Results showed that the frequency of VBAC success rose with increasing number of prior VBACs, from 63 percent with no prior VBACs to 88 percent for women with one and 91 percent for those with two or more prior VBACs.
The corresponding incidence of uterine rupture, a serious complication of labor, declined from 0.87 percent to 0.45 percent and 0.43 percent. The rates of other complications followed similar patterns with increasing number of prior VBACs.
In contrast, the investigators note, repeated cesarean deliveries are associated with higher risks of complications like placenta accreta (when the placenta implants too far into the uterus) and trauma to internal organs in the mother, as well as more frequent hysterectomies and blood transfusions.
"Women planning large families ... should be reassured by the increasing success rates and decreasing risks associated with VBAC attempts in successive pregnancies," Mercer and his associates conclude.
“The PR agencies and the mainstream breast cancer groups have promoted the concept that all cancers are the same, grow at the same rate, and that you must focus on curing cancer before it spreads. The problem as I see it is that breast cancers are all different. Breast cancer rests. Then it will spurt. It might rest again. I do not believe this is one disease. I think there are four to six kinds of breast cancer – some very slow growing that will never impact a woman in a normal lifespan,” she said.
“What we know how to do now is slash, burn and poison. But we don’t know what happens at the molecular level that turns on and off the cancer process. We need to know more about very dense breast tissue and cancers we can’t detect; the role hormones and replacement therapy plays. Why does exercise decrease breast cancer occurrence, and reoccurrence? We need to know about changes in the environment around us, and how it is affecting us. How does stress change our internal body’s environment? We need to know how to match our drugs specifically to the type of cancer we are treating and not take a shotgun approach because we simply don’t know what works best. We need to know more about how the body metabolizes drugs because each of us metabolizes drugs differently. Why do some drugs work on some cancers in some women and others have no effect at all?” she continued.
“I believe breast cancer is about three things – the uniqueness of the cell; the uniqueness of the environment and the uniqueness of the self. This is where research needs to go. Only 20 percent of breast cancers are explainable. For over 80 percent, we don’t have a clue!”
The Love/Army of Women is funded by a grant from the Avon Foundation for Women and is an initiative of the Dr. Susan Love Research Foundation. The goal is to recruit 1 million women – women who have had breast cancer, and those who have not, high risk women, low risk women, women of all heritages and ages. The mission is to match these women with researchers who are doing studies all over the world. Sometimes the commitment will be to fill out a questionnaire. Sometimes it will be more. Its second goal is to challenge the scientific community to study prevention in healthy women. Army of Women is largely a Web-based and social networking recruitment effort. As of this writing, 311,905 women have signed up. This October is the 25th annual National Breast Cancer Awareness Month. If you would like to be one in a million and join the Army of Women, you may learn more by visiting www.armyofwomen.org. Locally, you may contact the Rhode Island Breast Cancer Coalition and Marlene McCarthy at www.breastcancerri.org.
Alison has lived and thrived well beyond the expectations of the doctors that have treated her. Juana and the family hold onto a cautious hope that their days with her — however difficult at times —– will continue.
The medical advances in the field withstanding, Alison’s future is still uncertain and her condition is tenuous.
“She’s just so sensitive in a sense that if she gets a bad case of bronchitis, it might go wrong,” the physician assistant, Guerra, says. “But so far, so good. She always responds well when she gets treatments and surprises everybody. She’s just a fighter.”
From Alison’s bedside in the ICU unit, Juana says her one wish for Christmas is that her daughter not be in pain, that she continues to progress and advance and, most of all, that she can be with her “princess.”
“Spending the day with her is beautiful. Her smile and everything,” Juana says. “She is the most amazing gift God has given me.”