Dr. Lori Gore-Green | Women's Health Professional

Dr. Lori Gore-Green's Portfolio of Experience as a Women's Health Professional

Understanding the Stages of Breast Cancer

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Mammograms are an essential part of cancer prevention. Regular screening provides the best chance of early detection when cancer is easiest to treat and cure.

When breast cancer is detected, its pathology report will place it in one of five stages. Categorizing cancer into stages helps the doctor and patient decide upon and implement the best treatment options.

Recent advances in cancer staging guidelines from the American Joint Committee on Cancer (AJCC) make the staging and treatment of breast cancer more complex but more accurate. Information on tumor grade, hormone-receptor status, and possible Oncotype DX test results are considered in all stages when developing a treatment plan.

One of the best ways a patient can alleviate fears of a cancer diagnosis is to understand the stages of breast cancer and the treatment options available.

Stage 0

Stage 0 defines non-invasive breast cancer such as DCIS (ductal carcinoma in situ). There is no evidence of cancerous or other abnormal cells invading tissue outside of the immediate area where cancer began.

Stage I

Stage I defines invasive breast cancer, meaning that cancer cells are present in normal tissue immediately outside of where cancer started but still confined to the breast. The chance of cure for Stage 0 or Stage I is high. Stage I is further divided into subcategories IA and IB.

Stage II

Stage II describes invasive and growing breast cancer that’s larger but still confined to the breast. It may have spread to some axillary lymph nodes. Stage II divides cancer into subcategories IIA and IIB.

Stage III

Stage III comprises three subcategories–IIIA, IIIB, IIIC. Stage III generally describes a more aggressive and invasive cancer. Its size is more than 5cm and, it may be spreading into nearby muscle and lymph nodes. But it has not spread to distant organs.

Stage IV

In Stage IV, breast cancer has become metastatic. This means that it has spread beyond the breast and nearby lymph nodes to distant organs in the body such as the lungs, liver, brain, or bones.

The cure rate of stage IV is reduced dramatically. But, with today’s treatments, a relatively normal life can be prolonged for several years.

Most Important Questions to Ask Each Trimester

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What is your favorite question to ask during the first trimester? What about the second or third? In this blog post, we will discuss four questions that you should be asking yourself each trimester. Whether it’s through a simple check-up at the doctor’s office, or just some self-reflection on how you’re feeling, these are all important questions that will help keep your mind healthy and happy!

1st Trimester:

Am I feeling more tired than usual? Fatigue is a very common symptom of pregnancy. Many women will find that they need to take naps during the day, and will find it difficult to wake up in the morning or stay awake past 9 pm! This is because, throughout pregnancy, your blood volume increases by almost 50%, creating a greater demand for oxygen-rich red blood cells. For this increase to happen as quickly as possible, your body produces certain hormones, such as progesterone and estradiol, causing overall fatigue.

2nd Trimester:

Is my baby moving more than usual? Typically around week 18-20 gestational age (or the second trimester), most women will begin to feel their babies move for the first time. This can sometimes be startling and uncomfortable at first; however, it’s important not to panic until having confirmed with your doctor! Fetal movement is vital for proper development and growth. The more active and healthy your baby is, the better he or she will be able to fight off infections and sickness during pregnancy. It’s also important to know that the amount of movement your baby does in each session can vary – sometimes they can be very active, while other times they might not move much at all!

3rd Trimester:

What are my feelings about breastfeeding? Breastfeeding is one of the most natural things a woman can do after giving birth. The reality is, however, many women feel uncomfortable with the idea of breastfeeding – whether it’s because they don’t want their child becoming attached to them, or it makes them feel self-conscious about their physical appearance. Either way, it is important for couples choosing to breastfeed to discuss this with their doctor and one another. Breastfeeding can be challenging at first, but it is certainly worth all of the painstaking preparation you put in to ensure success!

As always, it’s critical for pregnant women to monitor their bodies closely and make sure they are taking care of themselves. Pregnancy is not an illness, but it does impact our bodies at a very deep level. Routine checkups and proper nutrition will help to ensure the health and happiness of you and your child during this time, as well as for years to come! Remember: motherhood can be one of the most challenging things you will ever do, but it can also be one of the most rewarding!

Dangerous Breast Cancer Myths

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Breast cancer is a dangerous disease that will affect roughly 13 percent of women at some point in their life. This makes it the second-most common form of cancer in women. Just like other types of cancer, the disease forms when the cells in the breast start to grow abnormally. Despite the prevalence of the disease, there is still a lot of misinformation out there regarding breast cancer. These are the most dangerous breast cancer myths.

There’s Always a Lump

While a lump in the breast is the most common symptom of breast cancer, they are not present in every case. This is why it is important to get regular screenings. You may think nothing is wrong, but a mammogram can find breast cancer in the early stages. Make sure to look out for the other common symptoms including breast swelling, inverted nipples, and flaky skin around the nipple.

Problem is Almost Solved

There are still a lot of people that think breast cancer is nothing to worry about because it is easily cured. While advancements in science have drastically reduced the death rate associated with breast cancer, it is still the second-deadliest form of cancer in women. A little more than 40,000 women are still dying every year from this horrible disease. A full cure is coming soon, but we are not there yet.

Screenings Are Only Defense

Regular screenings and self-checks at home are great ways to detect breast cancer in the early stages, but they are not your only defense against the disease. You can drastically reduce your chances of developing this disease by living a healthy lifestyle. Obese women are nearly twice as likely to develop breast cancer after menopause as those living at a healthy weight. The regular consumption of alcohol also drastically boosts your chances of getting breast cancer.

No Family History, No Problem

You should not take things lightly just because there is no history of breast cancer in your family. Roughly 85 percent of breast cancer patients have no family link to the disease. Those that do have a family history of breast cancer need to be extra cautious because your risk of developing the disease is nearly double of those without a family link.

What to Know About Forceps Births

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Forceps deliveries are carried out to deliver a baby whose head has become stuck in a bent position or help out when all other methods have failed (e.g., ventouse).

The instruments used for forceps deliveries are called “forceps.” They were originally designed in ancient Greece and consisted of two wooden spoons with handles.

Forceps deliveries are carried out under a general anesthetic, so the mother is asleep and will not feel any pain or pressure on her body.

The forceps are placed over the baby’s head through the vagina. The blades of the forceps are then carefully positioned around either side of the chin, cheeks, top of skull, and forehead. 

Gentle, steady pressure is then applied until they lock into place. The midwife or doctor monitors this by listening to sounds inside the birth canal with a “stethoscope.” It may be necessary to apply more than one pair of forceps to ensure an effective fit, and this can take several attempts if the first attempt is unsuccessful. This type of delivery should only take about 5 minutes.

After the delivery, the midwife or doctor will check that your baby is healthy before you are allowed to wake up and meet your new little one. Forceps deliveries may leave you feeling a bit sore and bruised, and it can take a few days to recover fully from having a general anesthetic.

About 1 in 8 labors need to use forceps, so it is not too unusual. Of those, about 4 in every 100 women will need an assisted forceps birth like this. Delivery by ventouse (suction) is becoming more popular as it usually means no after-effects such as bruising or tearing; however, if this isn’t working, forceps are be needed instead of an emergency Caesarean section (C-section).

Some mothers find the use of forceps frightening from the word go, as it sounds as though they are being forced to have a cesarean section. It may be helpful to think about it as an alternative to a ventouse delivery with no bruising afterward. A good way of looking at it is as a ‘helping hand’ that can make all the difference between tearing and not tearing.

In conclusion, forceps can be a successful instrument, although not always effective. It is much easier for the mother to recover from than an assisted ventouse delivery, but it may pose a risk to both mother and baby if not used properly or if the wrong forceps are used.

A Potential Breakthrough in the Treatment of Endometriosis

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The discomfort in women with endometriosis is painful. It causes inflammation and tissue growth on the outside of the uterus. It’s not just painful. It can also lead to complications with getting pregnant.

Endometriosis is typically treated with hormones and invasive surgery. However, it is a treatment of the symptoms. For patients who suffer continued growth from endometriosis, having multiple hysterectomies or laparoscopy surgeries can be stressful and costly. New studies show that there may be a way to achieve the same results without invasive methods.

What is Endometriosis

Endometriosis is a common condition in women ages 18-35. It is a tissue disorder in the uterus that causes tissue similar to the inner lining of the uterus to grow on the outside. It can become painful and cause irregular menstrual cycles.

Neuropeptide S Receptor 1 (NPSR1)

A genetic study by scientists from Baylor College of Medicine, the University of Oxford, the University of Wisconsin-Madison, and Bayer AG has uncovered the specific gene associated with the disorder. They found neuropeptide S receptor 1 (NPSR1). The researchers inhibited NPRS1 in their mouse models with the use of SHA 68R, a small molecular inhibitor. It reduced the abnormal growth of endometrial tissue outside of the uterus which led to reducing inflammation, pain, and endometriosis.

SHA 68R

The team of researchers sequenced the DNA of 32 families in which more than three women have endometriosis. Cross-referencing the data led the researchers to discover that women with more severe cases of the disease had variants of the NPSR1 gene. SHA 68R is a small molecular structure known to inhibit NSPR1’s expressions

The animal studies done to inhibit NPSR1 from activating were completed by injecting a small solution with SHA 68R. It has promising results as a gene inhibitor. Researchers have stated an excitement to continue their study in genome sequencing. Jeffrey Rogers, Ph.D. and associate professor at the Human Genome Sequencing Center at Baylor, states “This is one of the first examples of DNA sequencing in nonhuman primates to validate results in human studies.”

With future studies, SHA 68R and other NPSR1 inhibitors may make their way to the medical field as nonhormonal and noninvasive treatment options for endometriosis.

Intrauterine Insemination: Important Facts to Know

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Intrauterine insemination is a simple fertility treatment that helps a woman to conceive. It can be done with or without the use of fertility drugs. The procedure will transfer washed semen into the uterus with a thin catheter. This is done around the time of ovulation.

The Cost Of IUI

An IUI can range in price and depends on several different factors. This includes the cost of fertility drugs. Some insurance plans may cover IUI, so any woman who wishes to have it should check with her insurance plan. Typically, an IUI will cost anywhere from $300 to $3,000.

The Procedure

This procedure is painless and simple. Women undergoing this procedure will not require medications. The first thing that is done is that the semen is prepared. The partner will come in and give a semen sample unless you are using donor sperm. The sperm will be washed. During washing, impurities will be removed, and only viable sperm will remain. If the woman is using donor sperm, this sperm will be thawed before use.

A woman may be given ovulation drugs for their cycle, and their IUI appointment will be on or near the day they are scheduled to ovulate. If a woman is having ovulation difficulties, they may be given a drug like Clomid or Femara that will help to induce ovulation. When they go in for their appointment, they will lay down on the table, and a thin tube will be placed in the cervix where the washed semen will be injected. The doctor may suggest that they lay there for a few minutes or may let them get up immediately. The sperm will not come out of the uterus. They will then wait for two weeks and then do the pregnancy test.

After the IUI procedure, a woman may experience a few minutes of mild cramps but nothing serious. They should not have any discharge, bleeding, or anything else after the procedure.

Many women have had success with the IUI procedure. If it does fail the first time and the woman was not given fertility drugs, their doctor may suggest that they try again with the use of fertility drugs. This is especially true if the doctor believes that they are not ovulating.

Perimenopause and Periods

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Perimenopause is a period of time that occurs just before actual menopause when you cease menstruating. During this time, you’ll notice changes in your monthly cycle as estrogen and progesterone levels begin to fluctuate. Some months, your period may come sooner than normal. Others, you might be late. While every woman’s experience is different, knowing what to expect with perimenopause and periods can help you to navigate through this new stage in life.

Prepare for Heavier Periods

Many women struggle with heavy periods at various points in their life, but perimenopause can bring flooding. Technically, a heavy period is one that involves losing 80 mL of menstrual blood. You may suspect that this is happening to you if you consistently run through multiple tampons or pads within a short period of time. Heavy periods put you at risk for serious problems such as anemia, which means you’ll want to reach out to your doctor for help.

Get Ready for Spotting

You may have spotted in the past from various reasons such as changing birth control pills. However, spotting during perimenopause is caused by your body being confused by changing hormone levels. If spotting is new to you, then you’ll want to schedule an appointment to make sure that it isn’t from other causes. If you’ve noticed other changes in your period, then it is likely perimenopause.

Watch for Changes In the Color

Dark or brown blood may become more prevalent during this stage of your life. This is because your body’s hormone levels can disrupt how the blood leaves your uterus. Blood that sticks around in the uterus for too long oxidizes, which is why you see this color. Most likely, you’ll notice this more at the beginning and end of your periods. It can also occur with spotting.

 

Dealing with spotting, heavy periods and even the surprise missed start date can get frustrating. Make sure to talk to your doctor about any changes that you notice with your cycle. They’ll help to rule out other health problems and suggest ways to make this transition easier. Taking care of yourself can go a long way toward helping to minimize some of these symptoms. Perimenopause doesn’t last forever, but having the right types of support can make it more manageable until your periods eventually end.

How to Reduce Stretch Marks During Pregnancy

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Stretch marks, or striae gravidarum, are so common during pregnancy that many mothers wear them as badges of honor. However, even strong maternal pride doesn’t keep women from feeling self-conscious about how their abdomens look. Whether donning bikinis or wearing their birthday suits, most long for the days when their tummies were taught and absolutely blemish-free. The good news is that pregnancy doesn’t have to result in severely damaged belly skin. There are a number of things that you can do to prevent these scars and many strategies for making them fade.

Keep Your Skin Hydrated

Much like their name implies, stretch marks are the result of rapid and excessive stretching of the skin. They form when the skin is pushed beyond the limits of its natural elasticity. When stretching is severe, the elastic fibers beneath the skin’s surface break. The new collagen that the body produces to replace these broken fibers tends to be a lot less pliable and firm. This leads to collagen stores with a slightly different texture, and indentations or raised scars. To keep your skin supple and resilient, drink plenty of water and eat lots of fresh, water-dense foods. Fresh fruits and vegetables won’t just keep your skin optimally hydrated, they’ll also supply a generous array of antioxidants and other skin-supporting nutrients.

Stretch marks are most likely to form during periods of rapid growth or expansion. Given that stretch marks are essentially scars, it isn’t always possible to make them totally disappear once they’ve formed. Diligent prevention is far more effective than using corrective efforts to repair skin after significant scarring has occurred.

Does Everyone Get Stretch Marks During Pregnancy?

Whether or not stretch marks will develop during pregnancy is dependent upon a variety of factors. Among these are how durable and elastic the skin is at the start of gestation, how well expecting moms care for themselves in general, and how they carry their babies. Some women never form stretch marks during pregnancy. Others develop dark, noticeable marks early on. Women with lighter complexions tend to develop slightly pinkish marks, whereas women with deeper or darker skin tones often get stretch marks that are slightly lighter than skin tone. As these scars heal, they might shrink or gradually fade.

Moisturizing the Belly

During pregnancy, it’s important to keep the belly well-moisturized. Cocoa butter, aloe vera, and coconut oil are excellent moisturizers during this time. These applications are all-natural, unlikely to cause irritation, and rich in nutrients that support both skin renewal and overall skin health.

Cosmetic Procedures for Minimizing the Appearance of Stretch Marks

Once stretch marks have formed, most corrective cosmetic procedures focus on creating controlled skin damage. During these treatments, micro-wounds or tiny, painless abrasions are made at the surface layers of the skin. This incites the body’s natural healing processes to promote rapid skin cell renewal, and increased collagen production. As the body heals, the treated scars marks will increasingly become less conspicuous. Some of the top procedures for minimizing or eliminating stretch marks include:

  • Chemical peels
  • Laser therapy
  • Microdermabrasion
  • Micro-focused ultrasound

and more.

To limit their likelihood of developing stretch marks, women should start applying high-quality moisturizers as soon as they become pregnant. By making good hydration a priority, expecting mothers can keep their skin sufficiently supple for avoiding major skin damages. When moderate to severe stretch marks do form, various cosmetic procedures can assist the skin in healing itself.

Why Expecting Mothers Need Paid Maternity Leave

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Many countries in the developed world offer paid maternity leave to mothers. In the United States, though, that’s not always an option for women who work. Sometimes, they are put on state temporary disability programs. Even when employers do offer paid leave, they may require someone to have a certain length of service with the company before making it available. That can pose a challenge to women who are just starting out in their careers.

Another issue is the length of the leave on offer. Many women are able to step away from work for just a handful of weeks. In fact, research shows that mothers often benefit from spending more time than that at home with their baby. Women with lengthy paid maternity leaves are less likely to suffer from physical illness or post-partum depression. Their children seem to benefit, too. In fact, their babies have a lower chance of dying of SIDS.

In the US, everyone is able to take three months’ unpaid leave. This is a stark contrast to countries like the United Kingdom, which offer 12 weeks of paid leave. This alone may make a huge difference to a new parent’s mental health. A new baby also brings many new expenses, from follow-up doctors’ appointments to diapers, food, and clothing they will rapidly outgrow. Other countries do even better. Japan offers 36 weeks, and Estonia pays new mothers on leave for over a year.

Many activists and politicians, especially on the Left, would like to see the US join the ranks of these other nations. They believe that a national paid maternity leave would make a big difference in the family lives of millions of Americans. This is particularly true for the middle and working classes. Many executive-level women are able to take the time they need, and they can afford highly qualified nannies. The average American family, however, may struggle to juggle work schedules and vaccine schedules.

While maternity leave remains controversial in some circles, all the evidence points to benefits. A national maternity leave program is expected to remain an issue in Congress and at the state level. Of course, not every mother wants these benefits. But they would not be mandatory, rather just available.

Everyday Essentials to Help Your Pregnancy

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Waiting for a baby to arrive is such an exciting time, but it’s also a time when an expectant mother could use some extra help to make pregnancy easier, safer, and more comfortable. Here are a few suggestions:

Use prenatal vitamins

These contain all the nutrients the body needs for both mom and baby. Especially important is folic acid, an essential nutrient in the B vitamin family that helps to prevent a type of birth defect. Be sure to get at least 600 micrograms of folic acid during pregnancy. Ideally, a woman would be getting at least 400 micrograms before becoming pregnant.

Use pregnancy-safe skin products

The skin is the body’s largest organ, and many substances can be absorbed through it. With this in mind, it’s best to use natural, organic products for skin care, hair care, and makeup. Specifically, avoid the following:

  • Retinoids
  • Hydroxy acids
  • Acne products
  • Chemical hair removers
  • OTC steroid creams like 1 percent hydrocortisone

All of these have the potential to penetrate the skin and cause a possible problem for a growing baby. The risk may be small, but it’s there, so just avoid the problem by avoiding the product. If acne breakout due to hormonal changes is an issue, ask the obstetrician for a safe solution. Sunscreens are typically safe for use during pregnancy. For a sunscreen that doesn’t penetrate the skin to work, check labels for the ingredient zinc oxide.

Bellaband

The Bellaband is a versatile device allowing the expectant mom to comfortably and easily transition the clothing gray area when regular pants still fit but not properly. The clever Bellaband allows the pregnant mom to wear regular pants unbuttoned or unzipped, while still keeping the area covered. The result just looks like the clothes have been layered. The Bellaband helps to save money on maternity clothes, too.

Belly butter

Few things are more annoying than a persistent itch. As the skin stretches more and more across the belly area, it will tend to itch. Look for itch lotions and creams intended for use during pregnancy. Especially helpful are jojoba oil and natural plant butter like shea butter and mango butter.