said Sandoval.

One in eight U.S. women will develop invasive breast cancer in their lifetime. The treatment of invasive breast cancer should be personalized because what is best for one woman may not be right for another. If you have breast cancer, it's important to take an active role in your health by learning about your available treatment options. An ongoing, collaborative discussion with your doctor is key in determining what treatment option best fits your individual needs. Below are a few questions to ask your doctor:

• What stage is my breast cancer and what are the chances of my cancer recurring (coming back) after surgery?
• Can you order the Oncotype DX test to determine if I will benefit from chemotherapy?
• What are my treatment options? What do you suggest for me and why?
• What are the benefits of each treatment option? What are the drawbacks/side effects of each one?

Breast cancer patients and caregivers can visit ChemoYesorNo.org to download the full physician discussion guide and learn more about the test.

“I want women who were recently diagnosed with early-stage breast cancer to know that there is no one-size-fits-all treatment approach,” said Sandoval. “The test gave me the confidence I needed to forgo chemotherapy, which has allowed me to continue to enjoy my life with my husband. Ask your doctor to order this genomic test before finalizing your treatment plan.”

Tips to Improve Wellness and Prevent Stroke

(Family Features) Stroke is often thought of as something that happens to older people, but more people under 50 are having strokes due to increased risky behaviors, such as smoking and untreated high blood pressure.

Strokes don’t discriminate, according to the American Stroke Association, a division of the American Heart Association, the world’s leading voluntary health organization devoted to fighting cardiovascular disease and stroke. They can happen to anyone, at any age. About 1 in 4 people worldwide will have a stroke in their lifetime. However, up to 80% of first strokes may be prevented.

“Healthy habits can protect and improve brain function and lower your stroke risk,” said Dr. Lee Schwamm, MD, American Stroke Association volunteer chairman and executive vice chairman, department of neurology at Massachusetts General Hospital.

In recognition of World Stroke Day on Oct. 29, the American Stroke Association offers these five tips to help reduce your risk of stroke and maintain mental sharpness as you age:

• Keep blood pressure in mind and under control. High blood pressure is the No. 1 controllable risk factor for stroke. Work with your doctor to manage your blood pressure and get it into a healthy range (under 120 over 80).

• Eat colorful fruits and veggies. Eating lots of fruits and vegetables can lower blood pressure over time, which may help reduce your stroke risk. Some fruits and vegetables, such as mangos, avocados and blueberries, are especially rich in vitamins and minerals that improve brain function and heart health.

• Rest up. Getting 7-9 hours of quality sleep each night can improve brain function both today and long-term. A soothing bedtime routine and avoiding screen time before bed can increase the quality of sleep you’re able to get. Sleep-related breathing issues may also increase stroke risk, so seek treatment right away if you suspect sleep apnea or similar problems.

• Meditate. Emerging science shows practicing mindfulness and being aware of your breathing may reduce blood pressure. A quick way to be mindful anytime is to pause, notice your breath and observe details in your surroundings.

• Take a hike. Getting active activates brain cells, encouraging them to grow and connect more efficiently. Aerobic exercise, like going for a walk, also gives your arteries a workout and makes your brain more resilient to reductions in blood flow that can cause strokes. To maximize health benefits, the American Heart Association recommends adults get at least 150 minutes per week of moderate activity or 75 minutes of vigorous activity (or a combination) and two days per week of moderate- to high-intensity muscle strengthening activity.

“These simple suggestions are great for everyone to follow, even if you don’t think you’re likely to have a stroke,” Schwamm said. “While many adults don’t think they are at risk for stroke or reduced brain function, the reality is that nearly half of all adults in America have high blood pressure, and untreated high blood pressure is one of the most common causes of stroke and also causes up to 60% of dementia.”

For more information and tips for preventing stroke, visit Stroke.org/WorldStrokeDay.

Photo courtesy of Getty Images

Health Care Solutions for Rural Americans

(Family Features) Heart disease, cancer, unintentional injuries, chronic lower respiratory disease and stroke. These top five causes of death in the United States all have a higher incidence of death among rural residents and research points to lack of access to health care as a culprit.
Today, rural hospitals are closing at a rapid pace, expanding an already vast health care desert (defined as inhabited areas more than 60 minutes away from an acute care hospital) across the country.

According to the University of North Carolina’s Rural Health Research Program, since 2010, more than 105 of America’s 1,700 rural hospitals have closed. Additionally, a Navigant report found that 21% of rural hospitals are at high risk of closing unless their financial situations improve.

Every day, rural Americans find themselves farther from medical care.

Practical challenges facing patients

Fatal injuries and illnesses aside, rural residents face other practical concerns related to the health care in their communities.

• Doctors are more concentrated in urban areas, while there are shortages in rural communities. A shortage of doctors can mean less availability for appointments, difficulty capturing enough attention from a busy provider, longer distances to reach a physician and limited access to specialists.
• Statistically, rural residents tend to be older and need more frequent visits to their primary doctors and other specialists.
• Pregnant women have to travel even farther to deliver a baby, leading to an increased risk of complications at birth. Similarly, pre-natal and post-natal care are harder to access.
• Rural residents often enjoy more outdoor activities (such as hunting, hiking and riding ATVs) than urban residents and therefore are at a greater risk of injury that requires treatment at a trauma center.

Airborne answer

One solution to fill the gap in rural health care is air medical services, which transport patients to critical care facilities in minutes. With nearly 90% of patients transported living in rural areas, air ambulance services are an essential part of health care access in these communities.

However, just like rural hospitals, air ambulances are threatened as well. Medicare and Medicaid reimbursement rates have remained steady for decades, while operational costs required for air medical services have increased, creating a financially unsustainable situation. Some private insurers also refuse to cover air medical services or pay minimal costs, requiring patients to assume the balance.

How to take action

The challenges facing rural health care access may be significant, but rural residents can take individual actions to make a difference for themselves, their families and even their communities.

• Express support to elected officials. Rural residents can call or write letters to their senators and representatives and demand they keep local hospitals open and protect access to air medical services. Reaching members of Congress at their local offices may be more effective than contacting their federal offices.
• Support efforts to secure grants. Some universities have been given grants from the Health Resources & Services Administration, an agency of the U.S. Department of Health and Human Services, to create or expand community health initiatives and facilities in rural areas.
• Explore alternative sources of care. Many rural areas have community health workers who complete home visits to assist people with chronic diseases like diabetes and high blood pressure. Although their training is limited compared to that of a doctor or nurse, their service increases health care access and they’re able to spend more time with patients.
• Get educated about your care. One role of community health workers is teaching patients about how to manage their own medical needs. This education helps residents be proactive and preventative in their health care, which can reduce the need for hospitalizations in certain cases, such as learning how to properly manage diabetes.
• Make an emergency plan. For families who reside in a rural community, it’s a smart idea to have a plan in place for how to respond in the event a medical emergency. The plan should include information about the location of the closest hospital, emergency contact information in the community and other details necessary to gain emergency care.
• Consider remote access care. Another option for both rural and urban residents alike is telemedicine, which allows patients to connect with a doctor or nurse virtually using technology and without having to travel. The two-way communication can facilitate evaluation and treatment for minor conditions. The service is offered as a cost-saving incentive through some insurance plans, as well as private providers.

Protecting Patients Against the Unexpected

With increasing frequency, insurance companies are not covering the full cost of medical emergencies, leaving families with out-of-pocket expenses they didn’t expect.

If you need medical transport and a physician or first responder determines air evacuation is the best – or only – option to get you to care, you shouldn’t have to worry about the bill you’ll receive afterward. Many emergency service providers have support efforts in place to help you focus on recovery, not finances.

For example, many air medical companies provide patients access to their patient advocates, who work with the patient’s insurance provider to properly cover air medical transport, taking the patient out of the middle. This process can result in significantly lower costs for the patient, often amounting to just the usual copay and deductible.

Visit globalmedicalresponse.com/protect-patients to learn more about these services in your area.

Photos courtesy of Getty Images (doctor and man, woman speaking with doctor on computer)