Tag: Cancer

The Dangers of Elle Macpherson’s Cancer Treatment Choices

(Title image: Photo by Naser Tamimi on Unsplash)

Supermodel Elle Macpherson recently made the news with an interview with the Australian Women’s Weekly magazine when she revealed her breast cancer diagnosis.

She was diagnosed in 2017 (as I was!), so the fact that she’s here and talking about it suggests that her treatment worked.

But what was her treatment? According to the article, following diagnosis Elle consulted with 32 doctors (and experts, although it’s unclear in what) and ultimately decided to follow a holistic treatment path. In her own words, “an intuitive, heart-led, holistic approach”.

She decided to forego a mastectomy in favor of a lumpectomy (as I also did) but also dispensed with the conventional chemotherapy, radiation and hormone therapy (I went the conventional route).

So let me clarify some things here: Elle had the lump removed. If the cancer had not spread (which presumably it hadn’t) AND no rogue cancer cells had gotten out AND the surgeon confirmed “clear margins” upon excision of the tumor, it’s certainly possible that all evidence of the cancer was removed from Elle’s body with that surgery.

As we survivors know, everyone’s cancer is different. That’s why we discourage comparing tumors or offering advice. What works for one person may not for another because so much depends on the state of the individual…and probably on a lot of other factors that we are not even aware of, even with present day advances in cancer treatment.

Elle has even stated that her treatment is not for everyone. Who knows, she might have said this for legal reasons…because you can see what’s going to happen. While Elle, as a former supermodel, businesswoman, etc., might have access to whatever specialists and level of care she desires, most of us will not.

Do you feel lucky? Rejecting conventional cancer treatments in favor of clinically unproven ones can be a big gamble.
(Photo by Chris Liverani on Unsplash)

Elle asserted: “I want to help and encourage others to follow their heart and give things a go.” Sadly, when it comes to something as slippery as cancer, following our hearts is not always the best choice of action, no matter how much we want it to be.

My concern is that a newly-diagnosed breast cancer patient, fearful of the admittedly-harsh treatments that modern medicine offers, might decide to take Elle’s path (“she did it so I can too!”). But unless this person is independently wealthy or otherwise connected, they will have to cobble together a questionable plan with minimal support, and possibly fall prey to unscrupulous players looking to make a buck out of someone’s desperation.

And in these days of growing suspicion of science and the advice of doctors—brought on by pandemic-related missteps or perceived draconian measures—the chance of patients rejecting well-worn treatments is even more likely. Statistically, this would result in more lives lost to the disease.

When I made my own treatment choices, I didn’t go with the harshest stuff that my oncologist offered, opting for very effective (and, yes, cardiotoxic) Herceptin immunotherapy instead of lobbying my insurance to cover the even-more-effective (but even more toxic) Perjeta for my HER2+ cancer. I also had to cut my hormone therapy short by a number of years due to how it affected my ability to exercise, which has also been shown to have a strong effect on preventing cancer recurrence. These were measured choices, as it’s clear that Elle’s were.

At the same time, in the back of my mind I know I can’t say I did everything I could to blast my cancer into submission. But I do feel that taking everything into consideration, I did enough. My oncologist agrees.

As far as Elle’s treatment is concerned…I also did a number of things that she did, including meditation, exercise, therapy (our cancer center was very supportive of complementary therapies) and more. I cannot say how much conventional treatments vs. complementary ones contributed to my remission, but I assume each played a role. And the combination gave me peace of mind, which I would not have had, had I chosen only alternative therapies.

Ultimately, I hope we get to the point where we can eliminate the most toxic treatments and heal ourselves more gently. Ideally, we’d even prevent cancer. Huge strides have been made in cancer treatment, but we are not there yet. Every time we decline a proven treatment, we roll the dice. I’m hoping that Elle’s story does not unnecessarily put people with fewer resources at risk.

I Saw My Oncologist…and Left Ridiculously Happy

(Title image: Photo by Nick Fewings on Unsplash)

Yep, this is another installment of “I had another oncologist appointment today”. This time I’m marking seven years since completing my chemo treatment, which I can assure you at the time was a very happy event…

…marred only by that little nail infection a few weeks later. But don’t go there unless you have a strong stomach.

Regardless, I had a great meeting with my oncologist. The concern now is about whether I’m experiencing anything cancer-related, either long-term side effects or—perish the thought—a recurrence. Today the answer was neither.

We talked about the recent death of my father…and that’s pretty much the way the appointment went–catching up on the last six months. Naturally, I forgot to tell him about a bunch of the other concerns I had, little weird things in my body. But really, they’re not unusual given what I’ve gone through.

If there’s one thing I’ve learned, it’s that I need to slow down when interpreting body sensations as health problems. Usually they’re not. (Even though once they were cancer.)
(Photo by LOGAN WEAVER | @LGNWVR on Unsplash)

We did, however, discuss how it takes a little while to get used to all those sensations in your body. After cancer, I was on high alert. My medical team was asking detailed questions about what I was feeling, and as a result, I was laser-focused on every twitch and twinge…and maybe some that I just imagined. At one point, I was sent for a brain MRI because of what I feared were serious cognitive issues. But in reality it was anxiety, not a tumor.

Seven years out, however, you kinda get expect all those funny sensations and don’t interpret them as being dangerous anymore. Even the heart palpitations that I would get from time to time…yeah, I still get those, maybe once a week, maybe a couple of times a month. But they only last a handful of seconds and I no longer think that my heart is failing (especially not when I can turn around and do a HIIT workout). I haven’t been back to the cardiologist and my oncologist agrees that it’s not necessary.

He asked if I wanted to come back in six months. Sure, I like being back in the Cancer Center as *NOT* a cancer patient. It’s nice being there and remembering doing jigsaw puzzles in the radiation oncology waiting room, or even feeling well-taken-care of after my treatments were done. There ARE positive memories in a place that you’d think would only be negative.

That can change very quickly, of course. But for the time being, I’m feeling happy.

Staying Present in Discomfort: Being Here When You’d Rather Not

Title image: Photo by Tolga Ulkan on Unsplash

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Thank you everyone for your patience during this time of my father’s passing from cancer and dementia. I have appreciated the quiet visit to my childhood home, supporting my mother and being comforted by close friends and relatives.
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There are times that the present moment is an uncomfortable place to be in.

That’s when things are not going well and you want the current situation to be over so that you can move past it and onto healing. But one could argue that this is exactly the time you need to sink even deeper into the present moment.

And even more important to get more granular and still. To observe what is going on even more closely. To understand the important of this very point in time, how it will never come again in the same way. And even in this discomfort there is something to learn, something to lean into, something to accept.

I felt this strain while my father was still in in-home hospice, declining at a pace that was both quick and slow depending on what you’re focusing on. It evoked an axiety in me: wanting to hold on to him and save him–but knowing that this was an impossibility. The tug of time is unrelenting, taking everything with it like a glacier or a tsunami that continues onward no matter what is in its way.

But this is also an opportunity to remember that the impermanence of life does not take away from the joy and beauty of it. Dropping down into what is happening right now, taking a front seat on top of that glacier/tsunami, and allowing everything to be here is the way to appreciate all of this.

So while I would rather that the things that were happening not be happening, I couldn’t stop them. I sat here trying to understand my feelings and allowing gratitude for my father’s long life to remain in the forefront. There was peace in knowing that he was living his last days at home, in familiar surroundings with my mother there.

I could have made all sorts of stories up about what he was feeling or thinking, but the reality is that I didn’t know. So I didn’t pretend and instead noticed the sounds around me, the feeling of the air on my skin and the knowledge that my father’s imminent passing unscored all the many things about him and my own life that I have to be thankful for.

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It’s easier to ignore reality and think about other things, but that doesn’t help us deal with them.

Patient vs. Survivor: The Impact of a Label

(Photo by Joshua Hoehne on Unsplash)

The first devastating realization I had following my breast cancer diagnosis was that I was now a cancer patient. In my mind I immediately went from “happy-go-lucky, fitter-than-average” to “sick beyond belief”.

Except that nothing physical had changed. But my mindset had. And when I found out that my triple-positive tumor was going to require chemo, I knew that everyone else was going to be aware of my hairless, frail status.

Cancer. Patient. I imagined myself pathetic and scrawny, walking around hunched over in a hospital gown with light shining off my bald scalp. Sounds dramatic, huh?

How do your labels affect you?
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Recently, however, I learned that there’s been a change in the language surrounding those individuals who have been diagnosed, are undergoing treatment for or have finished cancer treatment. The word “patient” as it relates to someone’s status has been supplanted by “survivor” much earlier in their cancer experience.

This is curious to me because I went through a mini identity crisis after I was done with chemo and radiation–I thought that only then could I start calling myself a (hopeful) cancer survivor. But I was a bit anxious about doing so, because I didn’t know whether I truly deserved that title. I thought that I needed to have some special designation before I qualified as a survivor.

These days, the survivor label is given when you receive a diagnosis. The idea is that while initially we didn’t know your status, now that we’ve confirmed your tumor, you are going through the experience of surviving the disease. As stated on the Cancer.net site, “When people talk about ‘survivorship,’ they are usually referring to navigating their life experiences and challenges resulting from their cancer diagnosis.” Read more about how ‘survivor’ is used here.

This sounds a lot better to me than using the term “patient”. By referring to myself as a patient when I didn’t have any reason to–meaning no physical symptoms–I was imagining myself sicker than I really was, which increased my anxiety levels. That made my entire experience worse and it didn’t have to. I did that to myself (‘cept that I was only using the common labels of the time).

How are you choosing to define yourself?
(Photo by Brett Jordan on Unsplash)

Instead of putting my energies into dealing with the side effects of treatment, I went down a dark hole.

Language matters! While there’s no doubt that cancer brings on stress and anxiety, terminology can make a difference in your cancer experience and that can either help or hinder you in the process.

So I urge you to consider the words you use to refer to yourself and pay extra attention to how that feels to you. You could be making yourself miserable without even realizing that you have some control over this.

Year 7 Mammogram in the Books

It’s enough to make me get a little cocky.

A few days ago I had my 7th yearly mammogram since my cancer diagnosis. Let me stress first, I am very aware of how fortunate I am. My appointment was early in the morning, my husband came with me (like he’s been doing, since he didn’t come during my diagnostic mammogram seven years ago) and I got a clean bill of health from the radiologist quite quickly.

I didn’t even feel those few minutes of hovering as I waited for the results. The technician had allowed my hubby into the mammogram room to wait with me, and he and I casually chatted so I didn’t notice the time pass.

Wow, things have changed.

‘Scuse me while I sit back and reflect on how fortunate I am for getting this far.
(Photo by Fuu J on Unsplash)

Every year, this feels different, cancer feels further away and I feel less “impending sense of doom” that I had in the first several years.

That’s why something like Kate Middleton’s announcement that she had started chemotherapy for cancer shocked me back to reality.

No matter how good I currently feel about my own situation, there are many reminders that cancer is still a terrible disease that doesn’t care who you are or what you have going on. And it’s still grabbing people and throwing them into treatment.

So much for my cocky attitude.

At times like these, I take a moment to reflect on gratitude for how far I’ve come and, as suggested by my oncologist, how much more life I have in front of me. I don’t think I would have ever felt this appreciation as deeply if I hadn’t gone through the soul-tearing experience that cancer is. Which is not to say that I’m glad I went through it, because I’m not.

Still reminders like Kate’s announcement help counter the selfish little feelings that I sometimes get when I see the free things available to cancer patients now and pout that those weren’t there for me. Yes, those are “human” feelings, but you know what, I can do without them.

Instead, it’s so much more fulfilling to bask in the golden hour sun, taking deep nourishing breaths, and shoo away the everyday concerns that disturb my sleep. At least I have the luxury of being able to busy myself with them, the bothersome little things, and know that I’m still around to have them be a bother.

White Paper: “Yoga Interventions for Cancer Patients and Survivors”

(Title image: Photo by Raimond Klavins on Unsplash)

I’ve been writing a lot lately about using yoga to mitigate cancer therapy-related side effects.

In this post, I want to bring your attention to the white paper entitled, “Yoga Interventions for Cancer Patients and Survivors” [Important: this links to the download page on the yoga4cancer website, *not* directly to the pdf itself]. It’s an evidence-based review of research regarding the benefits of a yoga practice in coping with negative side effects that afflict cancer patients and survivors, followed by recommendations for teaching yoga to this population.

This 24-page document (quoted directly from the paper’s abstract) “(1) provides a summary of research on the benefits of yoga for cancer patients and survivors, (2) highlights the most beneficial components of yoga for cancer survivors, (3) identifies barriers and solutions to the creation of accessible, evidence-based yoga programming, and (4) offers guidelines for developing yoga programs that best meet the unique needs of cancer patients and survivors.” [Again, this links to the download page.]

The white paper is written in non-technical language, distilling the research down into a form that doesn’t require a scientific background to understand. Additionally, editions are available in Spanish and Japanese, both available on the download page beneath the English version.

If you’d rather not download, you can read the English version below (or click the “download” button underneath the paper for a pdf):

yoga-interventions-for-cancer-patients-and-survivors_white-paperDownload

Unexpected News at my 7-Year Oncology Appointment

(Title image: Photo by Gary Fultz on Unsplash)

A few days ago I had my seven-year post-diagnosis appointment with my oncologist. Seven whole years. And it was a weird conversation.

He said something that set me aback. He told me that he didn’t think I should worry about the cancer coming back. Essentially, I was cured (note: MY words, not his, but that’s the idea). [See bottom of post for disclaimer!]

He’s alluded to this before during previous appointments. But this time around felt different.

I’ve officially hit SEVEN!
(Photo by Himiway Bikes on Unsplash)

I returned home a bit confused. See, for the last seven years, I’ve been a full-on cancer survivor. Still holding on to the fear that at any moment, I would get those terrifying scan results back and–WHAM–I’m a cancer patient once more, back on that sickening rollercoaster ride through treatment.

As difficult as it was to accept that–even trying my best to live a healthy life–I had somehow been smacked down by cancer…now, I had a new problem. Reentering life as maybe not-so-much a cancer survivor anymore, but rather just a healthy, active postmenopausal woman with years ahead of her.

And that is a weird feeling.

For the first five years after my diagnosis, I was frustrated, even angry. Cancer was a devastating detour at a time when I was already struggling to find my way back into a career. Well, forget that. Derailed. I was bitter.

Eventually, I realized that while life sucked, it sucked for a lot of people and I wasn’t special in that regard. That was an important turning point in how I perceived my own role in my cancer story–it was humbling but also gratifying.

Humbling because my experience could have been so much worse. There were people whose treatment did not end well. I was incredibly fortunate, even when it felt like I’d been thrown in a sack and beaten with sticks. At least, I made it out.

Gratifying because early on I held myself responsible for getting cancer, even though I had literally done everything protective (lots of exercise, high fitness, plant-based diet, breastfeeding, not smoking, not drinking) that I could think of. I was desperate with frustration and helplessness about this. Letting go of that guilt was healing.

Feels like I’ve got the green light to hurry up and get on with the rest of my life now.
(Photo by Possessed Photography on Unsplash)

So the last two years have been more about understanding my perspective and then stepping out of it to view things more objectively. Mindfulness and meditation helped with that, which is why I often write about them here. But I hadn’t been ready to get out of the breakdown lane and drive myself back into mainstream life, in part fearful of the pain of having the expectation of cancer-free “normality” smashed to smithereens by a potential diagnosis.

Gradually, that’s changed. But this last appointment felt like getting shoved out the door by someone yelling, “YOU’RE OKAY, DAMMIT!” Here I am, standing and blinking in the sunlight, trying to make sense of exactly what that means for me now. Wow, after seven years, I can actually stop being afraid.

I don’t know if I even remember what that feels like.

Yes, I’m still going to refer to myself as a survivor, because it’s a part of my natural history. I’m never going to forget that experience and I continue to be driven by a need to support others going through this disease.

And if it does return? Well, at least I will have had a brief glimpse of life completely outside the notion of cancer.

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Of course, because we’re talking about cancer, the statements above call for level-headness in the midst of levity. While my oncologist feels that the chances of the same cancer coming back are low, the possibility for a brand spankin’ new tumor, breast or otherwise, never goes away. It happened once, it can happen again. But that’s life. I’ll take it.

“Moving Through Cancer”: A Short Film from ACSM

(Title image: Photo by guille pozzi on Unsplash)

I’ve been coming across a lot of interesting–and hopefully useful– videos. The one I’m posting here is presented by the nonprofit Fund for Sustainable Tomorrows and the American College of Sports Medicine, the latter being the organization through which I received my personal trainer certification almost 16 years ago.

This is a 20-minute film with a hopeful message!

The film, narrated by former Olympic figure skater and cancer survivor Scott Hamilton, showcases the stories of how survivors are using exercise to make themselves feel better and increase their chances for survival. It also shows how our knowledge about physical activity’s benefits during cancer treatment has increased, and the programs that have been created to help cancer patients become and stay active.

It’s amazing to see how within a decade or two the attitude about cancer and exercise has changed. Whereas individuals undergoing cancer treatment used to be told to rest as much as possible, now it’s understood that exercising through your treatment is one of the best ways to not only minimize associated side effects but also decrease the chances of cancer recurrence.

For me, exercising during my treatment was a way to feel normal when everything else felt out of control.

The current recommendation is aerobic activity for 150-300 minutes per week along with twice weekly resistance training sessions. And it’s best to do both types of exercise for a well-rounded program, if you can manage it.

But the most important thing to remember is that no matter what you do, doing something is better that doing nothing. Research has discovered the existence of myokines, hormones that are produced in the tissue of skeletal muscles. They are released during muscular contractions and seem to have anti-cancer properties, slowing cancer growth and spread. That is very exciting news!

Of course, exercise is not a cure, and there is no guarantee that if you are an avid exerciser you won’t get cancer or won’t have it recur. However, there’s a very good chance that physical activity will make you feel better and help you continue with life-saving treatments.

As E. Ronald Hale, MD, MPH, Medical Director of Radiation Oncology at Kettering Health states (from the video), “The best cancer treatment in the world is useless if you can’t get through the cancer treatment.” The side effects from cancer therapies can be debilitating, but getting out and moving will improve your quality of life and help you finish your treatment.

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It’s worth mentioning that the number of exercise professionals who have had additional training in working with cancer patients is growing, which means that cancer-informed trainers and yoga teachers are becoming easier to find. Now it’s the insurance companies that need to get on board.

yoga4cancer: Bringing the Benefits of Yoga to Cancer Patients and Survivors [VIDEOS]

(Title image: Photo by Zoltan Tasi on Unsplash)

In February 2022, I started a yoga teacher training program with a singular goal: to eventually teach yoga to cancer patients and survivors.

With its mix of physical postures (asanas), breathwork (pranayama) and meditation, yoga is ideal for someone going through the traumatic experience that cancer can be. Yoga can provide enough physical exertion to count as moderate exercise and the ability to help the practioner calm their mind, things that are so important for improving cancer treatment outcomes. However, classes must be designed carefully and taught thoughtfully.

Yoga4Cancer Q&A for Cancer Patients and Survivors (Yoga Alliance on YouTube)

Keep in mind, yoga teachers were yoga practitioners first. Many of them got really good at the practice, developed great flexibility and balance and gained respect for the tradition of yoga. But that doesn’t automatically make them appropriate yoga teachers for cancer patients, who need an instructor that understands the nuances of what cancer is and how treatment affects us.

A yoga teacher and breast cancer survivor by the name of Tari Prinster addressed that need by creating yoga4cancer (y4c), “an evidence-informed Oncology Yoga method tailored to address the specific physical and emotional needs left by the cancer and cancer treatments. The approach matches breath and movement to stimulate the immune system, improve flexibility & strength, reduce anxiety and boost overall well-being” (from the y4c website).

I’m planning to begin the y4c advanced 75-hour certification program (see informational video here) either later this year or early next. I’ve been so impressed by y4c’s emphasis on understanding the unique situation that cancer patients and survivors are in–it’s not just your garden variety beginner yoga class with “also for cancer patients” dressing. The program is well-thought out and comprehensive, and I’m so excited to embark on this next leg of moving closer to my teaching goal.

In the meantime, here is a selection of videos created by Tari and her instructors that are specifically geared for the mental and physical needs of cancer patients and survivors:

Yoga4Cancer Oncology Yoga for Cancer Related Fatigue (Yoga Alliance on YouTube)
Yoga4Cancer Yoga for Bone Loss (Yoga Alliance on YouTube)
Yoga4Cancer Yoga for Range of Motion (Yoga Alliance on YouTube)
Yoga4Cancer.com Yoga for Anxiety (Yoga Alliance on YouTube
yoga4cancer.com Yoga for Lymphedema (Yoga Alliance on YouTube)
yoga4cancer.com Yoga for Constipation (Yoga Alliance on YouTube)

Enjoy!

Effects of Diet and Exercise on Chemotherapy Tolerance and Efficacy: Research

(Title image: Photo by Hermes Rivera on Unsplash)

Many cancer patients complain of feelings of helplessness after their diagnosis, and I can certainly relate to that. As a result, I’m particularly interested in research that explores whether patients can gain control over the success of their treatments.

The most recent study I’ve come across includes breast cancer patients undergoing treatment at Yale and Dana Farber Cancer Centers.

This study appeared in the Journal of Clinical Oncology (Sanft et al., 2023). Researchers examined the effect of diet and exercise on “relative dose intensity” (RDI), which is the relationship between the amount of chemotherapy delivered to the patient compared to the standard amount prescribed. Low RDI means that there was a reduction in the chemotherapy the patient received and is generally associated with a poorer outcome. Dose reductions result from the patient’s difficulty in tolerating the drug.

The researchers also looked for “pathologic complete response” (pCR), which is “the lack of all signs of cancer in tissue samples removed during surgery or biopsy after treatment with radiation or chemotherapy” (definition from cancer.gov). This was for women receiving neoadjuvant chemotherapy, which is chemotherapy administered prior to surgery.

Yep, once again we come back to diet and exercise, even during chemo.
(Photo by Yulissa Tagle on Unsplash)

The subjects of this study were women recently diagnosed with stage I-III breast cancer, who either received the “usual care” or a diet and exercise intervention. Those in the intervention group received nutritional counseling with a focus on a plant-based diet. The physical activity included counseling and support for maintaining a home-based exercise program that included strength training (2x/week) and brisk walking (150 min/week of moderate intensity or 75 min/week of vigorous intensity).

What the research confirmed first was that the subjects in the intervention group were able to increase their exercise and diet quality, which showed that it was feasible to make lifestyle improvements even in the midst of chemotherapy.

However, in this study, the RDI for both groups (“usual care” and diet & exercise intervention) ended up being similar, but also quite high, which meant that women in both groups completed most of their treatment. The researchers noted that the study should be re-run with patients who were at greater risk of not being able to complete all their chemo to see how much of an effect improved diet and exercise would have, especially since exercise has been shown in other studies to have a positive effect on patient outcomes.

But a striking difference was seen for women receiving neoadjuvant (prior to surgery) chemotherapy in that the rates of pCR (disappearance of cancer in the tissues) were 53% for women in the intervention group versus 28% for women receiving usual care. That suggests that the intervention enabled the chemotherapy to be more effective.

There are many physical activities you can choose from–clifftop not required.
(Photo by Sigmund on Unsplash)

The researchers stated the following in summarizing their study: “Given that pCR is an accepted predictor of recurrence and mortality, our findings could provide oncologists with a supportive care intervention that affects the ability to potentially improve survival outcomes” (Sanft et al., 2023, J Clin Oncol). And this is very good news indeed.

The take-home message here is not surprising, and it’s good advice for life in general: no matter what your current lifestyle, prioritizing a healthier diet (emphasis on whole foods, plant-based, less processing, etc.) and engaging in regular cardiovascular and strength training exercise will improve your quality of life. It is always worth the effort.

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REFERENCE:
Sanft et al. (2023) Randomized Trial of Exercise and Nutrition on Chemotherapy Completion and Pathologic Complete Response in Women With Breast Cancer: The Lifestyle, Exercise, and Nutrition Early After Diagnosis Study. J Clin Oncol, 41: 5285–5295. https://doi.org/10.1200%2FJCO.23.00871. [This paper is Open Access and can also be found in PubMed Central: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10691793/]