Sunday, August 23, 2015

Read of the Week! Available at Amazon.com


Another one is worth your time...



The page-turning psychological thriller from the author of #1 bestsellers The Magpies and Because She Loves Me.
It was supposed to be the trip of a lifetime, a final adventure before settling down. But after a perfect start, an encounter with a young couple on a night train forces Daniel and Laura to cut their dream trip short and flee home.
Back in London, Daniel and Laura vow never to talk about what happened that night. But as they try to fit into their old lives again, they realise they are in terrible danger—and that their nightmare is just beginning…

58 of 59 people found the following review helpful By DASchultz on July 1, 2015
Format: Paperback
I was fortunate to receive an ARC of this book through NetGalley for an honest review.

I have never read Mark Edwards before and am relatively new to thrillers, having just really begun reading them this past year. I am in awe of this creative ingenious author!

The story begins with happiness and fun. Daniel and Laurel are off to tour Europe before settling down in London and hopefully starting a family. They have so many plans, have carefully put together an itinerary packed with places to see and experience. Everything is going as planned and the couple are on the next leg of their trip, traveling on a train through Romania. They are exhausted but happy and sneak into an unlocked sleeper carriage to get some sleep. It is at this point that their lives are changed forever.

Without giving away the plot let's just say that they see, hear and feel terror as never before when they are forced to leave the train in the middle of a heavily forested area. After their encounter with evil they flee home to London and swear never to speak of it again.

But as the title states, evil has followed them home.

This book is incredible. For me it started out as a thriller, then almost seemed supernatural and ended as a mystery, 3 genres in one book! There are enough twists and turns to make your head spin and your mind reel and your stomach clench, at least that's what happened to me. Just when you think you have a handle on the plot, it changes, then changes again and finally at the ending, well you'll have to read the book.

I have never been so frightened reading a book and yet so riveted that I couldn't stop reading. I have read the many rave reviews about Mr. Edwards books and now I can see why. I know that I will read another of his books, that is after my nerves settle down a bit.

Buy this book, read it, but not in the dark and not alone.


Friday, August 21, 2015

Things to Think About Before You Talk With Your Doctor

Most of us when hearing that we have cancer find that our brains turn off, become numb.  Here are a list of questions you may want to ask:

What to ask your doctor about breast cancer treatment

Men and women discussing breast cancer
Some questions you may want to ask your doctor
  • Has the cancer spread?
  • What stage is the cancer?
  • What grade is my cancer and what does that mean?
  • What is the likely outcome (prognosis) of my cancer?
  • What type of treatment do I need?
  • What is the aim of the treatment
  • Is there any choice of treatments?
  • Is there a specialist nurse I can see?
  • Is there a counsellor I can talk things through with?
  • What are the short and long term side effects of the treatments?
  • What can I do to help with side effects?
  • What written information can you give me about my treatment?
  • How often will I have to go to the hospital for treatment?
  • Is any transport available?
  • Is it possible to have help paying my fares?
  • How long will the course of treatment be?
  • Could you arrange for me to have a second opinion?
  • Are there any experimental treatments or trials you would recommend for me?
  • What happens if I decide not to have treatment?
  • How often will you want to see me after my treatment is finished?
  • What will happen at the follow up appointments?
  • Are there any signs of the cancer coming back that I should I be looking out for?
  • Is there a number I can call if I'm worried between appointments?

From: http://www.cancerresearchuk.org/about-cancer/type/breast-cancer/treatment/what-to-ask-your-doctor-about-breast-cancer-treatment

Wednesday, August 19, 2015

What to Expect... After Breast Surgery

After surgery I actually fainted...  Read the below to be better prepared than I was.

The healing process

It can take some time to adjust to a new body shape after breast surgery. After your operation the swelling will go down, bruising will fade, and scars gradually become less obvious. The scars can continue to fade for a year or more.
Most women gradually become used to their new shape, whether they've had conservative surgery or a mastectomy, or a reconstruction after mastectomy. You will get more used to your false breast shape (prosthesis) if you wear one, and less worried that it will fall out or that other people will notice it. You are likely to find that your confidence will gradually come back.
The emotional ups and downs may last longer. You may find anxieties coming back when you go for check ups or if a programme on the television or radio mentions cancer. Or new situations may bring more fears, anger and insecurities. If you get involved with a new partner, you may get very anxious.
Breast cancer surgery can leave you emotionally and physically drained. It is important to give yourself time to adjust. Get care and support from others in whatever way is best for you.

Your feelings after breast surgery

It is not unusual to feel very upset at times in the the first months after surgery. Many women have intense feelings including 
  • Grief
  • Fear
  • Shock
  • Anger and resentment
These feelings may be mixed with relief that the cancer has been found and treated. People react very differently to surgery. Most women need time to come to terms with the changes to, or loss of, their breast. Breast cancer surgery can leave you emotionally and physically drained. Give yourself time to adjust. It can help to talk to people you find supportive, including friends and family members, or your breast care nurse. Talking to people who have had breast surgery can be helpful and you can contact them through a support group or online on Cancer Chat.
We have a page about your feelings. It explains the different emotions you may have and also describes how friends, family and others may help.

How you will look after surgery

Women find different ways of dealing with the changes to their bodies. Some prefer to see the results of the surgery for the first time alone. Others want a partner or friend, or doctor or nurse, to be with them when they take their first look.
Your surgeon will do all they can to make sure your scars are as small and discreet as possible. And with time, many scars will fade and be far less visible. How you look is an important part of your self esteem. It can be very hard to accept sudden changes in your looks that you are not happy with. Women often say they feel angry, upset and confused for some time after this type of surgery.
You may feel worried about how friends and family see you. You may think that you are no longer as attractive as you were. Going back to work and meeting new people can be more of a struggle if you are trying to cope with changes in your appearance. Even though people may not be able to see the changes, you may worry that you somehow look different.
If you have children, you may be concerned about how they will see you and how it might affect them. It is normal to worry about these things. But the people closest to you will not see you any differently as a person. They will want to support you as much as they can, so it can help to let them know how you are feeling. Talking things through can help you to feel less isolated and more able to cope.
There are several things that may help you to cope with changes in the way your breasts look. They may not take away all the emotions that you have but they can make things easier. They are described below.

Finding out what to expect ahead of time

Talking through your treatment with your surgeon and breast care nurse is probably one of the most important things to do before your operation. Even if you feel at the time that you don't want to know, it can really help you deal with things later on. If you let your surgeon and nurse know that you want to have the complete picture, they will be completely honest with you. They will answer any questions that you have about how you will look and what the surgery will involve. 
You are likely to be very swollen and sore just after surgery, but this is temporary. Your surgeon and breast care nurse will know how worried you are and will want to put your mind at rest wherever possible.
We have information about exercises to do after breast surgery.

Talking to people who've had similar surgery

This may not help everyone. But some people find it really reassuring. Your surgeon may be able to put you in touch with someone who has had a similar operation. You may prefer to find other women yourself. Have a look at our list of breast cancer organisations. Some of the organisations can put you in touch with people who've had the same operation.

Looking in the mirror

Your first reaction after surgery may be that you don't want to look at yourself. This is not unusual. When you look is up to you. It is usually better to wait until a day or two after your operation, when you have recovered a little.
When you do want to look at your scars, you may want to have someone with you. You could choose someone to be there, such as your doctor, nurse, a friend or your partner. But this is up to you. If you would rather be on your own, that's fine. Even if you think you are prepared, your first view may be a shock. You may see stitches or surgical clips, swelling and bruising. So it may be best to have someone there to support you or answer any questions that you have.
Some people feel angry at first and wish that they had never had the operation. You may wish you'd been better prepared. It is important to give yourself time to let everything sink in. The staff will be very aware of your feelings and will do all they can to reassure, help, and support you.

Talking to people close to you

The best source of support for most of us is family and friends. You may feel worried about upsetting them. But many people are surprised how much it can help just to share your feelings.
If you are having problems with your intimate and sexual relationships because you are worried about the changes to your body, try letting your partner know. Sometimes counselling can help you to work through any worries that you have.

Sexuality after breast surgery

Breast surgery will not directly affect your physical ability to have sex. But your emotions may change your sexual feelings for a while. Many women need to feel fairly happy with their bodies to have a satisfying sex life. If you think that your partner may be put off, you may worry about the time when you allow them to see or touch your body. There is no right or wrong time to take this step. When and how, depends on your own feelings and relationships.
Some women feel very sensitive and need time to build up their courage before they feel able to let their partner look at them or touch them after the surgery. Other women need almost instant comfort and find that touch relieves their fear of being rejected.
Arriving home from hospital after surgery can be an anxious time. Coming to terms with everything you have experienced and the changes to your body can be a lot to deal with. If you would like to talk to someone outside your own friends and family, look at our breast cancer organisations page for counselling organisations. To find out more about counselling look at our counselling section.
If undressing with your partner on the first night home from hospital worries you, there are things you can do to prepare. While you are still in hospital, you could ask the nurses to help you tell your partner what the result of the operation may look like. Or you could ask them to speak to your partner for you, if you prefer. A nurse, or your doctor, can be with you when you let your partner see the operation scar. Or you may choose a relative or friend to be with you and talk it over together afterwards.
You may find it helpful to take your partner with you for your clinic visits before the operation. That way they will be prepared for how you will look after the surgery and when you come home. They may also be more able to help support you emotionally at a difficult time if they understand what is being planned.

Getting help and support

There are many people who can help and support you. Not everyone feels comfortable asking for outside help and support, but many people find it useful. There are a number of sources of support after breast cancer surgery.
  • Many hospitals have specialist breast care nurses to support you
  • Often doctors can help
  • A caring partner or close friend can give you support
  • The Cancer Research UK nurses on freephone 0808 800 4040
  • Breast Cancer Care have a national volunteer support programme to put you in touch with women in your area who have been through the same experience – they can offer comfort and practical help
  • Breast cancer support groups around the UK help you meet other women who have had breast cancer
There is information on our who can help page that may also give you some more ideas about where you can find support.

Practical aspects of recovery

This page doesn't cover practical aspects of recovering from surgery. There is detailed information about getting over the operation and what you can and can't do on the page called after your operation. There is also information in the breast reconstruction section about exercises to do after this type of surgery.

From: http://www.cancerresearchuk.org/about-cancer/type/breast-cancer/

Monday, August 17, 2015

Read of the Week! Available at Amazon.com

A Day Late But Well Worth the Wait!!!


New York Times bestselling author Julie Ann Walker continues to thrill readers with her sexy Black Knights, Inc. romantic suspense series. Behind the facade of their tricked-out motorcycle shop is a covert team comprised of the most elite ex-military specialists.

"Edgy, Alpha, and downright hot!" – USA Today Bestselling Author Catherine Mann

Steady Hands, Cool Head...

Carlos "Steady" Soto's nerves of steel have served him well at the covert government defense firm Black Knights Inc. But nothing has prepared him for the emotional roller coaster of guarding the woman he once loved and lost.

Will All He's Got Be Enough?

Abby Thomson is content to leave politics and international intrigue to her father-the President of the United States-until she's taken hostage half a world away, and she fears her father's policy of not negotiating with terrorists will be her death sentence. There's one glimmer of hope: the man whose heart she broke, but she can ever tell him why...

As they race through the jungle in a bid for safety, the heat simmering between Steady and Abby could be a second chance for them-if they make it out alive.

Praise for Hell for Leather:

"Deft characterization, red-hot chemistry, and a satisfying finish demonstrate Walker's mastery."-Publishers Weekly

18 of 19 people found the following review helpful By 2shay on December 2, 2014
Format: Kindle Edition
"Son of a blueballed biscuit eater".....this a great story! That quote is just one of the many hilarious phrases used by the newest heroine, Abby Thompson, in the very best book in the Black Knights, Inc. series. I have loved this series for a long time. How Ms. Walker keeps making her heroines more engaging and her heroes hotter is a mystery to me....I just want her to keep them coming. *cough*

Carlos "Steady" Soto first met Abby when he and his twin sister, Rosa, were in medical school and Abby was a eighteen year old pre-med college student with a father running for President. At twenty-five, Steady knew that Abby was much too young for him. Age isn't the only obstacle between them, though. Aside from the security detail assigned to follow the probable next first daughter everywhere she goes, how can the son of a Puerto Rican working class family possibly find a future with the daughter of one of the most powerful men in the world? Those questions become unimportant when a life altering tragedy separates them for eight years and they don't see each other until they are thrown together in the Malaysian city of Kuala Lumpur.

When Abby is kidnapped by Jemaah Islamiyah, an indigenous Islamic terrorist group who killed her protection detail, Carlos Soto is the only man left with the skill and will to take on a dangerous group of highly trained and motivated terrorists. Their escape through the humid, sweltering jungle of Malaysia is a trip into hell. Besides the obvious problem of out running a group intent on recapturing the President's daughter and killing Carlos, they have to maneuver through an inhospitable terrain, a pissed off pachyderm, river gorges and unstable bridges. It is intense! And through it all, they are remembering..........

Carlos remembers a young woman whose intelligence, good looks and charm were only out weighed by her incredible sense of humor while Abby is thinking of the terrible secret she has kept from him for all these years, a secret she knows that the fierce warrior he has become can never forgive. As they race for safety, they both discover that all of the qualities that attracted them when they were younger have grown in the years since they last met and their desire for each other is hotter than the jungle heat.

This is book seven of a series, but I think it might work just fine as a stand alone for a new fan. There are appearances by characters from previous books as well as some fascinating newcomers, but none of that will detract from this story in any way. Julie Ann Walker gives us multiple points of view, allowing us to know what's happening on several fronts while Carlos and Abby are dodging bullets in the jungle.....and then Abby says something outrageous, Carlos laughs and I nearly fall out of my freakin chair! Pure entertainment from beginning to end!

I hope you enjoy this book as much as I did. Have fun!

This review first appeared in the blog, It's About The Book!

Sunday, August 9, 2015

Read of the Week! Available at Amazon.com



Alexandra Gaither is a savvy, beautiful attorney who finally has the power to get what she has always wanted -- justice. Twenty-five years before, her mother died a scandalous death. Now as she investigates her mother's former lover, his best friend, and the father figure to them both, she will risk everything to uncover their best kept secrets.

Editorial Reviews

Review

"Brown fires your imagination with irresistible characters, unexpected plot twists, scandalous secrets...so electric you feel the zing".-- The Literary Guild "RM"

About the Author

Sandra Brown is the author of numerous New York Times bestsellers - including most recently Smash Cut, Smoke Screen, Play Dirty, Ricochet, Chill Factor, White Hot, Hello, Darkness, The Crush, and Envy. She is the recipient of the 2008 Thriller Master Award from International Thriller Writers, Inc. She and her husband live in Arlington, Texas.
By A Customer on May 8, 2000
Format: Mass Market Paperback
Alex (Alexandra) Gaither, an attorney out to find out who really killed her mother, travels to Purcell County to investigate three men, one of whom she feels killed Celina. She finds herself attracted to Reede, one of the suspects. Bad things happen and she is involved every time especially as her investigation finds her closer to the murderer. I'm not so disturbed about the 18 years difference in ages; she's 25 and two of the suspects (Reede & Junior) are 43. The other suspect is Junior's father. I had a problem accepting the fact that Reede and Junior were both involved with her mother Celina and now wanted Alex the daughter. One could easily have been her stepfather had Celina not died first. I also found that I was angry at Reede most of the time because he was plain nasty to Alex throughout most of the book. I couldn't stand it that he treated her with so much disrespect. He's actually a good guy (deep deep down) but his mean attitude stemmed from an overwhelming desire to avoid the daughter of the woman he loved that had now filled his thoughts. (At least he acknowledges it's wrong). Junior, in my opinion would have been better for her in some ways as he was always kind to her, but he was such a 'Papa Pleaser'. Lastly, a few issues were never brought to justice and I'm not talking about the murder. Nevertheless, the ending caught me by surprise and the epilogue was good enought to merit the 4-1/2 star rating (Had it been available).

Friday, August 7, 2015

Er / Pr Positive Breast Cancer

Solving a breast cancer mystery – why do ‘double-positive’ women do better?


When a doctor suspects a woman might have breast cancer, one of the first things they do is take a small sample of cells from her breast, called a biopsy, for tests.
The cells in this tiny tissue sample carry answers to crucial questions about what happens next. First and foremost – is it cancer or not? If it is cancer, has it started spreading? And how aggressive it is likely to be?
The levels of different molecules within these cells also yield information about cancer’s nature – and in breast cancer, one of the most crucial for helping guide treatment is the oestrogen receptor(ER).
Women with high levels of this molecule in their cancer cells (called ‘ER-positive’ breast cancer) benefit from hormone therapy – drugs that either lower their oestrogen levels, or prevent cancer cells responding to the hormone. About 7 out of ten women have ER-positive breast cancer.
But there’s a second molecule – the progesterone receptor (PR) – levels of which inside breast cancer cells also seem to be important.  Doctors have known for a long time that women with high levels of both the oestrogen and progesterone receptors (‘double-positive’) have the best chance of surviving – they respond better to treatment, and their cancer is less likely to spread.
But these ‘double-positive’ women are given the same hormone therapy as those who have no progesterone receptor in their breast cancer, so doctors don’t always routinely test for this second molecule any more.
Until now, it’s been unclear why having high levels of both molecules is good news for the patient, or what benefit testing for progesterone brings.
But thanks to Cambridge-based Cancer Research UK researcher Dr Jason Carroll and his team, and their colleagues at the University of Adelaide in Australia, there are finally answers to this mystery.
Today, they’ve published surprising results of a study in the journal Nature that finally solves the puzzle of why ‘double-positive’ women do better.
And if their findings are confirmed in follow-up studies, it could make a big difference to how women are treated.

How do the ER and PR receptors work?

Only certain types of cells that respond to hormones make these receptors – for example breast, ovary and womb cells.
Both receptors are directly involved in switching genes on and off – they’re called transcription factors.
When oestrogen and progesterone are present, these hormones physically stick to their respective receptor, causing them to move into the nucleus of the cell, where DNA is housed. They can then attach to specific regions of our DNA and turn genes on or off, changing the cell’s behaviour.
When breast cancer develops, the tumour cells become overly sensitive to oestrogen. When oestrogen activates the oestrogen receptor, it turns on a panel of genes that tell the cells to keep dividing, driving tumour growth:
150707-Oestrogen-Breast-Cancer
But what happens when breast cancer cells have a working progesterone receptor too?  Dr Carroll and his team set out to find out.

The first hint

The first piece of the jigsaw fell into place when they looked at the physical relationship between the two receptors. Using ‘double-positive’ breast cancer cells grown in the lab, they made sure the cells had sufficient oestrogen and progesterone to activate both receptors, then they cracked the cells open.
When they used a sophisticated method to ‘fish out’ the progesterone receptor from the resulting mixture, they discovered something unexpected: it was physically stuck to the oestrogen receptor. This was a strong hint that progesterone – via the progesterone receptor – was somehow affecting how the oestrogen receptor works.
Using the same lab-grown breast cancer cells exposed to oestrogen only, the researchers used cutting-edge technology to pinpoint the sites in the cells’ DNA where activated oestrogen receptor attached – hence which genes it was controlling.
But when the scientists then added progesterone to the cells too, it caused a rapid shift in the points where oestrogen receptor attached to DNA.
150707-Progesterone-Breast-Cancer
At least 470 genes were controlled differently when both hormones were present compared to just oestrogen alone – the progesterone receptor was, in effect, ‘reprogramming’ the oestrogen receptor, changing the genes that it influences.
But, most crucial part was the overall effect this on the cancer cells themselves – progesterone seemed to cause the cells to stop growing as quickly.
By changing the genetic ‘programme’, the progesterone receptor was applying the brakes to the cells’ growth.

Seeing is believing

The cells used in the above experiments are based on tissue samples taken many decades ago, and kept artificially growing in a lab (called ‘cell lines’). These are a good starting point, but it was important to show this ‘ER reprogramming’ actually happens in human disease.
So the team turned a special technique developed by scientists in Professor Wayne Tilley’s laboratory at the University of Adelaide in Australia. This allowed small samples of tumour tissue to be removed from women with breast cancer and grown in the lab for a short time.
Remarkably, the team saw exactly the same effect – adding progesterone at the same time as oestrogen slowed down the rate tumours grew.
They also saw exactly the same phenomenon in mice transplanted with human breast cancer cells: oestrogen fuelled tumours’ growth, but progesterone put the brakes back on.
The final, and most crucial, experiment was to see if their findings had any potential implications for treating breast cancer.  Again working with mice transplanted with tumour samples and given oestrogen, the researchers used the standard treatment for hormone-responsive breast cancer – tamoxifen, which slowed down tumour growth.
But when they gave the mice tamoxifen AND progesterone, the tumours grew even more slowly.

Changing the way breast cancer is treated?

Dr Carroll’s research is a big step forward in understanding the role of progesterone receptor in breast cancer. Until now, its presence was simply considered an indication of how good a woman’s chances of surviving were.
But Dr Carroll’s study findings reveal that the receptor itself is the direct reason why these women have a better outlook.
Understanding the progesterone receptor’s role as a molecular handbrake on oestrogen-fuelled growth could also explain the observation that breast cancers frequently evolve to get rid of their progesterone receptors – this is an advantage to cancer, helping it grow quicker.
This new research offers a unique opportunity to exploit the braking action of the receptor with hormone therapy to improve breast cancer outcomes. According to Dr Carroll, this is precisely what needs to be done, and the next steps are obvious.
“The results are pretty clear and potentially have direct benefits for many women with breast cancer,” he told us.
“We’re already discussing a clinical trial to test whether giving women with ER/PR double-positive breast cancer progesterone, alongside oestrogen-blocking drugs, helps more women survive this disease”.
If proven successful, they suggest that it could benefit up to half of women diagnosed with the disease.
It’s even possible that Professor Tilley’s new technique of growing tumour tissue samples in the lab could form the basis of a test to help doctors identify who might benefit from this combination of treatments.
“The pioneering technology we used in this study could be used as a simple way to see if adding progesterone to oestrogen blocking drugs further slows tumour growth,” Tilley predicts.
This potential new dual therapy is still a way off – there’s a lot of clinical research ahead before we know for sure that giving progesterone to women with ‘double-positive’ breast cancer will definitely help them.
But it’s an elegant and exciting demonstration of how hard graft in laboratories around the world is continuing to make strides against a disease that – despite undoubted progress – still claims the lives of nearly 12,000 UK women each year.
– Emma
[Note: In the light of media coverage of this story this morning, we want to clear up an important point: the effects observed in this study were from using progesterone itself. Many contraceptives, and certain forms of HRT, contain derivatives of progesterone (e.g. medroxyprogesterone acetate, MPA) – these seem to act differently. So headlines claiming that a hormone ‘found in The Pill slows growth of tumours’ are slightly inaccurate.]

Reference

Mohammed H. et al. Progesterone receptor modulates estrogen receptor-α action in breast cancer, Nature (2015), DOI: 10.1038/nature14583


This article and more at http://scienceblog.cancerresearchuk.org/2015/07/08/solving-a-breast-cancer-mystery-why-do-double-positive-women-do-better/