I recently had the wonderful opportunity to lead a book club discussion on the book, Kosher Nation. I use the term lead loosely, as the group really led itself. I’m not sure if I’ve ever been to any kind of book discussion where there were absolutely no lulls, all of the points brought up were interesting, and everyone there was engaged. Good stuff.

I did panic a little bit when I realized that I couldn’t find any book club discussion questions or guide for leading a discussion of the book. Sure, it’s not on Oprah’s reading list, but I thought I might come across something. So, I put together a few questions for every chapter, and have shared my document via Google docs. If you end up leading or wanting to lead a discussion on this title, I think they’re at least good base to initiate a discussion . Or if you’re reading it alone, they might still be useful for you.

Happy reading and discussing!


30th annual meeting of the San Antonio Breast Symposium occurred in mid-December. The goal of the symposium is, “to provide state-of-the-art information on the experimental biology, etiology, prevention, diagnosis, and therapy of breast cancer and premalignant breast disease, to an international audience of academic and private physicians and researchers.” Interesting and innovative research comes out of this symposium every year. Some of the research that I found especially interesting this year:
A research group based in San Francisco has found a way to discover “lethal cases of DCIS (ductal carcinoma in situ) from ones that will never become life-threatening”. This could potentially prevent other other women in my situation from having a mastectomy or even a lumpectomy, which would be amazing.
new approaches to detecting early stage breast cancer and DCIS using high resolution MRI
the use of telemammography in rural communities
inaccurate application of the clinical breast exam (CBE)
High incidence of brain metastases found in patients with HER2 positive metastatic breast cancer
Survival outcomes in pregnancy-associated breast cancer

There’s lots of other interesting research presented at the symaposium. Abstracts and poster information is available at the site.

it occurs to me that no one would ever respond to a person who’s face had been disfigured in, what say, a car accident that at least they got a free face lift out of it. however the “at least you got a free boob job” seems to be a surprisingly frequent response to women who’ve had reconstruction after breast cancer.

fortunately no one has ever actually said this to me within my range of hearing or in conversation, but if they did, i promise that my response would not be pretty.

At 15 Rob Dyer had the idea that he’d skate across Canada and the US to raise money for cancer research at Princess Margaret Hospital, in Toronto, Canada. It was dismissed as crazy.

Now at the age of 23 he’s already skated across the US, is skating across Canada this year, and is planning to skate across Australia in 2008. Skate4Cancer has morphed into it’s own organization. Rob and others speak at schools, organize concerts to raise money, and have launched a a line of logo t-shirts to keep the funds coming in so they can keep moving. In February of this year they launched the Cure is Knowledge campaign to push the Canadian Government for better prevention through complete blood tests, check-ups, and education in schools.

Over the course of a few years Rob lost two grandparents, and in 2000, his mother to cancer. It’s easier to sit back and do nothing when we’re affected by what is often unexplainable disease and devastating loss. It’s certainly easier than taking a deliberate, expansive, and creative approach to making things better, in this case, mile by mile.

skull putting on lipstick

I’ve turned you all off all ready with the whole breast cancer thing, no? Sorry about that.

Anyway, now that I’m in treatment limbo I’ve got a bit more time on my hands than before and am thinking of the permanent changes I want and need to make to keep “the beast” at bay. Exercising (just as soon as I can, I swear), eating more healthfully, getting enough rest are just some of the obvious things that I’ve been doing even before my diagnosis, but certainly after.

I’m really interested in the environmental causes of cancer (and other aliments, especially chronic diseases). Because from all that I know, from my medical team (as I like to think of them), cancer researchers, and from my own research there is no reason I should have breast cancer at my age. Even a “low key” form of it.

It seems only logical to me to eventually turn to what I’m putting “on” my body and what is going into it just by being out in the world. Since there are obviously numerous directions I could take with this, I’m starting with the things I personally put on my body – cosmetics, lotions, etc.

Parabens are preservatives commonly found in cosmetics, and pharmaceutical products. I checked my shelves and found them in all my lotions, moisturizers, some foundations, etc. The link between parabens and breast cancer appears to be a weak and controversial one. But as a statistical anomaly, I’m buying organic fruit too, I figure why take chances. The problem with parabens is that there is some evidence that they do seem to cause some estrogenic activity and act as xenoestrogens within the body. So far all of my cancer has been estrogen and progesterone receptor positive. I’m currently taking a daily selective estrogen receptor modulator (SERM) to regulate and lower the estrogen levels in my body and with the diagnosis was ordered by every doctor to get off the pill, which I had been taking for about 9 years, immediately. (This is another controversial topic all together as the research seems to be contradictory, but certainly gives me pause.) Although the paraben-breast cancer link seems uncertain at best, again, being a bit of a medical curiosity myself, I see no reason not to take precautions. If I’m going to slather my body with various lotions, extra thanks, in part to the tamoxifen prematurely turning me into an old lady, they can a least be paraben free, right?

A big fan of Lush cosmetics I thought that I could probably go on a shopping spree there and get yummy, paraben free products and was unhappy to find that most of their moisturizers contained parabens.

So I sent them a letter:

“Hello, I am a a 29 year old woman currently undergoing treatment for breast cancer which is estrogen and progesterone receptor positive (meaning that estrogen and progesterone feed the cancer and need to be reduced in my body). I’m currently on hormone therapy treatment (to reduce the amount of estrogen in my body) but have been told to avoid parabens of all kinds (ethyl-methyl-butyl-propyl parabens) as some research indicates that when absorbed into the body it can mimic the female hormone oestrogen. As a result, I have become more selective in the cosmetic products that I use and was almost certain that I could turn to Lush to provide me with an ethically responsible, quality product, which didn’t contain these potentially harmful chemicals.

I’ve been using Lush cosmetics regularly and giving them as gifts since I found my first Lush store while on vacation in Dublin. Shortly thereafter I moved to Washington DC and was delighted to be able to shop in the Georgetown store. You can imagine my disappointment when I discovered that many of your facial moisturizers contain at least one paraben product. After checking the ingredient list of several products, I stopped looking for one which doesn’t contain parabens. Is it simply a lost cause? Must you use parabens in your products? Will I have to discontinue my use of your lovely soaps and moisturizers? Considering my young age, I take what my team of DC doctors recommend very seriously and am doing all I can to prevent recurrence (the odds of which are 50%) and attempt to have a normal lifespan. I would think that this would be an understandable position on my part.

I simply wanted to bring this issue to your attention in case it wasn’t on the table for your company. I have loved your products, have suggested them to and bought them for others. Unless I can find some products which are paraben-free, for my health and the health of those that I love I’m afraid that I can no longer do so, which saddens me greatly.

Best regards,

and I received a nice response,

“Hi Sarah,

Thank you for taking the time to write this email to us. We are very sorry to hear about your current situation. We understand that you are concerned, and you have every right to be concerned about your health. Please allow us to explain our position on parabens.

We try to avoid preservatives whenever possible. At the end of January 2006 133 out of 205 of our products were preservative-free. The normal life of a cosmetic is 30 months under EU regulations unless one states a use by date. Lush products range in shelf life from 3 weeks to 14 months for products one would normally preserve. We can do this because we use far fewer preservatives than many other companies.

Most manufacturers today will use 4 or 5 different preservatives in each product. As you may know, we only will use one or two in our products. We do not want to use them but there are occasions when for practical reasons we want to use a type of formulation for it’s benefits along with the ingredients that are effective and customers need to product to last so we have to preserve. In these instances, we use methyl and propyl parabens because they have a long record of safe use and are the mildest available.

A study published in 2004 (Darbre, in the Journal of Applied Toxicology) detected parabens in breast tumors. The study also discussed this information in the context of weak estrogen-like properties of parabens and the influence of estrogen on breast cancer. However, the study left several questions unanswered. For example, the study did not show that parabens cause cancer, or that they are harmful in any way, and the study did not look at possible paraben levels in normal tissue.

Although parabens can act similarly to estrogen, they have been shown to have much less estrogenic activity than the body’s naturally occurring estrogen. A 1998 study that was published in the Journal of Toxicology and Applied Pharmacology found that the most potent paraben tested in the study butylparaben, showed from 10,000- to 100,000-fold less activity than naturally occurring estradiol (a form of estrogen). This information combined with the knowledge of what a small amount of parabens that we use in our products stands to reason that there is little cause for concern.

We as the manufacturers are responsible for making safe products and if we have any doubts will drop an ingredient or a product. In this particular case we do not have any plans to stop using methyl and propyl parabens if we need to preserve a product although we will as always try not to preserve a product in the first place.

We understand that many people are concerned about the use of preservatives, which is why we try to provide our customers with as many options as possible. We manufacture many products that contain no parabens. Most of the products that you see in our stores or online that are solid contain no preservatives whatsoever. This includes our solid shampoo and conditioning bars, solid facial care products, massage bars and body butters, all of our soaps and buttercreams.

We hope that you have found this information helpful. Please do not hesitate to contact us again if you have any further questions or concerns.

Thank you!

Lush Cosmetics


So there. Mostly paraben free, but not completely. Because of their great and fast response, I’ll continue to buy what I can there, but certainly not their moisturizers.

I emailed M.A.C. on the same day as I couldn’t even find an ingredient list on their web page but have yet to get any kind of response which pisses me off.

I have found a list of companies making paraben free cosmetics via Think Before You Pink. I think a lot of those products are made by small companies (a good thing usually) but can make them hard to find. I’ve had luck with a company called Beauty Without Cruelty whose products I’m able to find at Whole Foods if nowhere else.

To some it may seem like I’m overreacting, but really I’m trying to take this cancer thing in stride and treat it like I would anything else in my life by becoming active and informed. Being an active consumer is never a bad thing.

American Cancer Society Logo

One of the most frustrating things about a cancer diagnosis is what you can’t do about it. You can have treatment and surgery, etc. but you can’t fully predict the results, nor can you make certain that the cancer won’t return or the treatment from the first cancer won’t increase the likelihood of a different type or cancer or illness in the future. You have to deal in the now and do it quickly. Without the diagnosis of a serious illness like cancer yourself, it’s easy not to think about it unless it’s touched someone you love or care about.

If you’ve dipped your toe into the cold pool of research or academia you know how difficult it is to fund and plan for a longitudinal study. The American Cancer Society is in the process of launching an exciting new study that will follow half a million men and women who have no personal cancer history for the next twenty years. The study is referred to as CPS-3. The goal is:

to better understand the lifestyle, behavioral, environmental and genetic factors that cause or prevent cancer and to ultimately eliminate cancer as a major health problem for this and future generations.

Each one of my bevy of doctors has told me, “we have no idea why you have this.” My doctors are affiliated with such places as NIH, Johns Hopkins, and George Washington University. It is disconcerting at best to have such an amazing team of experts tell you that you’re an inexplicable anomaly. In my own personal life, I have two other friends under the age of 35 who have also been diagnosed with various forms of cancer that for all intents and purposes, they should not have.

If you fall into the age range of 30-65 and have no personal history of cancer and are interested in the study, you can contact them by phone (1-888-604-5888) or email ( for more information.

Incidentally, I know I’ve mentioned it before but I still plan to participate in the Komen National Race for the Cure on Saturday June 2nd. If you’ve donated already, I can’t tell you how much I appreciate the support. If you’re considering making a donation, there’s still plenty of time. I’m still hoping to run, but the way I’m feeling now, I may be walking, but more importantly, I’ll be there.

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