One out of every nine women will develop breast cancer, which means one in nine nail techs will probably develop breast cancer too. The beauty industry has rallied behind the cause of awareness and research, but how does our industry of predominantly women address the disease on a personal level?
Editor’s note: The line between our personal and professional lives can be a fine one. NAILS is debuting this month the first part in an occasional series on women’s health issues — because our industry is comprised mainly of women, both nail professionals and clients. The first is this piece on breast cancer, which according to the National Alliance of Breast Cancer Organizations is the most common form of cancer for women and one that the industry has rallied around through awareness campaigns and fund-raising efforts. We’ll tell you more about the most common medical conditions for women and what can be done to prevent, detect, and treat them. After you read each piece, we encourage you to share them with your coworkers, your clients, and your friends. Because the way we see it, your health is your most precious resource, both on and off the job. See also our piece on Ostseoporosis in a previous issue.
Mother, sister, friend, coworker, client ... when we first started researching this article we sought nail technicians who had been touched by breast cancer. Sadly, it proved too easy to develop our contact list.
According to the National Alliance of Breast Cancer Organizations (NABCO), breast cancer is the most common form of cancer in women in the United States, with one out of nine women developing breast cancer in their lifetime. (Some sources place the rate as one in eight.) In 1999 alone, 175,000 new cases of breast-cancer were diagnosed and 43,300 women died from the disease according to NABCO statistics. Even more compelling than the sheer numbers, though, are the stories like Monica Bruin’s and Lesa Perry’s, both nail salon owners who’ve had breast cancer.
When Bruin, owner of Color My Nails in Salt Lake City, first discovered a lump in her breast back in 1991, the 31 - year-old had given birth to her third child just four weeks before. Her doctor assured her that it was nothing, but Bruin insisted he do an ultrasound and mammogram to be certain. Not only was the lump cancerous, but the cancer had spread to her lymph nodes. Bruin underwent surgery, followed by both radiation and chemotherapy, and remained cancer-free until 1997.
“The first time was devastating but I thought I could beat it by really taking care of myself,” Bruin, now 40, remembers. “When it came back again it was tough — there was at least a month where I thought I would die. But I decided that I could fight it. Everyone has trials and everyone has tragedies; it’s what you do with all those that make you who you are.”
The second time around, in addition to radiation and chemotherapy, Bruin underwent a stem cell transplant. She remembers that even brushing her teeth exhausted her. While those days are well behind her now that she’s been in remission for over a year, she takes life one day at a time. “I’m so grateful for every day that I have,” she says. “My chances are high that it will come back, but I can at least say I’ve done everything possible to stay alive.”
Similarly, Lesa Perry, co-owner of For Your Nails Only in Brentwood, Tenn., discovered a lump in her breast at age 31. “When they did the mammogram they handed me the X-rays and told me to walk them back up to my doctor,” she remembers. “So I walked out and looked at them in the light and I could see it.” Her doctor sent her immediately to the surgeon, who did surgery just three weeks after Perry first found the lump. Still, the cancer had already spread to her lymph nodes. Because her cancer was deemed an advanced Stage II, Perry’s specialist recommended a stem cell transplant after chemotherapy. She has remained cancer-free for four years.
“Even after five years you’re not considered ‘cured,’” Perry notes. “You really can’t keep it off to the side in your mind. I still have to go back every three months for blood work and chest X-rays. I quit doing nails when I found out I had breast cancer because my immune system was going to hit such low levels. That was a huge loss to me because a lot of my clients had been with me most of my 14 years in business. But it’s such a leveling experience that I think you really understand what’s important in life and what’s not. I was trying to wear too many hats before and it’s been a great opportunity to focus just on the salon and on my 7-year-old.”
The impact can be just as great when it’s family, a friend, or a client: going through this ordeal. For example, Marti Preuss, an industry veteran in Houston, shared with us a story about Jewell, a client: she first started seeing in 1972. “In 1979 Jewell had been fighting a kidney infection for several months before finally being admitted to the hospital for testing and treatment,” Preuss explains. “I called her a few weeks later and she told me she had breast cancer.” After a long battle Jewell was deemed “cured” (a term no longer used).
“She was cancer-free for about eight years and then got it in her other breast. She had the lump removed and went through chemo,” Preuss continues. As Jewell’s hairstylist, Preuss went with her to purchase a wig and then went to Jewell’s home to shave her head and style the wig. For as long as Jewell wore the wig Preuss says she did her hair at home because Jewell didn’t want everyone in the salon, whom she’d known for years, to see her in such a vulnerable state.
“I went through this with her for years,” Preuss says sadly, adding that Jewell died almost a year ago. “She was always saying, ‘Check yourself.’ I pass the word along to everyone to examine themselves and get proper check-ups. I have clients who’ve told me they have a lump but don’t want to go to a doctor and I tell them about Jewell. If your doctor says it’s nothing, go to another doctor. You’re never too young for a mammogram. This is your life.”
Who’s at Risk
Researchers have yet to pinpoint a specific cause of breast cancer. In fact, at this time scientists agree only that breast cancer is a “multi-factorial disease,” with many causes that interact with others in ways that are not currently completely understood, explains Marlene Werner, a spokesperson for the National Breast Cancer Coalition.
By the same token, there are a number of factors that increase a woman’s risk for developing breast cancer. They include family members who have had breast or ovarian cancer; mutations in the BRCA1 and BRCA2 genes; and beginning menstruation before age 12 or entering menopause after age 55. Other risk factors include alcohol consumption, taking hormone replacement therapy or birth control pills for long periods, having your first child after age 30, and radiation treatments. While these factors heighten your risk, anyone can get breast cancer: Women in the genetic “high-risk” category account for only 5%-10% of all cases of breast cancer.
Likewise, while the risk of developing breast cancer rises proportionately with age, with women over 50 at highest risk, Bruin and Perry prove that breast cancer can strike at any age. And with no known prevention, your best bet is early detection. According to the American Cancer Society (ACS), breast cancers that are detected due to symptoms tend to be relatively larger and are more likely to have spread beyond the breast, while breast cancers found during screening examinations are more likely to be small and localized. The ACS advocates a three-pronged approach to detect breast cancer in its earliest and most easily treated stages. Specifically, ACS recommends that:
- Between the ages of 20 and 39, women should have a clinical breast examination by a health care professional every three years. After age 40, women should have a breast exam by a health care professional every year.
- Women age 20 or older should perform a breast self-examination every month (see “How to Do a Breast Self-Exam” on page 50). By doing the exam regularly, you get to know how your breasts normally feel and you can more readily detect any signs or symptoms.
- If a change occurs, such as development of a lump or swelling, skin irritation or dimpling, nipple pain or retraction (turning inward), redness or scaliness of the nipple or breast skin, or a discharge other than breast milk, see your health care provider as soon as possible for evaluation.
- Women examining their own breasts should discuss any new lump with their health care professional. Experienced health care professionals can examine the breast and determine whether the changes are probably benign or whether there is a possibility they’re cancerous.
The good news, emphasizes the National Cancer Institute, is that more than eight out of 10 lumps turn out to be benign. However, only professional evaluation will tell. Doctors can learn much from carefully feeling the lump and surrounding tissue because benign lumps often feel different from cancerous ones. A mammogram can reveal even more about a mass, as well as reveal lumps undetectable during examination.
In the initial stages, breast cancer usually does not cause pain and, in fact, may manifest no symptoms at all. As the disease progresses and spreads, though, changes will appear. Be alert to the following changes in your body:
- A lump or thickening in or near the breast or in the underarm area
- A change in the size or shape of the breast
- Nipple discharge or tenderness, or an inverted nipple
- Ridges or pitting of the breast (the skin may appear dimpled like an orange
- A change in the way the skin of the breast, areola, or nipple looks or feels (for example, warm, swollen, red, or scaly)
Treating Breast Cancer
While there is not yet a “cure” for breast cancer, NABCO says it can be treated effectively with surgery to remove the lump followed by radiation treatment. These localized treatments often are coupled with chemotherapy and/or hormonal therapy even when the cancer hasn’t spread. When it has spread to the lymph nodes or beyond, patients may undergo several courses of chemotherapy treatment.
When undergoing treatment, cancer patients’ immune systems are weakened because anticancer drugs affect rapidly dividing cells, which includes blood cells that fight infection. In addition to nausea and cramping, weight loss, and hair loss, cancer patients may also find their nails are more prone to splitting, peeling, and breaking. However, while the organizations we checked with weren’t aware of any recommendations against nail services, common sense dictates that these patients should avoid any services that risk breaking the skin. Also, Preuss remembers giving Jewell a manicure before a trip, and when she returned a week later Jewell had developed a yeast infection around several of her nails that took several months to clear even with prescription oral and topical medications from her physician. As a precaution, always consult with both the client and her physician about a service before doing it, just to be safe.
Race for the Cure: Salons and Manufacturers Lead
The beauty industry has been especially supportive of breast cancer research and treatment at all levels, with salons, manufacturers, and industry associations raising millions of dollars over the past decade alone. For example, the ABA has raised several hundreds of thousands of dollars a year over the past few years for the City of Hope through its Beauty Ball fundraiser. Toolmaker Tweezerman presented a check for $38,000, a portion of the profits from the sale of its Slant Tweezer, to local breast cancer organizations in February. And Sally Beauty Supply has raised more than $500,000 to fund breast cancer research through corporate donations and a store canister campaign. The distributor also offers free breast self-exam information in its stores and breast cancer information to its vendors and store managers during its annual sales convention.
Equally inspiring is the support for breast cancer awareness and research at the salon level. For example, on Valentine’s Day in 1999, Details in Bloomington, 111, raised $900 for the Susan G. Komen Breast Cancer Foundation in six hours by offering manicures in exchange for a $10 donation. Bakeries donated food, a day spa donated a $65 gift certificate for a raffle, and salon manager Beverly Dickerson made up banners and fliers that other local salons posted to promote the fund-raiser.
“This year we asked other salons to participate and we had 17 technicians volunteer to work in two-hour shifts,” Dickerson says. “The response from other salons was quite positive. I don’t think there’s a technician here who doesn’t have a friend or family member who’s had breast cancer.”
At Love Those Nails in Westborough, Mass., the reasons to get involved hit closer to home. Just a few weeks before the salon’s November 1998 fund-raiser, a salon coworker and friend lost her battle with breast cancer. Manager Beth Van Blarcom spent months planning the fundraiser by working with the ACS to obtain literature, pink ribbons, and other materials to heighten awareness of breast cancer and the fund-raiser. She also called and visited other local businesses to drum up support. When all was said and done, though, she feels the effort was well worth it. “We feel we had a great response with just a five-operator salon.”
Van Blarcom emphasizes, though, that organizing a fundraiser takes a lot of time. At Color My Nails, Bruin solved that problem by organizing a six-member committee that met weekly to develop and execute the plans to reach its goal to raise $5,000 for City of Mope. In this case, Color My Nails teamed up with Nail Gallery, another local salon, and met with a City of Hope representative to brainstorm ideas. Tapping their client bases, they got a client to develop a logo for a T-shirt and asked Cottonwood Dry Goods, a local business, to donate T-shirts at cost that they could have printed with the logos to sell.
“Everyone was so great about just charging their costs that I only had about $200 out of pocket,” she says. Working to raise the money through Voices That Care, a fund-raiser sponsored by Masters (Laguna Beach, Calif.), Bruin challenged motivational speaker Winn Claybaugh to come do a free presentation if she and Nail Gallery raised $5,000. Claybaugh happily agreed, and the two salons sold tickets to his event for $15 each. Ultimately, they doubled their goal by raising $10,000.
“We never pressured clients by asking them to give money or to buy something,” Bruin notes. “We had little signs at: our desks noting that one in eight women have had breast cancer and that we were raising money for research, but it was very important to us that clients didn’t feel they had to do something.”
While these hands-on fund-raisers are exhausting, everyone involved agrees that what drey get out of it is well worth the effort. For example, Tiffany Greco, a nail technician at Capriccio’s Salon & Day Spa in Oceanside, Calif., originally got involved in organizing a fund-raiser as part of Creative Nail Design’s fund-raising effort for City of Hope. The salon owner agreed to donate the use of tire salon on a Sunday, Creative and Paul Mitchell provided the working product, and many local businesses donated raffle items ranging from an overnight stay at a local resort to a family pack of sunglasses. “We even auctioned off two spa pedicures by Doug Schoon to local technicians through our distributor, so we got the industry involved as well,” Greco notes. “It ballooned to such a point that when we went out afterwards, people were thanking me for letting them participate, and clients have been asking when we’re going to do another one. I had a nail technician drive all the way from Yuma, Ariz., that day to fill someone else’s spot. It was one of the most amazing, heartwarming things I’ve ever done.”
Not to mention that everyone involved raised $6,200 that day. In all, Creative Nail Design and its salon customers raised more than $600,000 through similar fund-raisers in 1998. Similarly, Masters organized Voices That Care in 1999, raising more than $38,000 for City of Hope through pledges from almost 200 salons (including $10,000 from Color My Nails and $4,150 from Van Michael Salons in Atlanta). Masters also has pledged to City of Hope all the proceeds from the motivational tape “How To Balance My Career and All That Other Stuff."
Sponsoring a major fund-raiser takes a lot of planning and time, no matter how you divide the work, which is why Bruin and Greco champion other fund-raising programs as well. For example, a few years ago Color My Nails donated $1 from every service performed in December to a breast cancer organization, while this past October Capriccio’s donated a portion of each service ticket for a week to City of Hope. “We decorated boxes and set a station decorated in pink with flowers and balloons. For the week the staff wore buttons and pink roses and told clients about it,” Greco says. “We found clients would add their own money to the box as well, which helped us raise several hundred dollars in one week.” Then the salons simply presented the proceeds to the respective organizations.
Regardless of how little or how much you choose to do, every action does count. Even encouraging one hesitant client to have a lump checked by her doctor or presenting clients with literature during Breast Cancer Awareness month could save a life — on which no dollar amount can be set.