Health 29 October 2018
Women who receive a breast cancer diagnosis often shut down. When I was diagnosed with breast cancer, I did just the opposite. I told everybody I knew, and invited them to share the news. This is how I found my way to individuals and organizations that empowered me to make informed decisions, including patient advocates, integrative oncologists, and global communities including BreastCancer.org. I also have an academic background that helped me research the literature, so it was easy to access the wealth of information in books, scientific journals, and online.
More than 40,000 women in the U.S. die every year from breast cancer, and many more suffer with debilitating side effects. I myself live with the aftermath of a breast cancer surgery that my surgeon now agrees I may not have needed. Some of my decisions would have been different if I had known then what I know now. When you have cancer, you are afraid, and it's easy to cave to authority. I unfortunately did. The surgeons were simply following the standard of care at the time. I call this the “one-size-fits-all-approach."
My message to you: we all need to question authority when it comes to cancer treatment. Think about how thoroughly you research any major purchase—a car, a home. Cancer treatment is a big-ticket item involving choices that determine whether you live or die.
Why do we stop asking questions?
When you first receive a breast cancer diagnosis, you may ask “Why?", then “Why me?" And very quickly, many who are diagnosed become compliant, passive, and silent.
We stop talking because of fear. Of course, we fear our own death, and we fear pain and suffering. And, some may be afraid that their illness may be too big a burden for friends, family and work associates to bear.
A history of male authority in medicine contributes to our silence, too. As women with an intimately feminine form of cancer, we may literally feel embarrassed, ashamed or afraid to ask, and definitely afraid to disagree. When we begin to ask and explore, we find out that treatment options are complex.
Much of the most cutting-edge information is not presented by mainstream medicine.
You can find this information yourself, and you can also work with a patient advocate if you need help.
When you're confronted with a breast cancer diagnosis, become informed so that you can interact responsibly with your medical team and ask the right questions:
- What are all of the treatment options, including alternatives to the standard of care?
- What is the statistical outcome for survival for each option?
- What are short-term and long-term risks, and side effects?
- How can I minimize side effects?
- What can I do to improve my chances of a good outcome?
- What would you do if you were in my situation?
- What stage is my cancer?
- How large is my tumor?
- What grade is my tumor?
- How quickly is my cancer growing?
- Is my cancer invasive?
- Has my cancer metastasized?
- Am I a candidate for other diagnostic tests such as Oncotype Dx?
- What is my hormone receptor status?
- What is my HER2 status?
Ask the tough financial questions
Be sure that your doctor and your hospital will be covered by your insurance. If any part is not covered, have a financial agreement in writing prepared beforehand. Get help from a patient advocate in doing this if necessary.
Prevention is underrated, and poorly understood.
According to the American Cancer Society, about 85% of those diagnosed with breast cancer have no family history. This means that lifestyle and environment play a greater role than heredity, which is good news because it means that many of the factors that cause cancer are in our control and largely preventable.
I am convinced that our constant exposure to man-made carcinogens in the environment is a big factor in cancer incidence. Because these substances are produced by huge corporations and allied with many governments, getting them out of our environment is a lifelong mission that requires long-term legislation.
On a personal level, my experience is that removing carcinogens from your own individual “terrain" will support your health, whether you want to lower your risk of initial cancer, or lower your risk of remission. An integrative oncologist may be of help to you here. My integrative oncologist gives me regular blood and saliva tests to measure the factors that help cancer grow, and we correct whatever is off through a combination of nutrition, supplements, exercise, stress reduction, and avoidance of environmental carcinogens.
Ask, question, research, and ask again
Remember that your surgeon and other doctors involved with your treatment cannot make the best decisions for you—you must do that for yourself. Question your MD's medical directives, and get second, third and fourth opinions. Own that power, and find the help you need to make your most conscious, deliberate choices.
There are many resources available. You can get medical information from the National Cancer Institute (cancer.gov) and The American Cancer Society (cancer.org). You can get support from other patients at Cancer Support Community (https://www.cancersupportcommunity.org/), and BreastCancer.org, where I found community as well as information. For example, through the remarkable global network of women living with breast cancer, treatment and side effects, I learned how to keep my hair – for which I am forever grateful!
When I was diagnosed with breast cancer, all five of the surgeons I consulted agreed that I needed the procedure.
"The story would be different today, and it can be different for you. And I am grateful that I am now empowered to bring my message as an author and public speaker to everyone whose life is changed by breast cancer."
Business entities can be defined as the corporate, tax and legal structures which an organization chooses to officially follow at the time of its official registration with the state authorities. In total, there are fifteen different types of business entities, which would be the following.
- Sole Proprietorship
- General Partnership
- Limited Partnership or LP
- Limited Liability Partnership or LLP
- Limited Liability Limited Partnership or LLLP
- Limited Liability Company or LLC
- Professional LLC
- Professional Corporation
- Nonprofit Organization
- Cooperative Organization
As estates, municipalities and nonprofits do not concern the main topic here, the following discussions will exclude the three.
Importance of the State: The Same Corporate Structure Will Vary from State to State
All organizations must register themselves as entities at the state level in United States, so the rules and regulations governing them differ quite a bit, based on the state in question.
What this means is that a Texas LLC for example will not operate under the same rules and regulations as an LLC registered in New York. Also, an LLC in Texas can have the same name as another company that is registered in a different state, but it's not advisable given how difficult it could become in the future while filing for patents.
To know more about such quirks and step-by-step instructions on how to start an LLC in Texas, visit howtostartanllc.com, and you could get started with the online process immediately. The information and services on the website are not just limited to Texas LLC organizations either, but they have a dedicated page for guiding fresh entrepreneurs through the corporate tax structures in every state.
Sole Proprietorship: Default for Freelancers and Consultants
There is only one owner or head in a sole proprietorship, and that's what makes it ideal for one-man businesses that deal with freelance work and consulting services. Single man sole proprietorships are automatic in nature, therefore, registration with the state is unnecessary.
Sole proprietorships are also suited to a degree for singular teams such as a small construction crew, a group of handymen, or even miniature establishments in retail. Also, this puts the owner's personal financial status at jeopardy.
Due to the fact that a sole proprietorship entity puts all responsibilities for paying taxes and returning loans, it directly jeopardizes the sole proprietor's personal belongings in case of a lawsuit, or even after a failed loan repayment.
This is the main reason why even the most miniature establishments find LLCs to be a better option, but this is not the only reason either. Sole proprietors also find it hard to start their business credit or even get significant business loans.
General Partnership: Equal Responsibilities
The only significant difference between a General Partnership and a Sole Proprietorship is the fact that two or more owners share responsibilities and liabilities equally in a General Partnership, as opposed to there being only one responsible and liable party in the latter. Other than that, they more or less share the same pros and cons.
Registration with the state is not necessary in most cases, and although it still puts the finances of the business owners at risk here, the partnership divides the liability, making it a slightly better option than sole proprietorship for small teams of skilled workers or even small restaurants and such.
Limited Partnership: Active and Investing Partners
A Limited Partnership (LP) has to be registered with a state and whether it has just two or more partners, there are two different types of partners in all LP establishments.
The active partner or the general partner is the one who is responsible and liable for operating the business in its entirety. The silent or investing partner, on the other hand, is the one who invests funds or other resources into the organization. The latter has very limited liability or control over the company's operations.
It's a perfect way for investors to put their money into a sector that they are personally not experienced with, but have access to people who do. From the perspective of the general partners, they have similar responsibilities and liabilities to those in a general partnership.
It's the default strategy for startups to find funding and as long as the idea is sound, it has made way for multiple successful entrepreneurial ventures in the recent past. However, personal liability still looms as a dangerous prospect for the active partners to consider.
Limited Liability Company and Professional LLC
Small businesses have no better entity structure to follow than the LLC, given that it takes multiple good ideas from various corporate structures, virtually eliminating most cons that are inherent to them. Any and all small businesses that are in a position to or are in requirement of signing up with their respective state, usually choose an LLC entity because of the following reasons:
- It removes the dangerous aspect of personal liability if the business falls in debt or is sued for reparations
- The state offers the choice of choosing between corporation and partnership tax slabs
- The limited legalities and paperwork make it suited for small businesses
While more expensive than a general partnership or a sole proprietorship, a professional LLC is going to be a much safer choice for freelancers and consultants, especially if it involves risk of any kind. This makes it ideal for even single man businesses such a physician's practice or the consultancy services of an accountant.
B, C and S-Corporation
By definition, all corporation entities share most of the same attributes and as the term suggests, they're more suited for larger or at least medium sized businesses in any sector. The differences between the three are vast once you delve into the tax structures which govern each entity.
However, the basic differences can be observed by simply taking a look at each of their definitive descriptions, as stated below.
C-Corporation – This is the default corporate entity for large or medium-large businesses, complete with a board of directors, a CEO/CEOs, other executive officers and shareholders.
The shareholders or owners are not liable for debts or legal dispute settlements in a C-Corporation, and they may qualify for lower tax slabs than is possible in any other corporate structure. On becoming big enough, they also have the option to become a publicly traded company, which is ideal for generating growth investments.
B- Corporation – the same rules apply as a C-Corporation, but due to their registered and certified commitment to social and environmental standards maintenance, B-Corporations will have a more lenient tax structure to deal with.
S-Corporation – Almost identical to a C-Corporation, the difference is in scale, as S-Corporations are only meant for small businesses, general partnerships and even sole proprietors. The main difference here is that due to the creation of a pass-through entity, aka a S-Corporation, the owner/owners do not have liability for business debt and legal disputes. They also are not taxed on the corporate slab.
Cooperative: Limited Application
A cooperation structure in most cases is a voluntary partnership of limited responsibilities that binds people in mutual interest - it is an inefficient structure due to the voluntary nature of its legal bindings, which often makes it unsuitable for traditional business operations. Nevertheless, the limited liability clause exempts all members of a cooperative from having personal liability for paying debts and settling claims.
This should clear up most of the confusion surrounding the core concepts and their suitability. In case you are wondering why the Professional Corporation structure wasn't mentioned, then that's because it has very limited applications. Meant for self-employed, skilled professionals or small organizations founded by them, they have less appeal now in comparison to an LLC or an S-Corporation.