Women and melanoma risk

Risk factors and outcomes of cutaneous melanoma in women less than 50 years of age.  Tellez, Rueda, Conic, et al.  J Am Acad Dermatol. 2016 Jan 11.

“Melanoma is the fifth most common cancer in the United States, with recent reports indicating increasing incidence among young women.  This [retrospective] study sought to investigate histopathology, staging, risk factors, and outcomes of cutaneous melanoma in women younger than 50 years.

All female patients aged up to 49 years with biopsy-proven diagnosis of melanoma between 1988 and 2012 were included. Patients with a follow-up of less than 2 years were excluded. A total of 462 patients were identified, with mean age of 34.7 years. Invasive melanoma was less common in women 19 years of age or younger. Positive sentinel node status, recurrence rates, metastatic disease, and death rates  were higher for women ages 40 to 49 years. The 41 patients with a pregnancy-associated melanoma had a significantly worse prognosis in comparison with a control group of nonpregnant patients, with a 9-fold increase in recurrence, 7-fold increase in metastasis and 5-fold increase in mortality.

The increasing incidence of melanoma for women younger than 50 years suggests that regular skin checks and self-examinations are warranted. In addition, in women given the diagnosis of melanoma during or within 1 year after childbirth, regular follow-up and monitoring for recurrence are recommended.”

This post covers several articles that looks at the odds for positive sentinel nodes and recurrences in folks with thin melanoma lesions - also noting being less than age 40 increases risk: With melanoma you can never be too rich or too thin! But, you can be too young! 

The article covered here indicates:  "the only clinicopathologic factors associated with longer Progression Free Survival (PFS) and OS were being female and a normal pretreatment serum lactate dehydrogenase (LDH) level."  Being female with low LDH and no ulceration in primary and BRAF V600 positive = increased survival rates with BRAFi 

And then there is this:  Melanoma risk significant among pregnant women

For what it's worth - c 

Do pesticides, herbicides or hormonal replacement contribute to melanoma?

The short answer?  No.  Yes.  No.  Here's the deal:

The association between pesticide use and cutaneous melanoma: a systematic review and meta-analysis. Stanganelli, De Felici, Madnel, et al.  J Eur Acad Dermatol Venereol. 2019 Sep 21.

The incidence of cutaneous melanoma (CM), the deadliest form of skin cancer, has gradually increased in the last decades among populations of European origin. Epidemiological studies suggested that farmers and agricultural workers are at an increased risk of CM because they were exposed to pesticides. However, little is known about the relationship between pesticides and CM.  To investigate the association between exposure to pesticides and CM by systematically reviewing the literature. Secondary aim was to determine the categories of pesticides mainly involved in CM development.

A systematic review of the literature was performed up to September 2018 using Medline, Embase and Web of Science. Studies assessing CM risk in licensed pesticide applicators were considered. Priory criteria were established to select independent studies and risk estimates; random effect models, taking into account heterogeneity, were applied. A pooled risk estimate for CM was calculated for the use of each type of pesticide and type of exposure. Between-study and estimates heterogeneity was assessed and publication bias investigated.

A total of 9 studies (2 case-controls and 7 cohorts) comprising 184389 unique subjects were included. The summary relative risks for the categories "herbicides - ever exposure", "insecticides - ever exposure", "any pesticide - ever exposure" and "any pesticide - high exposure" resulted 1.85, 1.57, 1.31 and 2.17, respectively. Herbicides and insecticides had no between-study heterogeneity, while a significant heterogeneity was detected for the high exposure to any pesticide. No indication for publication bias was found.

Individuals exposed to herbicides are at an increased risk of CM. Future properly designed observational studies are required to confirm this finding.

So, basically - YES!!!  The pesticide issue is a little unclear, but folks exposed to herbicides (like Round Up, etc.) ARE at increased risk for cutaneous melanoma.

Now this:

Premenopausal Use of Progestogens and Cutaneous Melanoma Risk: A French Prospective Cohort Study.  Cervenka, Rahmoun, Mahamat-Saleh et al.  Am J Epidemiol. 2019 Oct 29. 

The influence of sex hormones on melanoma risk has been suggested, but the influence of premenopausal use of progestogens on this cancer has never been investigated. E3N (Etude Epidémiologique auprès de femmes de l'Education Nationale) is a prospective cohort of 98,995 French women aged 40-65 years at inclusion. We used Cox models adjusted for age and melanoma risk factors. Over 1992-2008, 540 melanoma cases were ascertained among 79,558 women. We found a modest association between self-reported progestogen use and melanoma risk  which was reduced after adjustment for melanoma risk factors. There was no heterogeneity across types of progestogens, and use of multiple progestogens was positively associated with melanoma risk. Among users, we found no relation with duration of progestogen use, age at start and last use, and time since first and last use. Although our results did not show evidence of a confounding effect of sun exposure, progestogen users had lower levels of residential sun exposure and were more likely to report sunscreen use, suggesting specific sun exposure profiles in users. Our findings do not support a strong influence of progestogens on melanoma risk. Further research is needed to confirm these results.

Exogenous Hormone Use and Cutaneous Melanoma Risk in Women: The European Prospective Investigation Into Cancer and Nutrition.  Cervenka, Al Rahmoun, Mahamat-Saleh, et al. Int J Cancer. 2019 Sep 10. 

Evidence suggests an influence of sex hormones on cutaneous melanoma risk, but epidemiologic findings are conflicting. We examined the associations between use of oral contraceptives (OCs) and menopausal hormone therapy (MHT) and melanoma risk in women participating in the European Prospective Investigation into Cancer and Nutrition (EPIC). EPIC is a prospective cohort study initiated in 1992 in 10 European countries. Information on exogenous hormone use at baseline was derived from country-specific self-administered questionnaires.  Over 1992-2015, 1,696 melanoma cases were identified among 334,483 women, where of 770 cases among 134,758 postmenopausal women. There was a positive, borderline-significant association between OC use and melanoma risk, with no detected heterogeneity across countries. This risk increased linearly with duration of use. Among postmenopausal women, ever use of MHT was associated with a non-significant increase in melanoma risk overall, which was heterogeneous across countries. Our findings do not support a strong and direct association between exogenous hormone use and melanoma risk. In order to better understand these relations, further research should be performed using prospectively collected data including detailed information on types of hormone, and on sun exposure, which may act as an important confounder or effect modifier on these relations.

So, basically, though some self-reported answers on questionnaires demonstrated vague associations between oral contraceptive use and melanoma, overall, there was no significant increased risk for the development of melanoma and postmenopausal hormone replacement. 

Then, there's this, added 12/7/2019:

Hormone replacement therapy and the risk of melanoma in post-menopausal women.  Hicks, Kristensen, Pedersen, et al.  Hum Reprod.  2019 Dec 5

Is hormone replacement therapy (HRT) associated with an increased risk of melanoma skin cancer or prognostic outcomes amongst post-menopausal women?  Whilst we found evidence of an association with melanoma risk, the lack of dose-response and associations observed with recent use, localised disease and intravaginal oestrogens suggests this is a non-causal association.  Evidence on HRT and melanoma risk remains inconclusive, with studies providing conflicting results. Furthermore, evidence on melanoma survival is sparse, with only one previous study reporting protective associations with HRT use, likely attributable to immortal time bias.

We conducted a nation-wide population-based case-control study and a retrospective cohort study utilising the Danish healthcare registries. Case-control analyses included 8279 women aged 45-85 with a first-ever diagnosis of malignant melanoma between 2000 and 2015, matched by age and calendar time to 165 580 population controls. A cohort of 6575 patients with a diagnosis of primary malignant melanoma between 2000 and 2013 and followed through 2015 was examined to determine if HRT use had an impact on melanoma survival outcomes.

Based on prescriptions dispensed since 1995, ever-use of HRT was defined as having filled at least one prescription for HRT prior to the index date. In total, 2629 cases (31.8%) and 47 026 controls (28.4%) used HRT.

High use of HRT was associated with an OR of 1.21  for melanoma risk, with no evidence of a dose-response pattern. Results were most pronounced amongst recent high users, for localised disease and for intravaginal oestrogen therapy. Compared with non-use, there was no evidence of an association for secondary melanoma for post-diagnostic new-use or continuous HRT use. Similar associations were observed for all-cause mortality.

Despite the large sample size and the use of robust population-based registries with almost complete coverage, we lacked information on some important confounders including sun exposure.

Whilst we cannot rule out an association between HRT use and melanoma risk, the associations observed are also compatible with increased healthcare utilisation and thus increased melanoma detection amongst HRT users. No association between HRT use and melanoma survival outcomes was observed. This should provide some reassurance to patients and clinicians, particularly concerning the use of HRT in patients with a history of melanoma.

There is obviously much we do not understand about melanoma period.  We certainly lack a clear understanding regarding the implications of being female and the role pregnancy plays in melanoma:  Women and melanoma risk  These studies add to a start.  The more you know. - c

Women

When I was in my late teens, early twenties, I railed that there was no true difference between the sexes. Distinctions between the sexes were more about societal expectations and demands. Then - I had a boy - and a girl - and I discovered...I was wrong! There really is a "buden-buden" gene and a " I love pink and sparkly" gene!!! One is no better than the other. This isn't about male bashing. My son is one of the most wonderful humans I have ever met and many of my dearest friends in my life have been male. But there is a special quality that is distinctly feminine. I have been thinking about this for some time (obviously!!) and wanted to share what I have seen and experienced first hand.

Having grown up in a family of 3 girls, trained as a nurse (3 times!), and worked in that field for 27 years...I have spent plenty of time in almost exclusively female domains. Women are not all sweetness and light. Plenty will stab you in the back...and the front. Just as many as will give you a helping hand will give you a shove down the stairs as you fall. Yet, there is a bond and gift, to all they touch, that only women can give.

I have been fortunate to explore museums in Athens, London, Paris and across the United States. I have seen amazing art and artifacts. But the pieces to which I am most drawn are the small things from the lives of women who went before me. Just as Agatha Christy, whose second husband was an archaeologist noted, "There are her needles, the remnants of her earrings, her cooking utensils, her pots for rouge." I realize looking at these things how alike we are. How, centuries before me, she lived as I do now. Taking care of her family, trying to look pretty.

I once read an essay written by a woman whose name I don't recall, in which she noted that when you put two women together who are both parenting a 6 year old, all else will drop away....social status, educational level, race, ethnicity, politics, religion. The commonality of rearing that child will bring them together, equalize their lives, in a way that nothing else can.

I watch the women in the hair salon. I have written several novels in my mind. I watch the hair dressers and the patrons...some are shy and uncertain, others loud, some prissy, some for whom this care and primping are just a routine part of their feminine world. It is comforting and entertaining to watch and listen as they let their hair down as I do mine...we are the same, we are here, we are sisters.

Then, there are the women who have and currently share my work life. These sisters have shaped my world and taught me all I know about being a nurse and taking care of children. They have supported me when I am down and rallied around others ANYTIME they are needed. They are there: with humor, with hugs, with tears, with casseroles. They will diaper your baby, they will diaper you. If you but ask, and even when you don't. It is a blessing. It is real. It is a gift beyond measure. I wish only to live up to the gentleness, the strength, the kindness, the joyousness that these women...strangers and intimates alike...my sisters...have shown me.

c

NSAID's and cancer (Colon and melanoma specifically!) ~

Much has been written in the literature regarding NSAID use and melanoma. NSAID's are drugs like aspirin, ibuprofen, naproxen, and lots of prescription ones, that block COX enzymes.  Enzymes that produce prostaglandins which lead to inflammation, pain and fever when left to do their own thing.  By blocking the enzyme, NSAID's reduce the prostaglandins and the unpleasantness they cause.  I first reported on them in 2012!  Here is a break down of how they might work in melanoma world from 2015:  An aspirin a day...keeps melanoma at bay....and makes immunotherapy work better!!!! 
Here are a zillion additional reports:  NSAID's - do they help or not? 
Basically, the data (and reports) cover:
"YES!!!  NSAID's make immunotherapy work better!"   "NSAID's increase survival in melanoma patients."  "No, NSAID's make no difference."

Though these drugs are not to be trifled with despite being accessible over the counter, most data says at worst they "do no harm".  Given the aches and pains immunotherapy causes, I've long said you would be hard pressed to find a patient on immunotherapy who did NOT partake in the use of NSAID's!!  I know I certainly took my share of advil during my treatment!!!  Now, there's this:

The Impact of Nonsteroidal Anti-Inflammatory Drugs, Beta Blockers, and Metformin on the Efficacy of Anti-PD-1 Therapy in Advanced Melanoma.  Wang, McQuade, Rai, et al.  Oncologist.  2019 Nov 29.

Anti-programmed cell death protein-1 (anti-PD-1) therapy has greatly improved outcomes of patients with melanoma; however, many fail to respond. Although preclinical studies suggest a potentially synergistic relationship with anti-PD-1 therapy and certain concurrent medications, their clinical role remains unclear. Here, we retrospectively evaluated the use of nonsteroidal anti-inflammatory drugs (NSAIDs) and other drugs in 330 patients with melanoma treated with anti-PD-1 therapy from four academic centers. In the cohort, 37% of patients used NSAIDs including aspirin (acetylsalicylic acid; ASA; 47%), cyclooxygenase (COX)-2 inhibitors (2%), and non-ASA/nonselective COX inhibitor NSAIDs (59%). The objective response rates (ORRs) were similar in patients with NSAID (43.4%) and no NSAID (41.3%) use with no significant difference in overall suvival (OS). There was a trend toward improved progression-free survival (PFS) in patients who took NSAIDs (median PFS: 8.5 vs. 5.2 months). Most patients (71.3%) took NSAIDs once daily or as needed. Multivariate analysis did not reveal an association with NSAID use with ORR, PFS, or OS. Concurrent use of metformin or beta blockers did not affect ORR, PFS, or OS. Our study found no conclusive association of concurrent NSAID or other medication use with improved outcomes in patients with melanoma treated with anti-PD-1 therapy. Larger and more systematic analysis is required to confirm these findings.

Given my current condition, it is pertinent that my 2015 report started with this quote:
 "NSAID's, including aspirin, decrease the incidence and mortality from colon cancer in humans by 45% to 50%."  DuBois, Cancer Research, 56(4), 1996.

Now, there's this - The Association between NSAID use and Colorectal Cancer Mortality: Results from the Women's Health Initiative

Which notes:  "Randomized trial evidence demonstrates that non-steroidal anti-inflammatory drug (NSAID) use, particularly long-term use, reduces the incidence of colorectal neoplasia. Recent data also suggests an inverse association between NSAID use and death due to colorectal cancer (CRC). We examined the association between NSAID use and CRC mortality among 160,143 post-menopausal women enrolled in the Women's Health Initiative. Women provided details on medication use at baseline and three years after enrollment. Overall, NSAID use at baseline was not associated with CRC mortality. However, women who reported NSAID use at both baseline and year-three experienced reductions in CRC mortality compared to non-users.  Results suggest that NSAID use is associated with lower CRC mortality among post-menopausal women who use these medications more consistently over time. Our results support prolonged NSAID use in post-menopausal women for the prevention of poor CRC outcomes."

I have discussed all of this with my various docs.  They didn't have too much to say or contribute on the subject one way or another.  However, I was given their blessing to start an aspirin regimen of one baby aspirin (81mg) per day.  So, I did!  For what it's worth! - c

May Reads

Hamnet - Maggie O'Farrell.  Historical fiction, telling Shakespeare's story leading up to the writing of Hamlet.  The following passages hit incredibly close to the bone...

"...He carried with him, always, the sensation of his father's calloused hand enclosing the soft skin of his upper arm, the inescapable grip that kept him there so his father could rain down blows with his other, stronger hand.  The shock of a slap landing, sudden and sharp, from above; the flensing sting of a wooden instrument on the back of the legs.  How hard were the bones in the hand of an adult, how tender and soft the flesh of a child, how easy to bend and strain those young unfinished bones.  The doused, drenched feeling of fury, of impotent humiliation, in the long minutes of a beating.

His father's rages arrived from nowhere, like a gale, then blew quickly on.  There was no pattern, no warning, no rationale; it was never the same thing twice that tipped him over.  The son learnt, at a young age, to sense the onset of these eruptions and a series of feints and dodges to avoid his father's fists.  As an astronomer reads the minuscule shifts and alterations in the alignment of the planets and spheres, to see what lies in store, this eldest son became an expert in reading his father's moods and expressions.  He could tell, from the sound the front door made when his father entered from the street, from the rhythm of his footsteps on the flagstones, whether or not he was in for a beating."

"...He is, he prides himself, adept at dissembling, at reading the thoughts of others, at guessing which way they will jump, what they will do next.  Life with a quick tempered parent will hone these skills at an early age...."

Very few changes would be needed to make that story one I experienced and observed.  Damn.  At any rate - while Shakespeare's life and experiences are the bones of the story - the heart is built on the history, daily life and experiences as a mother, of his wife, Anne Hathaway.  I was incredibly touched by her strength, free spirit and depth of maternal love.  Highly, highly recommend.

Bark - Lorrie Moore.  This volume of short stories had been recommended by multiple sources.  Chose to try it as Hamnet was so powerful that I wanted something rather small and light.   Sorry.  Not a fan.  I didn't like a single character in this collection; always a problem for me.  Almost didn't finish it - but I did!  

INTRO to Marie Benedict's (aka Heather Terrell) work:   First and foremost, though her books tend to be a bit contrived and juvenile in presentation, wordy with a penchant to use "frisson" far too often, I have been most pleased to find them.  The women she writes of have certainly not been given their due in so many ways.  It was interesting to do a bit a of research on each woman and her life independent of these books - which - in one interview - was exactly what Ms. Benedict said she most wanted her writing to achieve.

The Mystery of Mrs. Christie - Marie Benedict.  Having read several biographies of Agatha Christie, there were no astonishing revelations in this one, though the premise of a letter left to her husband, found by him after she vanished, and the unraveling of both her mysterious disappearance and her husband's affair told through his eyes was fun to entertain.

Lady Clementine - Marie Benedict. Perhaps the best written of the lot, I learned a great deal about Churchill and his wife, Clemmie, that I did not know or had never really thought through.  Most impressive were her efforts on behalf of women in particular and Britons generally, during the war.  Their relationship. at least in this telling, was more mutually respectful and appreciative than some of the others of which she wrote.  In addition to reading about Churchill and his wife, I was led to watch Darkest Hour.  While good, it was disappointing how little light it shed on Clementine especially given who she was, the role she played in Churchill's life, and the fact that Kristin Scott Thomas was playing her!!!  Oh well.  You can't have everything.

Carnegie's Maid - Marie Benedict.  Despite the Carnegie name being associated with everything from innumerable libraries, colleges, the discovery of insulin, the dismantling of nuclear weapons and even Sesame Street - I knew little about the man.  An immigrant from Scotland, Andrew Carnegie, was one impressive dude. Brilliant and at times ruthless in his business ventures (telegraph, railroads, steel, bridges) he was an incredible and dedicated philanthropist.  Often directed toward education and libraries. he gave away 90% of his incredible wealth in his lifetime and at his death additional funds were dispersed to individuals, charities and various foundations.  At the age of 33 he wrote, 

"... The amassing of wealth is one of the worst species of idolatry. No idol more debasing than the worship of money."  In order to avoid degrading himself, he wrote in the same memo he would retire at age 35 to pursue the practice of philanthropic giving for "... the man who dies thus rich dies disgraced." 

The book is based on a premise that a relationship and unrequited love for his mother's maid led to this mantra; a possible but unlikely scenario?  Either way, it was used to good effect as a vehicle to tell the story of this complicated and generous man and is the only book that does not feature a woman known to actually exist.

The Other Einstein - Marie Benedict.  The story of Einstein's first wife and brilliant physicist, Mitza Maric.  Soooo - spoiler alert ~  Einstein was an ASSHOLE!!!!!!!!!!  Damn!  They had a daughter together - prior to their marriage - who was either put up for adoption or lost to scarlet fever.  (Further reading seems to favor the later.)  An entire experience that Albert was insensitive to at best.  Marriage did eventually follow along with the birth of two sons.  Despite her assistance with a great deal of his work, through his direct manipulation, Mitza's name was never credited on any of Albert's publications or in connection with any of his other recognitions.  I guess you could say she got the last laugh as his Nobel Prize money was placed in trust, and later in property, to provide income for her and their sons, one of whom required institutionalized care due to schizophrenia, after he left her for his cousin.  That would be his first cousin on his mother's side and second cousin on his father's!  Yes, one of the equations Mitza helped him develop is required to figure that one out! What the tub???!!!!

The Personal Librarian - Marie Benedict and Victoria Christopher Murray.  Perhaps the most tediously written of the group, describes the life of Bella da Costa Greene, who was JP Morgan's personal librarian from 1905, continuing even after his death in that role, working for his son until 1948.  She was a black woman 'passing' for white in a man's world.  I can't even imagine how it felt to face the challenges or the choices she made.  As glad as I am to know of Ms. Greene, the book itself is a bland shadow compared to Passing by Nella Larsen.  Then again, I don't think its authors were trying to reach those heights.  

Her Hidden Genius - Marie Benedict.  The story of Rosalind Franklin who, through her use of crystalline X-ray techniques, led to the understanding of the helix formation of DNA.  Sexism, underhanded stealing, and her death from ovarian cancer, likely caused or at least exacerbated by her excessive exposure to radiation at the age of 38, precluded her being awarded the Nobel Prize for that discovery, which was instead awarded to Watson and Crick in 1962.  She also worked on unraveling the mystery of RNA, learning things that enabled Doudna and Charpentier to attain the Nobel prize in 2020 for their work on CRISPR genome editing technology - paving their way as a researcher on the subject and woman in the field.  Sadly, this book may have been the most poorly written of the series, standing in sad relief when compared to The Code Breaker by Walter Isaacson.

The Aviator's Wife - Melanie Benjamin.  Another spoiler alert!  Ready?  Charles Lindberg was an ASSHOLE!!!  Much like, Einstein, he never gave ample credit to his wife Anne Morrow Lindberg who, though they met and married after his historic transatlantic flight, was his copilot and cowriter for many years.  He was a cold man who never seemed to really appreciate his children or wife, or the toll exacted on Anne after the abduction and murder of their first child, and was a Nazi sympathizer to boot!  If that wasn't enough, turns out he had three additional families through three women in Germany (two of whom were sisters!!!!) and a total of 7 children with those women from 1958 to 1967 in addition to the 6 he had with Anne.  Additional reading indicates that DNA testing demonstrated that those 7 were indeed his.  The children he had with Anne became aware of their existence after his and her death.  The book presumes that Anne learned of those "families" through letters he did actually write to the women imploring them to keep his secret even after his death, upon his death bed.  My reading indicates that finding the letters led to the aforementioned DNA testing and those children reaching out to their American siblings.  Hmmm....  Benjamin has written her story in a style and manner similar to those by Benedict - but it is worth reading.

When Crickets Cry - Charles Martin.  Though utterly predictable and more than a little romanticized (from someone who is a pediatric medical person) and not as good as Unwritten - Martin has a way of holding your attention.

Little Fires Everywhere - Celeste Ng.  I couldn't have read this at a more pivotal time.  Abortion, adoption (from both sides - those who wish to adopt and those who for myriad reasons are compelled to give their baby up), socioeconomic/class distinctions, race, cultural issues, raising children who are and aren't of your ethnicity, surrogacy -  motherhood in all its forms - it's here. Heart rending issues. Fairly well addressed - making one think.  Not sure the book lived up to all its hype - but that's not really the fault of the book nor the author.  If these issues of motherhood interest you - one of the more recent pod casts by Haptic and Hue - Fabric and Foundlings is definitely worth a listen as it addresses babies left, most often, by mothers who could not afford to feed and care for them, but were not lacking in love.  Because the foundling hospital - begun by a sea captain who wanted to improve the lives of those women and the children they could not keep, as a safe place, with accommodations to care for feed the children who previously were being left on the streets of 1720's London, required anonymity - most babies were left with bits of cloth attached to their blankets, which the mother could later describe and often had a matching piece of, so that should her plight improve, she could return and reclaim her child.  Records of these bits of cloth as well as the clothing the children were left in were meticulously kept.  This anonymous poem was left with one child ~

Hard is my Lot in Deep Distress

To Have No Help where most should find.

Sure nature meant her sacred laws

Should men as strong as women bind.

Regardless he, Unable I,

To keep this image of my heart.

‘Tis Vile to Murder! Hard to Starve,

And death almost to me to part.

If fortune should her favours give

That I in better plight might live

I’d try to have my boy again

And train him up the best of men.

I didn't plan to read predominantly of women and motherhood this month - but it seems I did and it was good.  "Sure nature meant her sacred laws should men as strong as women bind."  That says so much as we face determinations by the Supreme Court regarding women's health - having been placed in circumstances women did not - could not - attain alone.

Read chaotically!  - les

Safety nets and strong women.....

Yes, many men have more than helped me along my path in life and melanoma.  Dear B, Fred-o, Dr. Michaels, Dr. Weber...are just a start to the list.  Yet, there is an incredible system, an old and knowing sisterhood, that so many women, (And NO!!!  Not all women possess this wisdom...but still.....) from dear Ruthie and Rosie, to so many others near and far, neighbors and coworkers, that literally took me into their hearts and arms, giving me strength when I could not make it on my own.

Over ten years ago, I wrote this:  Women

 More recently, I recalled this post from 2011...

PPP = Pinky Pink Power Women...or...

  ...as I sewed and created a new post and story ~

Sew Chaotically! - Pinky Pink M6752 and "pattern" from J Crew RTW tank!!!

Then there's the many times a wide variety of potty pics have figured largely in my world:

TB - From 2015: Happy Halloween...and then some!!!

For a better explanation read:  What to say and do....and NOT!!...for a cancer FRIEND (not patient)!

Then today...this, posted by Jeanne...brought memories flooding back and sweet tears to my eyes:

Yes, I have been carried in that net and heard those songs.  Great thanks, big hugs, much love, with laughter that makes your tummy hurt and tears flow ~ to each of you.  love, c

Sew Chaotically! - Sew bots????!!!

B shared this video from the Wall Street Journal with me today:  WSJ series - Moving upstream: How sewing robots may put humans out of work

The sewing and textile industry has always been an amazing utilitarian and artistic venture while simultaneously being one that often abuses, underpays, and mistreats its employees, who are, and have historically been, predominantly women.  In New York City in 1911, 145 workers died in the The Triangle Shirtwaist Fire ~ a sweatshop that employed about 600, mostly non-English speakers, who worked 12 hours a day, 7 days a week, for $15.000 per week.  There were 4 elevators in the building; only one worked.  The fire escape was narrow and dilapidated.  One exit door was locked and the other opened inwardly.  When the fire started in a box of rags, the manager discovered the fire hose was rotten and the water valve rusted shut.

Sadly, I'm not sure 'we've come a long way baby'!  Although the fashion industry has provided families, through the employment of the women in them, a wage that lifts them out of the most devastating poverty, these women remain frequent victims of demanding work quotas in poor working conditions for very little pay.  They are often illiterate, lacking in education generally and math in particular.  As the video at the top notes, today in Bangladesh, these women are lucky to make $164.00 per month.  As if that were not enough, here come the machines and bots - machines that can knit a sweater for Zara faster than human hands.  The video details machines used in a Japanese prison where workers with as little as one day of training create guard uniforms.  In Arkansas and Japan completely automated bots are being developed to sew a variety of garments.  Check out the video to see how machines sew perfect pockets and distress your latest jeans!!!

MY Creative Corner!!!

Sew-bots!!!  Part of me LOVES this!!!  And, it is a fact, that we home sewists wouldn't be making OUR garments without OUR machines!!!  My sewing improved in gigantic leaps when B got me Bernie and Sergie!!! But, this needn't be a one sum game!  Why can't we utilize the best that  machines provide while keeping the human touch?

Afghan #9 zillion and one for a special baby on the way!!!

Here's the thing.  In 2018, why DO we have illiterate people on the planet?  Why do we have people in poverty?  Children with insufficient food?  Girls (as well as boys) with NO opportunity for a basic education?  I actually know some of the answers.  Basic greed and power covers most of it!!!  So, I guess the better question is:  Why do WE ALLOW this circumstance?????  And folks...it IS a "WE"!  You and ME!!!  If the human brain and spirit can invent self driving cars, shoot rockets (and cars ~ what a waste of a Tesla!!!!!!!!!!!!!) into space, along with machines that can create garments with no need for human hands, we can feed and educate the world's people!  This kind of entrepreneurship, creative genius, and absolute brilliance can do SEW much more!!!  There really is no reason for the women of Bangladesh to be impoverished or left behind as automation, as it surely will, moves forward!!!

We can do better!  Let's start now!!! Sew and live chaotically! ~ les 

December/January/ February/March Reads

December:  

The Book Thief - Markus Zusak. 1939.  Nazi Germany.  At her brother's grave, Liesel finds and keeps, The Gravedigger's Handbook, beginning her fascination with books and reading.  Her story of living with a foster family, their harboring of a Jewish man, her friendships, how they and others resist and comply with Nazi rule are an intense and poignant telling of the events and that moment in time, but speak volumes for us today.  I found Death as a character, while crucial in giving scope and providing narration, strange and disruptive at times.  However, it is a book that stays with you forever ~ and should. 

January:

The Dressmakers of Auschwitz - Lucy Adlington.  True story of amazing women and the horrors of those able to use others so completely.  Difficult to read in many ways.  But, apart from the absolute cruelty man is able inflict that others are miraculously able to withstand, the telling could get repetitive and disjointed at times as the author would interject each woman's arrival no matter the time or events surrounding it, rather than provide a cohesively linear story.  Not at all saying I could have done any better and I am sure the method was rooted in the desire to maintain facts and authenticity based on papers and interviews that had been used, which I really do appreciate.

February:

The Librarian of Auschwitz - Antonio Iturbe.  Based on the true story of Dita Kraus.  I will never understand how cruel some humans can be.  I cannot imagine living through such things.

World Travel, An Irreverent Guide - Anthony Bourdain and Laurie Woolever.  Not the book I thought it would be.  More of a list of cities/countries with a bit of travel data and Anthony's comments lifted from prior shows and books with no new material from Anthony.  Still, it is always nice to hear his voice.

March:

Resistance Women - Jennifer Chiaverini.  I wanted to love this more than I did.  It was a LONG haul.  While I was thrilled it was a real accounting of brave strong women during unspeakable times - it often felt trite and repetitious.  Through the lives of the characters - Mildred Fish, an American married to Avrid Harnack - a German economist who returned to Germany before all the horrors began;  Martha Dodd, daughter of the American Ambassador to Germany; Greta Kuckoff a German and aspiring writer; and the only fictional composite - Sara Weitz, German, Jewish student - we get lots of details but I never felt I knew the women.  Perhaps, simply my own fault, but it felt more like reading a report than a novel into which you breathe with the characters.  Still - filled as it was with details of these incredible women and their group of resistance fighters - it gives the obviously damning and horrible view of those who committed atrocities but almost more horrible - the inaction of those who stood quietly, and therefore complicitly, by - doing nothing - while their neighbors and friends were removed from their jobs, homes, families -  first to undesirable areas in town, then tenements, to compounds, to camps.  Much like The Dressmakers of Auschwitz - making it clear that while hatred and prejudice were key in the events of Hitler's Germany - basic greed combined with the desperate economic conditions of the depression - fueled many of Hitler's directives and the willingness of the populace to follow them.  Removing Jews from their jobs opened up positions for other Germans.  Their removal from their homes and the distribution of their possessions directly benefited those ruling and the citizenry as well.

Heavy reads in these months.  They were painful, so the going was slow.  Due to my own poor education in these matters, I had rather missed how large a role financial greed, obviously combined with the desire for power and general racist hatred, played in Nazi Germany.  There is so much to learn from Germany's Nazi past as well as how it has risen from such horrors.  Despite pushback from right wing extremists in recent years, Germany has laws against promoting Nazi sentiment on-line and off, wearing the SS uniform, supporting Hitler, using swastikas and hate speech, as well as publicly denying the Holocaust.  So much we could learn here... Man's incessant need for power and to tear down others is incomprehensible to me.  

Wishing you all the freedom to be who you are, love who you wish, worship as you desire, and tend to your own damn business.  I know I got enough on my plate without worrying about what somebody else has on theirs!!!

Live kindly if chaotically!  ~ les  

Come on, Bey! How come you be blonde?

Beyonce's new video and subsequent Super Bowl performance of "Formation" proves she was right.  "You know you dat bitch when you cause all that conversation!"   Indeed!! From NPR code switch to office lunch rooms to Facebook posts...everyone is talking!  The song, especially when paired with the powerful images in the video, has been variously described as ~ 'slay-worthy', 'powerful', 'hilarious', an 'insult', 'provocative', 'anti-cop', an 'anthem', 'insulting', a 'glorification of blackness'.  For me it is just as much the story of those left behind in the wake of Katrina, Black Lives Matter, and the injustices blacks have endured in our society as a tapestry of T and A, and wigs and weaves!  As such it seems that I have the only question yet to be posed:  Come on, Bey!  How come you be blonde?

Katrina.  That was back in 2005, y'all!  The fact that portions of New Orleans remain filled with empty lots, abandoned and broken, houses covered with tarps....STILL...is unconscionable to me.  The general lack of preparedness, the lackadaisical, ineffective management of government leaders before, during and after the storm, with a disproportionate number of blacks and poor communities left to suffer the most - remains a blot on our national history.  The 45 bodies pulled out of Memorial Medical Center after the storm is a story of stupidity, injustice and medical malpractice that SHOULD haunt us all.  This hospital lost power and supplies when the levees broke (Whole 'nother story there, peeps!!!) BECAUSE - despite knowing they lived in a city below sea level, despite the fact that within weeks of its opening in 1926, the hospital flooded!!!....in 2005....the generators and supplies remained housed in the frequently flooded basement!!!!!  How is all of this okay?


How do we as a society fail to recognize and address the perpetuating nature of poverty, lack of education and opportunity, and its deleterious effects on minorities and marginalized communities?  As Dostoevsky noted...after serving a little time..."You can judge a society by how well it treats its prisoners."  Clearly, that reflection starts with who we, as a society, imprison and why.  The fact that the majority of folks arrested and imprisoned in this country are from minority groups cannot be an accident nor appropriate.  There are good people and horrible people of every race, sex, creed, and color.  To look at the penal system in the United States you would have to believe otherwise.  The fact that a man walks free after killing an unarmed teen, while that man was armed with a gun - IN A VEHICLE - in "self defense"....says what exactly?  About us?  To us?  For us?  We should rectify our inequalities and the problems within our society that creates them!  But, it's not easy is it?

It is far easier to carpet bomb something that seems very clear and different...foreign.  It is easier to define the origin and horrors of Radical Islamic terrorists with their killing and mayhem inflicted on innocents on 9/11, in Paris and San Bernardino, than it is to face the good 'ol white boys with a Momma and a Daddy, often sitting at home with their Second Amendment arms, listening to hate stirring, free speech commentators, singing a siren song, who do the same:  Dylan Roof - killed 9 praying in their church in South Carolina.  Timothy McVeigh - responsible for 173 dead in Oklahoma City.  James Holmes - 12 killed for watching a movie in Aurora.  Adam Lanza - killed 26 elementary school children and teachers in Sandy Hook.  Harris and Klebold - murdered 13 of their classmates at Columbine.  Ted Kaczynski created terror by mailing bombs for 20 years!!!!  I could go on...but I'm feeling ill.  It is hard to carpet bomb the freaks of human nature when they live next door, isn't it?

We SHOULD decry exclusive old white men clubs!  The KKK.  The voting block for the Oscars.  The United States Congress.  ALL institutions should be judged on their merits and their reflection of the society they claim to represent.  West Point allowed women entry only in 1980. In 2015, the first two women graduated from U.S. Army Ranger School and women held only 104 of the 535 seats in Congress.  Still, the 114th Congress is the most diverse it has ever been, with non-whites making up 17% of its members though that is far from the 38% they constitute of the National population.  Male blacks attained the right to vote in 1869.  Even so, in 1940, only 3% of eligible African Americans in the South were registered.  Women did not gain the right to vote until 1920! But, at some point, women and blacks have to recognize that we can't ask for equality and special treatment at the same time.  I can't expect you to hold the door for me, cast your vote for me (Yes, I'm talking to you, Madeleine!!), allow me to join an elite branch of the military or enter the college of my choosing JUST because I am a woman.  Rather, I deserve these things either on the basis of human kindness...one for another...or because I earned them.  Similarly, while institutions like Ebony, BET, The Black Caucus American Library Association, Miss Black America, etc. all served a necessary and essential purpose in the fight for societal equality - there will come a time when the black community will have to reassess, as Howard and other institutions have done, whether their exclusivity remains deserved and appropriate - or simply an additional bastion of elitism and segregation.

"I like cornbreads and collard greens, bitch. Oh, yes, you best to believe it."  Oh, yes, I do, girrl!!!  Born and raised on beans and greens.  Had some for supper just the other night.  Yep.  I know all about being BAMA!!  Born and bred.  I have traveled the world, read more than many, attained a Master's Degree, and remain proud of where I'm from.  Like, Bey, I make no apologies for that.  And, yes, there are those who after a look and a listen, dismiss my ability to retain thoughts or have something meaningful to say simply on the basis of my being a female with a southern accent.  It used to bother me more.  But now....it's their loss.

Finally ~ Bey, why you be blonde?  Now understand, this is coming from a girl who ain't had her 'natural hair' for more than 20 years!!!  But, I ain't been telling anybody to keep their natural fro and nose either! And, girl...you know you can't find 24+ amazing dancers with their hair 'natural' and cut just so!!!  Just say'n!!

In the end,  I think 'Formation' and its hubbub is a good thing.  No matter which side of the discussion you fall on....even if it's a little bit on both....Beyonce got us talking.  Let's hope we all start doing something, too.

Cause:  "I slay, OK, I slay, OK.  We gon' slay, slay.  Gon' slay, OK.  We slay, OK!" - c

July Reads - began with lighter fare, after the heavy but important reads of June...

Paris for One - Jojo Moyes.  Short stories.  Okay.  Some better than others. Not close to "Me Before You" - but a nice diversion from recent heavier reading.

Trains and Lovers - Alexander McCall Smith.  Interesting dissertation on love - of various sorts.  McCall Smith - always able to preach without a sermon.

The Beekeeper's Apprentice - Laurie R. King.  Lovely introduction to Holmes in retirement and his young friend Russell.  King is able to keep the tenor of Arthur Conan Doyle's Holmes resonant without being redundant or reductive.  Enjoyed!

A Monstrous Regiment of Women - Laurie R. King.  This sadly felt incredibly pertinent to today's perils for women's rights as each chapter was introduced by incredibly infuriating quotes from all manner of men and the Bible deriding the rights and abilities of women, though they eventually morph into quotes that recognize female ability and what women accomplish daily.  As does Holmes.

The Marriage of Mary Russell - Laurie R. King.  Short story covering the only wedding possible for Holmes and Russell.  Nicely done.

Garment of Shadows - Laurie R. King.  Holmes and Russell - abduction and espionage in Morocco.  

Dreaming Spies - Laurie R. King.  Another Russell and Holmes tale, much of it taking place in Japan.

The Murder of Mary Russell - Laurie R. King.  Mostly the tale of Mrs. Hudson and Billy.  A nice addition to how Mrs. Hudson came to be Holmes' housekeeper!

Riviera Gold - Laurie R. King.  A continuation of Mrs. Hudson's story.  Not quite as good.  But loved getting to travel to Nice and Antibes again!!!

Everything I Never Told You - Celeste Ng.  The story of a Chinese American Family.  Their efforts to fit in, yet retain their culture in America as Americans.  The death of a daughter (no spoiler - it is revealed in the first sentence) unravels at least a portion of the secrets, expectations, and fears they (and we) fail to share with those we are closest to.

Crying in H Mart - Michelle Zauner.  Zauner shares her life growing up with her Korean mom and American dad.  Her difficulty fitting in - simultaneously desiring to be more Korean for her mom and aunts, yet more accepted as a regular American kid among her school mates.  Her teenage pull against her mom's exhortations, knowing all the while they are rooted in her mother's tremendous love for her.  Culminating in her mother's diagnosis, treatment and death from cancer.  Through it all, it was their powerful connection through their mutual love for Korean food that kept them close and in the end, allowed Zauner to cope with the loss of her mom.  Sharing H Mart with my girl made her story real and even more touching for me.

Read chaotically! ~ les

Women's Rights are HUMAN Rights!!!! In Chattanooga and beyond.....

Chattanooga: Thousands of women, activists march in solidarity for human rights. [Headline Chattanooga Times Free Press with their photos below]

WOMEN’S MARCH ON CHATTANOOGA HELD SATURDAY  [Headline: WDEF News Channel 12, their photo below] “Thousands turn out for 2 mile march...”

And in case you haven't guessed it...  YEP!!  We were there!!!  

We marched along with the most civil and polite folks I've ever been grouped with.  The slogans and participants varied.  Here's a selection of what I saw:

LOVE TRUMPS HATE!!!  
Make America Kind Again!
Christians Build BRIDGES not WALLS!
Girls just want to have FUNdamental Rights!
Nasty Girl!
Healthcare for ALL!
Lift and protect each other
Equality for all!
Resistance is character forming!
LOVE, HOPE, RISE!!!
Mujeres for America
Equal Pay for Equal Work!!!
Women make America GREAT!
Men with t-shirts saying, "THIS is what a feminist looks like!"

This march was not about who is or isn't the President.  Donald Trump IS the President of the United States.  But, WE are the PEOPLE....making it clear that at least some of us....actually, a great number of us....over 3 million nation wide...take a look at New York...

 ....are willing to use our voice, our time, our Saturday to say:  We are here.  One for the other. Patriots and advocates. In solidarity. To make sure that those in power...whoever they may be....understand that we are ONE.  No matter gender, creed, color, sexual orientation, religion, good health or poor... We stand TOGETHER...on this one planet...that we aim to protect...along with the rights of ALL its beautiful inhabitants!

How is it possible to find something that is partisan or filled with hate in that message?  - c

Jenny Hudgeson, Kim Burns, and Fredda Branyon...different or the same????

Remember the "Quack Watch" post of June 20th???  It covered the story of how "Ms. Burns" had been traveling about on the web, hijacking every blog/post with 'cancer' in the title to tout her "doctor" Branyon, including mine.  The comment Burns posted on my ode to Pati and women surviving baldness as well as chemo is noted below.  As you may also recall, Branyon is NOT a physician, but a criminal who pleaded guilty to "manufacturing" stem cells illegally and selling them illegally, while making thousands off the backs of sick and desperate people.  Since posting this info, and following Burns' comments with the truth in a comment of my own on every blog I found her inane writing on, I have succeeded in getting many comments removed.  Additionally....I made a new little discovery.  Suddenly, Ms. Burns deleted her picture and profile page.  It is blank.  The picture of a pretty brunette espousing her interest in L. Ron Hubbard and "learning about makeups" is no more.  BUT!!!!  Just as suddenly, on 7/1/2013, a new page was born, and belongs to none other than Jenny Hudgeson.  Simultaneously, Jenny began hijacking blogs to post comments highlighting Branyon.  AND....while looking around at that sick business, I found that the great Fredda Branyon herself is doing the same thing, albeit in a weird third person style.  Below, you will find samples of the comments made by all THREE of these women.  I ask you.  Do YOU think there are THREE women in this world who would: 
1.  Go to the sick trouble to search the web for blogs and posts by cancer patients and those who have lost dear ones to cancer.
2.  Post comments bringing the criminal Branyon to light on those very posts.
3.  Write so distinctively poorly with the exact same, incorrect, sad, grammar???????

I think not.  But, you can be the judge....

Kim_Burns   June 10, 2013 at 8:27 PM

Well me and Dr Fredda Branyon agrees that everything that we wear and have are all accessories, what's important is what's within and how well you show and impart yourselves to everyone.

 Fredda Branyon Scottsdale AZ said...

I agree on all the points that you have shared and thanks for informing us about brain cancer. Me and Dr Fredda Branyon is so happy about it. Keep inspiring others! Have a nice day.

May 22, 2013 at 8:06 PM

Jun 27, 2013 - Blogger Jenny Hudgeson said... 

Me and Dr Fredda Branyon supports you on this. I believe that this would be such a helpful study to everybody.

To the Ms. Burns, Branyon, Hudgeson trifecta:  You were warned once.  I wasn't kidding.  Keep using cancer patients to push your illegal and illicit agenda and I will make sure you get the PR you deserve.

PS  Since posting on my blog and following your comments...I have been contacted by several people who have very interesting stories to tell about how you swindled their sick loved ones with your QUACK medicines, which happen to be extraordinarily expensive.  Hmmmm.... Wonder if 60 Minutes or Front Line would be interested!!!!????? I'll have to check on that!!!  

Your tenacious 'friend' - c