Post #61- Breast Cancer Facts

BREAST CANCER FACTS

Types of Breast Cancer

Breast cancer is breast cancer, right? Sure, just like red is red... Actually, we know that red can be crimson or burgundy or scarlet or brick or... And breast cancer comes in many forms. How much do you really know about the different types of breast cancer?

1. How many different breast cancers have been identified?


Researchers have actually identified 14 different breast cancers. The most common is invasive ductal carcinoma (IDC), followed by ductal carcinoma in situ (DCIS), then invasive lobular carcinoma (ILC), and inflammatory breast cancer. The remaining 10 cancers are very rare.

2. Whether you have invasive (infiltrating) breast cancer vs. non-invasive (in situ) determines a lot about your treatment. What percentage of women have an initial diagnosis of invasive breast cancer?

80% of women receive an initial diagnosis of invasive breast cancer. And about 85% of those women are diagnosed with invasive ductal carcinoma (IDC), the most common type of breast cancer.

3. You can be diagnosed with two types of breast cancer at the same time.

Oftentimes a woman will be diagnosed with both invasive and non-invasive cancers in the same breast. She may have multiple tumors, some of which have spread outside their point of origin to surrounding tissue (invasive), and some of which remain where they started (in situ). Or a woman may be diagnosed with invasive cancer in one breast, and non-invasive in the other. It's rare for a woman to be diagnosed with different kinds of breast cancer (say, both lobular and ductal) at the same time, but it can happen.

4. What percentage of breast cancers are considered curable?

The cure rate for non-invasive breast cancers is currently 98% to 99%, which means doctors consider them curable. Non-invasive breast cancers represent about 20% of all breast cancer diagnoses, so about 20% of all breast cancer is assumed to be curable right from the get-go. What does that mean for the other 80%? It means that you have a longer wait to see whether or not you've been cured. The common assumption is that if you're treated for cancer and go 20 years without a recurrence, you're cured.

The great majority women with invasive breast cancer don't die from it. Statistically speaking, about 1 in 5 women diagnosed with invasive breast cancer eventually dies from it. And those cancers detected early, before they've spread to the lymph nodes, have much less chance of recurrence. So even with a diagnosis of invasive breast cancer, your chances are pretty darned good that it won't be the eventual cause of your death. And with continuing improvements in treatment, those odds are looking better all the time.

5. This breast cancer is aggressive, fast-growing, and often misdiagnosed. Which of the following best fits this description?

Inflammatory breast cancer (IBC) occurs when cancer cells block your breast's lymph system. It's aggressive and fast-growing. And unfortunately, since its symptoms can include redness, swelling, and a rash, it's commonly misdiagnosed as an infection, a sunburn, allergic reaction to an insect bite, or mastitis.



Thank you PJ Hamel for providing these Breast Cancer Facts!

Post #60- Fact Sheet about Her2 + breast cancer and Herceptin

HER2 (human epidermal growth factor receptor-2) Positive Breast Cancer

Breast Cancer Is Many Different Diseases
Researchers now understand that breast cancer is not one disease, but many different diseases. Even when tumors are classed together based on their appearance, they can act differently because of different genetic makeup. Only recently have researchers begun to understand this and to use it in predicting how a disease may progress — for example, the likelihood of a tumor to grow, spread, or recur. This is an important new area of research.

HER2-positive breast cancer is one form of breast cancer. Characterized by aggressive growth and a poor prognosis, it is caused by the overexpression of a gene called HER2 in tumor cells.

HER2 in Normal Cellular Function
Every one of the millions of cells in our body carries out its life cycle in a relatively orderly fashion dictated by its function and various other factors. The process can be altered by intra- and extra-cellular pressures that change the cell's environment. In the development of cancer, a key factor is a change in the growth rate of the cell and the ability of various control mechanisms to get the cell back on track.

The HER2 gene is responsible for making HER2 protein. When two copies of the gene are present in normal amounts, the protein plays an important role in normal cell growth and development. The HER2 protein transmits signals directing cell growth from the outside of the cell to the nucleus inside the cell. Growth factors — chemicals that carry growth-regulating orders — attach to the HER2 protein and signal normal cell growth.

Role of HER2 in Tumor Growth
In approximately 25 percent of women with breast cancer, there is a genetic alteration in the HER2 gene that produces an increased amount of the growth factor receptor protein on the tumor cell surface.

This overexpression can cause cells to divide, multiply, and grow more rapidly than normal. Research has shown that women with HER2-positive breast cancer have a more aggressive disease, greater likelihood of recurrence, poorer prognosis, and decreased survival compared to women with HER2-negative breast cancer.

It is important to understand that the HER2 gene abnormality is only present in the breast cancer cells, not in the rest of the cells in the body, and cannot be passed onto other family members.

Discovering HER2
HER2 is a normal gene; however, when amplified, it causes cancer and is called an oncogene. Many scientists had postulated that oncogenes were related to growth factors. In the early 1980s, a Genentech scientist, a British protein chemist, and an Israeli protein expert together proved that growth factors are related to cancer. They found an oncogene that was a mutated form of the epidermal growth factor (EGF) cell-surface receptor gene. By linking the study of cell-growth signals and cancer, this finding explained how an oncogene worked.

Genentech researchers then began searching for oncogenes similar to the EGF-receptor gene. They named the first one they found "HER2," for human epidermal growth factor receptor 2. With cloning technology, they discovered the protein the gene produced. They subsequently set out to find the link between HER2 and specific types of cancer. In collaboration, Dennis Slamon, M.D., Ph.D., of UCLA, looked for "matches" between the HER2 oncogene and tumor samples.

Slamon observed that the HER2 oncogene caused breast cancer cells to produce the normal HER2 protein, but in abnormally high amounts, and that the women with metastatic breast cancer whose tumor cells overexpressed the HER2 protein had an especially aggressive form of the disease. When the gene overexpresses the protein, he determined, the cell is overloaded with signals that cause it to grow out of control and become cancerous.

Taking the Biology of HER2 from Basic Research to Treatment
A Genentech research team began working on the basic science of HER2 in hopes that they could develop a potential treatment. They figured out how to transform normal cells into cancerous ones by adding copies of the HER2 gene. Next, they designed a targeted monoclonal antibody to "shut off" the HER2 gene, making the cancerous cells grow more slowly.

Antibodies are proteins made by the body's own natural immune system that are directed against foreign and infectious agents, called antigens. Monoclonal antibodies engineered through biotechnology are produced as therapeutic drugs to provide specific anti-tumor action within the body. A monoclonal antibody contains millions of identical copies of a single antibody, all of which attack the same targets.

Researchers injected samples of the monoclonal antibody into mice with tumors that overexpressed the HER2 protein. In many cases, the tumors, which were human breast cancers, shrank. The results were encouraging and researchers were anxious to test the therapy in humans. But the antibody was made of mouse protein, which might be rejected by the human body as a foreign substance. They had to figure out a way to "humanize" the antibody so the human body would accept it.

Working for more than a year, Genentech scientists developed a "humanized" version of the monoclonal antibody — Herceptin® (trastuzumab). Now, they were ready for early-stage human clinical trials. Phase I monitored for side effects and determined dosing, Phase II helped the understanding of the drug's efficacy and safety, and a large-scale Phase III trial proved Herceptin's safety and efficacy in the treatment of metastatic breast cancer.

Herceptin on the Market
The FDA first approved Herceptin in September 1998. Herceptin is the first monoclonal antibody approved for use in women with metastatic breast cancer who have tumors that overexpress the HER2 protein. It is indicated for the treatment of these patients, both as a first-line therapy in combination with paclitaxel and as a single agent for those patients who have received one or more chemotherapy regimens.

Herceptin was proven effective in clinical trials, both as a single agent and in combination with paclitaxel. In the Phase III combination trial, Herceptin plus chemotherapy, improved overall survival rates and slowed disease progression of women as a first-line therapy.

In November 2006, the FDA approved Herceptin, as part of a treatment regimen containing doxorubicin, cyclophosphamide, and paclitaxel, for the adjuvant treatment of patients with HER2-positive node-positive breast cancer. Adjuvant therapy is given to women with early-stage (localized) breast cancer who have had initial treatment — surgery with or without radiation therapy — with the goal of reducing the risk of cancer recurrence and/or the occurrence of metastatic disease.

This approval was based on data from a planned interim joint analysis of more than 3,700 patients enrolled in two NCI-sponsored Phase III clinical trials conducted by a network of researchers led by the National Surgical Adjuvant Breast and Bowel Project (NSABP) and the North Central Cancer Treatment Group (NCCTG). These results showed that the addition of Herceptin to standard adjuvant therapy significantly reduced the relative risk of breast cancer recurrence, the primary endpoint of the studies, by 52 percent (or a hazard ratio of 0.48) in women with HER2-positive breast cancer, compared to those who received standard adjuvant therapy alone.

In January 2008, the FDA approved Herceptin as a single agent for the adjuvant treatment of HER2-positive node-negative (ER/PR-negative or with one high-risk feature) or node-positive breast cancer, following multi-modality anthracycline-based therapy based on the HERA one-year data. The FDA approval expanded Herceptin's adjuvant label to include the use of Herceptin as a single agent and in patients with early-stage HER2-positive node-negative disease, including tumors that are hormone receptor-negative, grade 2 or 3 or >2 cm, or age <35. Herceptin also may be administered as a single agent in an every-three-week dosing schedule for one year, which may provide another treatment option for patients.

In May 2008, the FDA approved two new Herceptin-containing regimens for the adjuvant treatment of HER2-positive node-positive or node-negative (ER/PR-negative or with one high-risk feature) breast cancer based on the results of the BCIRG 006 study. The first regimen is in combination with docetaxel and carboplatin, (also known as TCH for Taxotere®, carboplatin, and Herceptin) which does not contain an anthracycline component. The second is part of a treatment regimen containing anthracycline (doxorubicin), cyclophosphamide, and docetaxel (AC-TH). The approval of the non-anthracycline TCH regimen added an important treatment option for patients as it reduced the rate of congestive heart failure (0.4% vs. 2%) as compared to the Herceptin anthracycline-containing regimen in the 006 study and significantly reduced the relative risk of recurrence by one-third, compared to chemotherapy alone. In comparison to AC-TH, TCH provided a similarly effective treatment option with less cardiotoxicity, which may potentially allow more patients to benefit from Herceptin therapy.

There are now four large randomized adjuvant trials (NCCTG-N9831, NSABP B-31, HERA, and BCIRG 006) involving more than 10,000 patients, demonstrating that the addition of Herceptin to chemotherapy increased disease-free survival (DFS) for patients with early-stage HER2-positive breast cancer. More than 420,000 women have been treated with Herceptin worldwide since its first approval in 1998.

Boxed WARNINGS and Additional Important Safety Information
Herceptin administration can result in sub-clinical and clinical cardiac failure manifesting as congestive heart failure (CHF) and decreased left ventricular ejection fraction (LVEF). The incidence and severity of left ventricular cardiac dysfunction was highest in patients who received Herceptin concurrently with anthracycline-containing chemotherapy regimens. Discontinue Herceptin treatment in patients receiving adjuvant therapy and strongly consider discontinuation of Herceptin in patients with metastatic breast cancer who develop a clinically significant decrease in left ventricular function.

Patients should undergo monitoring for decreased left ventricular function before Herceptin treatment, and frequently during and after Herceptin treatment. More frequent monitoring should be employed if Herceptin is withheld in patients who develop significant left ventricular cardiac dysfunction. In one adjuvant clinical trial, cardiac ischemia or infarction occurred in the Herceptin containing regimens.

Serious infusion reactions and pulmonary toxicity have occurred; fatal infusion reactions have been reported. In most cases, symptoms occurred during or within 24 hours of administration of Herceptin. Herceptin infusion should be interrupted for patients experiencing dyspnea or clinically significant hypotension. Patients should be monitored until signs and symptoms completely resolve. Discontinue Herceptin for infusion reactions manifesting as anaphylaxis, angioedema, interstitial pneumonitis, or acute respiratory distress syndrome.

Exacerbation of chemotherapy-induced neutropenia has also occurred.

Herceptin can cause oligohydramnios and fetal harm when administered to a pregnant woman.

The most common adverse reactions associated with Herceptin use were fever, nausea, vomiting, infusion reactions, diarrhea, infections, increased cough, headache, fatigue, dyspnea, rash, neutropenia, anemia, and myalgia.

Please see the Herceptin full prescribing information including Boxed WARNINGS and additional important safety information.

Mechanism of Action
Herceptin is a humanized monoclonal antibody (also called a biologic therapy). Antibodies are part of the body's normal defense against bacteria, viruses and abnormal cells such as cancer cells. Therapeutic monoclonal antibodies are created and produced in a laboratory through a complex and resource-intensive process. Their name comes from the fact that they are produced from a single cell.1

Based on preclinical studies, Herceptin works on both the extracellular and the intracellular domains of the HER2 receptor2-5

Continuously suppresses HER2 activity that may lead to tumor proliferation3
Leads to cell stasis and death3
In preclinical studies, synergy with Herceptin enhanced the effects of chemotherapy4,6,7
Herceptin provides constant inhibition of the HER2 receptor
Extended half-life enables Herceptin to maintain constant exposure

Herceptin Is the First FDA-Approved Targeted Biologic for HER2-Positive Breast Cancer
As the first in a line of targeted biologic therapies designed to seek and destroy specific breast cancer cells, Herceptin set the course for targeted therapy. With insights into the cellular and molecular mechanisms of the body, researchers increasingly are studying drugs that are able to target specific tumor cells. It is the hope of researchers and patients that this rational, gene-based approach to cancer therapy will continue to yield promising therapies.

Post #59- Chemo Cycle 3 (Week One)

Well this chemo cycle they took out Herceptin because I had a severe reaction to it. How did I feel about it, not happy. Why am I distraught because I am Her 2 Neu Positive and my rate is 8.2 which is very high.

What is HER2?

HER2+ Breast Cancer

Studies show that approximately 25% of breast cancer patients have tumors that are HER2+.

HER2 stands for Human Epidermal growth factor Receptor 2. It is very important to find out your cancer's HER2 status. This is because HER2+ tumors tend to grow and spread more quickly than tumors that are not HER2+. In addition, the treatment of HER2+ breast cancer is different than the treatment of breast cancer that is not HER2+. Women who are uncertain of their cancer's HER2 status should talk to their doctor.

HER2+ breast cancer is aggressive, so it is important to find out your cancer's HER2 status. This can help your doctor choose which treatments may be right for you.
How is HER2 positive breast cancer different?

HER2 stands for Human Epidermal growth factor Receptor 2. Each normal breast cell contains copies of the HER2 gene, which helps normal cells grow. The HER2 gene is found in the DNA of a cell, and this gene contains the information for making the HER2 protein.

The HER2 protein, also called the HER2 receptor, is found on the surface of some normal cells in the body. In normal cells, HER2 proteins help send growth signals from outside the cell to the inside of the cell. These signals tell the cell to grow and divide.

In HER2+ breast cancer, the cancer cells have an abnormally high number of HER2 genes per cell. When this happens, too much HER2 protein appears on the surface of these cancer cells. This is called HER2 protein overexpression. Too much HER2 protein is thought to cause cancer cells to grow and divide more quickly. This is why HER2+ breast cancer is considered aggressive. ( I have 8.2 Her2 genes per cell)

HER2+ breast cancer is aggressive, so it is important to find out your cancer's HER2 status. This can help your doctor choose which treatments may be right for you.

Higher risk of breast cancer returning (recurrence)
Women with HER2+ breast cancer:
May be less likely to respond to certain breast cancer treatments
May be more likely to have a recurrence (return) of their cancer

The One Good Thing

Inheriting the HER2 gene

Your tumor's HER2 status is not hereditary. This means that HER2 status is not passed down from your parents, and you can't pass it on to your children. However, there is a relationship between the genes in a person's DNA and breast cancer in general. Ask your doctor for more information about the relationship between genes and breast cancer.

Even though I didn't have Herceptin I had side effects this week from my chemo drugs Taxotere and Cytoxan. I had a rash on my hands. I developed neuropathy in my hands and feet. It has lessened slighty now. My nausea was very severe and my mouth stayed full of saliva. The worst part was the heart burn it felt like my food was coming up my esophagus and choking me. My throat felt tight. Of course the night sweats. When I called the Doctor on call he said I was experiencing all of the typical side effects of Taxotere and to take a benadryl. The Doctor oncal said if the rashes start to spread come in and see the Doctor the next day. This is all so insane!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! Oh and I had Diarrhea from Constipation to Diarrhea!!!

What is neuropathy?
Neuropathy is a condition that occurs after peripheral nerve damage. Neuropathy may affect a single nerve or several. A common type of neuropathy that occurs in people who have cancer is called peripheral neuropathy.

The nervous system is divided into central and peripheral parts:
The brain and spinal cord make up the central nervous system.
The peripheral nervous system includes the nerves that leave the brain and the nerve that come off the spinal cord and go to the internal organs, limbs and skin.

Diseases, injuries and toxins, such as chemotherapy, can cause neuropathy in cancer survivors. The damage may lead to changes in sensation or muscle function and can be mild or severe. Cancer survivors may experience this condition as tingling or numbness in certain areas of the body, especially the hands and feet. These sensations range from mild to painful.
Neuropathy can be an upsetting, and sometimes scary, condition for survivors. If you begin to notice symptoms, talk to your health care team immediately.

What causes neuropathy?

Neuropathy is a common disorder, affecting about 1 to 2 percent of Americans.

Some causes of peripheral neuropathy include:
Diabetes mellitus (sugar diabetes) – the most common cause of neuropathy in the industrialized world
Infections (such as leprosy, syphilis, HIV and some forms of hepatitis)
Nutritional deficiency (particularly of thiamine)
Inherited disorders of metabolism and other diseases passed down through families
Alcohol
Pesticides
Drugs used in cancer treatment, particularly the platinum compounds, the taxanes, the vinca alkaloids and thalidomide
Hypothyroidism
Renal failure
Extreme stress (such as the stress of living with a chronic illness)
Radiation therapy (effects may be delayed for many years)
Some cancer tumors are associated with neuropathy as a remote effect.

What are the symptoms of neuropathy?

The types and severity of neuropathy symptoms vary greatly. Determining the amount of peripheral nerve injury just by the amount of symptoms produced is difficult. Peripheral neuropathy can affect the nerves which allow you to tell the position of your hands or feet, the nerves that allow you to sense hot or cold, or the nerves that carry pain sensation. For peripheral neuropathy, symptoms are almost always greatest at night.

Common signs and symptoms of peripheral neuropathy include:
Numbness, especially of hands or feet
Pain or cramping, especially of the hands, feet or calf muscles
Sensitivity to touch or temperature
Loss of reflexes
Muscle wasting in the hands and feet
Weakness, especially in the feet or hands
Clumsiness
Loss of balance, particularly in the dark ( I feel down the steps)
Dizziness, especially when getting up from a bed or a chair
Sexual dysfunction

Which cancer survivors are at risk?

Neuropathy can affect almost any cancer survivor, but the following are high risk conditions either from the cancer or from the treatment received.
Cancer types
Lung
Breast
Ovarian
Prostate
Myeloma
Lymphoma and Hodgkin’s disease
Testicular
Having one or more of the following characteristics may increase the chances of developing neuropathy.
Advanced age
A family history of neuropathy (familial, diabetes)
Malnourishment
Excessive use of alcohol
Having a pre-existing medical condition such as diabetes or thyroid dysfunction
Some medications, including chemotherapy medications, also increase risk. Discuss your medication-related risk with your health care team.Chemotherapy medications that increase your neuropathy risk include:
Platinum compounds
Taxanes
Vinca alkaloids
Thalidomide
Velcade
Cytosine arabinoside
Misonidazole
Interferon

Can a survivor experience neuropathy during, immediately after and/or years after treatment?
Neuropathy related to cancer may develop in the course of treatment (such as with vinca alkaloids) or shortly after (common with Platinum compounds). Neuropathy may be delayed in onset, and often continues after the treatment has been completed. Nerve injury from radiation therapy may be quite delayed, with symptoms occurring in some instances years after treatment.
Peripheral neuropathy symptoms are often ignored by both patients and health care professionals and frequently are not recognized as being related to peripheral nerve damage. For lung cancer, neuropathy may be the earliest sign of the cancer. If you have symptoms of neuropahthy, it is important to discuss with the health care team.

Can neuropathy be cured?

The peripheral nerves have a great ability to heal. Even though it may take months, most patients recover. However, in some situations, symptoms of neuropathy may lessen, but not completely go away. Nerve injury caused by radiation often does not recover well. Neuropathy caused by platinum chemotherapy is also difficult to cure — recovery may take 18 months to five years or longer. During recovery of platinum-induced neuropathy, patients may suffer increased symptoms. Unfortunately, some patients with neuropathy from chemotherapy never recover.

Even if your neuropathy cannot be cured, you may benefit from treatments to relieve your symptoms and from rehabilitation designed to help you maintain your physical abilities.
What are the treatments for neuropathy?

The treatment for peripheral neuropathy depends on the cause. If the neuropathy is related to nutritional deficiences, supplements can help. If relted to a medical condition such as diabetes or thyroid dysfunction, treating this can sometimes reverse the neuropathic symptoms. For neuropathy related to chemotherapy, most treatments are supportive, designed to improve symptoms and function.

If neuropathy occurs during treatment, and you continue to receive the chemotherapty, the neuropathy can worsen.
Recovery can be helped by:
Adequate nutrition (foods rich in thiamine, protein and antioxidants)
Controlling and correcting contributing conditions such as diabetes or hypothyroidism
Pain medications
Physical and occupational therapy
Medications being researched in clinical trials show promise in helping peripheral nerves to heal and in preventing the neuropathy associated with chemotherapy from occurring or being as severe.

How will a cancer survivor’s life change if s/he has neuropathy?
Pain and other symptoms of neuropathy can be mild or severe. Each survivor’s experience will be different. However, with appropriate treatment, the effects of neuropathy can be limited. Medications, lifestyle changes, rehabilitation and other treatments can be used.
Neuropathy can make standing for long periods or walking without assistance difficult.
Balance can be affected, increasing the risk of falling.
Activities like buttoning and tying laces or ties can be difficult.
Survivors may be sensitive to heat or cold. Survivors with this sensitivity should avoid extreme temperatures if possible and use protective clothing and hats when needed.
Neuropathy may cause a lack of pain sensation. Survivors should pay careful attention to the skin on their hands and feet because they could receive a wound or a break in the skin and not feel it.
If neuropathy affects your ability to feel the foot pedals of your car, you should not drive unless your car is adapted for hand controls. Neuropathy can slow your reaction time in moving your foot from the accelerator to the break pedal and may cause an accident. Losing your ability to drive is upsetting. You may feel you are losing your independence. However, consider the increased risk to your safety and to the safety of others on the road. Talk to your health care team about your symptoms.
Neuropathy can be painful. Sometimes usual activities, such as putting your shoes on, or placing the covers over your feet at night can cause pain. There are treatments which can lessen the pain. It is important to talk with your health care team about potential treatments.
Physical and occupational therapists can provide suggestions and special equipment to make daily tasks safe and easier to manage. The suggestions may include night lights, grab bars and other home safety measures to help reduce the risk of falling. Therapists can assist survivors with physical exercises that can help them maintain physical abilities.
Pain from neuropathy can greatly affect your daily activities and quality of life. For some, the pain and changes required to manage it can lead to physical and mental stress. Watch for signs of depression and talk to your health care team or a mental health care professional about managing your feelings

Post #58- Chemo Cycle 3, I'm Getting My Chemo as I type and Only God Can Help Me!!!

The thing I did not want to hear I heard this morning. My chemotherapy appointment was at 10:30 am. It's 12:15 pm and my chemotherapy is set up for my Taxotere and Cytoxan. My Oncologist told me that he talked to the primary investigator and they will be taking me off of Herceptin because of my RARE SEVERE ALERGIC REACTION. They are going to monitor me today and only give me the Taxotere and Cytoxan.



HERCEPTIN is the only drug that stops and reduces the over expressed Her-2- neu gene that I have. The gene that causes cancer to rapidly reproduce my already aggressive cancer. The thing that could save my life I am allergic to can you believe that. The thing that the Doctors believe could save my life I am severely allergic to. Once again I am a rare case. ( My nurse just came over and started my Taxotere drip).



The test results I got for Her2-Neu were very high 8.2, so I am a little anxious about not having Herceptin.



It is all in GOD'S hands now. All I can do is have faith. I feel like crying a little bit. I don't want to tell my mother. I have faith so no matter what anybody says GOD has the finally say and my will is still strong. I am going to fight to the end. We all know tomorrow isn't promised. I am learning so much now. I've changed so much. I'm not the same person I was by a long shot. I love the person that I am now. Even though my days are long and hard I want to enjoy each day as much as I can. I promise myself that I will enjoy each day.



Everybody reading this don't take life for granted. Embrace a higher power whoever that may be and have faith. Let the things and the people that are toxic in your life go. Live your dreams and aim high. Don't be afraid to take a chance. DON'T BE AFRAID TO LIVE!!! NO AMOUNT OF SUCCESS IS WORTH SACRIFICING YOUR LIFE FOR, BE SUCCESSFUL AND BALANCE OUT YOUR LIFE!!!



Have faith!!!! Prayer and Faith works miracles!!!!!