Ren Ke
In recently years, breast cancer has become the first dangerous disease which threats women’s life. Recording by American Cancer Society, there are 40,460 people died for breast cancer in 2000. What is worse, the risk of getting breast cancer increases because of the contaminated environment and incorrect eating habit.
Though survive rate for breast cancer patients is not very high, people still need to have a right idea about it. This project may give some basic knowledge about breast cancer. Also it will give suggestions to people who have breast cancer, and help healthy people to decrease the risk to get breast cancer. After reading the project readers may not scary when they heard the name of this disease. Also, they may have a positive attitude to face it.
In the rest of the project, I will discuss the elements that cause breast cancer, treatments, and its side effects. Also, I will discuss how to manage fear and how to reduce the risk of getting breast cancer.
Before we talk about breast cancer, it is necessary for us to know fundamental knowledge about cancer.
Background
Cancer is caused by gene mutation. This mutation is likely to produce groups of cells, which do not respond to normal controls on cell division. Typically, we call them cancer cell.
Cancer cells divide fast and continuously. At the beginning, the growing of cancer cells, which is called begin tumors, may not endanger our health. As it develops, tumors, which is called malignant, will be formed around normal cells and eventually invade healthy cells. As the time pass by, tumors can travel to other part of body to produce new tumor cell, which is called metastasis and may endanger our life.
Like any cancer, breast cancer is also caused by gene mutation, but does that mean it is a disease that can be inherited from parents?
Elements that induces breast cancer
Someone believes that breast cancer is caused by inherited. They ask that if people have a high risk to get breast cancer, when there is breast cancer history in their family.
For some cases, it is true. Some geneticists show that most breast cancer is caused by the mutation of BRCA1 and BRCA2 genes.
In a family, if there is a one has the mutation of both BRCA1 and BRCA2 genes, then there is a high chance that their offspring

will get the same disease. However, it is not common that the two mutations happen at the same time.
Thus, for most cases, the answer is not. Breast cancer organization states that breast cancer has only 5%~10% chances to be inherited. In some family, if there is one or two female members have breast cancer, other female members can still be healthy.
Also, if breast cancer has a high risk to be inherited, all of the body cells may receive the cancer-causing genes, thus every body cell should become cancerous. However, breast cancer only appears in breast tissue and people may get the disease only when they reach an advanced age, so what is the major element that causes breast cancer?
Actually, the exact causes of breast cancer are unknown, but scientists have found out some factors, such as age, unhealthy eating habit and hormones, that may increase the risk to get this disease.
Ehealth (2004, p.3) States that the risk of getting breast cancer increase with age. This is because loss of heterozygosity (LOH for short, means loose of the normal function on one allele of gene) is easily to happen when people reach a relatively old age
(45~60 years old). LOH may induce gene mutation in body cells. Thus increase the risk of breast cancer.
Hormone is also a factor that may increase breast cancer risk. The longer that body cell exposure to sex hormone the higher the risk to get breast cancer. Estrogen (female hormone) plays a role of receptor on cell. It sends signals to breast cancer to let them grow.
Besides the two factors, unhealthy eating habit is another factor. Acidic food and fat food (red meat, cheese and milk) may increase the risk as well. This is because these foods may contain hormones, growth factor and even pesticide, which have high probability of causing gene mutation.
At early stage, breast cancer does not have obvious symptoms. However, if women find there is color changed on breast skin, they should go to hospital and take some further tests. The test can help to find out the characteristic of breast cancer, thus decide which treatment the patients should take.
Treatment—Surgery
As the development of medical technology, many efficient treatments are available for breast cancer patients, such as hormonal therapy and target therapy. However, there are still some people believe that surgery is the best way to treat breast cancer. Is this thought right?

Actually, this idea is not completely right because all surgeries may have potential risks. My grandma is a doctor. In her hospital, 60% of breast cancer patients die after surgery because of recurrent. By contrast, some patients who do not do the surgery eventually recover under a long time of chemical and radiation therapy.
However, from some point of views, surgery is a good choose as a treatment. There are two kinds of surgery: mastectomy and lumpectomy. In this section, I will focus on advantages and disadvantages of these surgeries.
Compared to other treatments, surgery is the quickest way to eliminate tumor cell.
Now, let us have a close look at each type of surgeries.
Mastectomy means removing the entire breast, and advantage of this surgery is that patients can avoid taking the radiation treatment. As we know, when radiation kills the cancer cells, it will also cause a big damage to normal cells. That is why cancer patients feel tired and sick after radiation therapy. If patients can avoid radiation therapy, it means they can leave a healthy body to fight against cancer.
Another surgery, Lumpectomy, which means remove the part of tumor tissues in breast, also have advantages. Firstly, this surgery allows the patients to keep parts of their breast. Also, the area of scar leave on breast may be relatively small than mastectomy. Because the wound area is not very large, the time of recovering will be shortened. Thus, patients can go back to their normal life as soon as possible.
Though these two surgeries are seemed to be the first line of attack against breast caner, they still have disadvantages.
To begin with, let us discuss disadvantages of mastectomy. Breast cancer organization states that after taking this kind of surgery, patients may have risks such as numbness
(lose of sense), fluid collection (seroma accumulate in the scar), and back pain.
Though these risks are not dangerous enough to threat patients’ life, they may bring them a lot of inconveniences.
What is worse, because the incision is large, it may cause patients loose amount of blood. If this situation can not be controlled, patients may die during the surgery. Also, even the surgery is successful patient may still die because of infection.
Compared with mastectomy, lumpectomy keeps some parts of the breast, but it does not mean it is safe than mastectomy.
This is because lumpectomy is quite a new technology right now. That means there are small groups of doctors can master this surgery. Indirectly, it increases the risk of having medical accident. Also, patients need to take six-week- radiation treatment, which may also cause a big damage to human body, before lumpectomy surgery.

People may wonder that if surgery is not the best choice. What is the best treatment for breast cancer?
State by breast cancer organization, treatments for each patient is different. It may depend on at which stage the cancer is.
At stage 0, radiation treatment and surgery is not necessary as soon as possible. At this time patients and doctor need to observe the growth of cancer, and find out the appropriate treatment based on the specific situation.
If the cancer develops into stage one or two, surgery can be considered but is still not necessary. Patients can take lumpectomy if the tumor is not more than 5 cm. After the surgery, patients also need to take radiation therapy or chemical therapy for couple of days.
If the cancer is in stage three or four, it means cancer cells have the ability to invade into other cells and start to spread into the whole body. This is the worst situation that could happen because tumor cells are traveling around the whole body and is hard to remove by surgery. In that case, doctors are suppose to use systemic treatments, such as chemotherapy, hormonal therapy and targeted therapy. These types of treatment may reduce the cell division rate in the whole body, thus it can control the distributed cancer cells.
Based on different cancer stage, patients can take two or three treatments at the same time. This may help them to decrease the recovery time and lower the recurrent risk.
Multiple treatments and side effects
However, does it always help if patients take a lot of treatments?
To this question, some appropriate multiple treatments can help. For example, radiation therapy is always done after the mastectomy because it may induce the recurrent frequency. Reported by breast cancer organization, 20% to 30% of patients are considered at a high risk of recurrent after mastectomy. As radiation may kill the remained cancer cells in breast, it would reduce the recurrent risk to 10%
But it does not mean it is better if patients take a bunch of treatments without any plan.
On contrast, it may make things worse because every treatment has its side effect.
Chemotherapy is a treatment that uses drugs to control the growth of cancer cell.
However, the drug not only inhibits the growth of cancer cell but also effect normal cells. Thereby, it can lead to bone loss, taxanes (discomfort in hand and feet)or even induce a toxic effect on heart.

The same as chemotherapy, hormonal therapy have side effect as well, and the side effects depend on the different hormone that used for treatment. For instance, tamoxifen may increase the risk of uterine cancer, aromatase inhibitor can cause upset and waken bones, and ERDs may result in stomach and headache.
Because these sides effects, it is better for patients to make a treatment plan. However, to make treatment plan is not the only problem that cancer will meet. One of the problems is loose of confidence. When they are diagnosed with breast cancer, they usually scare of the disease.
Attitude and Manage of breast cancer fear
To most of the cancer patient, manage fear of breast might be the hardest thing. When patients are diagnosed with breast cancer, some of them may be angry with doctors, and some may be think there is nothing can help. Will attitude effects the results of treatment?
Results of a recent Australian study reported in the Feb. 9, 2004, online issue of
Cancer showed that an optimistic attitude didn't prolong the survival of lung cancer patients
.
“Researchers followed 179 patients with non-small cell lung cancer, a disease that has a particularly bleak outlook. The patients answered questions about their attitude and optimism before their treatment began and again after it was completed. Five years later, after 96 % of the patients in the study died, the researchers found that their levels of optimism were not related to how long any of the patients lived or to the progression of their disease.”
Despite their findings, the researchers still recommend patients to have positive attitude. Earlier studies have shown that optimism can enhance health. Also, it can influence how well the patents care for themselves, which may eventually have an impact on their survival prospects
One doctor says that “Those who did not survive were weakly motivated and vacillated regarding what and how they would do to fight the cancer. I saw them die without trying. We have the popular notion that people are entitled to their opinion.
If this is true, then we must consider that we are also obligated to receive the consequences of our actions, including those brought about by our attitude.”
From that point, patients still need to learn how to manage the fear, and then build up an optimistic attitude.
Now we know that emotion is important for results of the treatment. Therefore, we need to learn how to manage the fear, and then build up an optimistic attitude.

Most patients are afraid of breast cancer because they do not know about this disease.
Thus, the first thing patients need to do is to learn about breast cancer. They can gather information by consulting with their doctor, reading book or searching on line.
The more information they get, the more they know about themselves. During this process, most patients may find out the characteristic of their breast cancer. After knowing their own situation, patients should predict the results of test, thus they can lower the surprise.
In order to decrease the anxiety for the results of test, patients can make a plan with their doctor about how to receive the results. Thus, the patients may get appropriate time to prepare for accepting the results. Also, during the waiting time, patients do not suppose to do heavy work, such as long time cooking and working.
When the results come out, patients should discuss it with their doctor, and find out a treatment plan early. Someone may wonder if the early plan may increase the pressure of the patients. Actually, this action may allow the patients to prepare for the treatments instead of concerning. When patients know what they should do next, their attitude will be more positive.
Also, take part in the breast cancer organization is another good choice to reduce the fear. Patients can get a lot of suggestions from other cancer patients, which will be more helpful for them to struggle with cancer. In addition, patients are easily to be encouraged when they meet people who have the same experience.
It is really help if people know how to control their emotion if they have got breast cancer. But, before we consider about how to face this deadly disease, why do not we think about how we can decrease the risk to get it.
Lower the risk
Every woman wants to know if they have chance to get breast in their life, especially for those who have breast cancer history in their family. However, does that really mean they can do something to prevent breast cancer?
Actually, the answer is no. There is no sure way to prevent breast cancer. But there are things all women can do that might reduce their risk before cancer does occur.
To reduce the risk to get breast cancer, we should know what risk factors are. Stated by breast cancer organization, there two kinds of risk factor: external and internal.
Internal factor refers things inside our bodies that influence our health, such as genetics (the genes you got from your mother and father), age and illnesses.
Unfortunately, this factor is what we cannot control.

By contrast, external factor is the things outside of our bodies that influence our health, such as air, water and food .
This factor is what we can control.
To begin with, get away from cigarette. Many research shows that smoking is related with an increased risk of developing breast cancer. What is worse, it can lead to a difficulty healing and blood clot after surgery and hormonal therapy.
Then, get more exercise also help to decrease the risk. Reported by University of
Southern California, exercise can reduce the cancer risk by changing metabolic rate and immune system. Researchers select 110,599 and divide them into two groups.
Then manipulate patients exercise time. The results show that exercise for more than
5 hours can decrease 31% risk of getting breast cancer.
Maintain body weight is another way to lower the risk. Researchers have found that overweight women have a high risk of getting breast cancer. This is because extra cells can produce extra estrogen, which may stimulate breast cancer cell growth.
In addition, overweight women are less likely to have enough exercise in their daily life, which means their probability to get breast cancer is higher than those who exercise more. Perhaps it is hard to keep weight as age increases. But if people can have a low fat diet and exercise regularly, weight is much easier to control.
To maintain weight, someone may just eat vegetables and fruits. Does that mean it can reduce the risk of getting breast cancer?
For this question, there no specific answer. Some scientists disagree on fruits and vegetable can reduce the risk of getting breast cancer. One report states that
“combined many dietary studies showed no clear decrease in risk of breast cancer from diets high in vegetables and fruits.”
However, there are also some different opinions. Dr. Mitch Gaynor believes that vegetarian diets can reduce the risk of getting breast cancer. From his experiments, he concludes that eat fruits and vegetable strengthen people’s immune system, which means people can fight against disease (include breast cancer) better. Also, in an indirectly way, fruits and vegetables can decreases the risk by helping people lose weight.
From these two opinions, it is hard to say which one is right, but there is one thing that is clear, fruits and vegetable (if not goes bad) will not increase the risk of getting cancer. Thus, it is still necessary for people to have appropriate quantity of vegetables and fruits every day.
Here are some suggested fruits and vegetables diets:

Add chopped squash and carrots to jarred or fresh spaghetti sauce (serve on pasta for a great dinner).
Eat tomatoes, tomatoes, tomatoes — raw in salad, sandwiches, salsa, juice, or alone (like a piece of fruit), or cooked in sauces.
Eat whole fruit rather than drink juice to reduce calories, add fiber, and increase feelings of fullness.
Snack on baby carrots and celery (keep a cooler of them in the car).
Throw handfuls of spinach into stews and soups.
Add shredded lettuce to potato salad.
Add broccoli, tomatoes, or zucchini to scrambled eggs or omelets.
Freeze grapes and berries in single-serving containers for a cool treat during summer months.
It is not enough if people just know the three risk factors that mentioned above. There are also some other risk factors we need to pay attention, such as alcohol use and the pregnant age. Both elements can reduce the risk of getting breast cancer by regulating the formation of estrogen (a factor can cause breast cancer).
Conclusion
This project gives a general idea about breast cancer. Firstly, it introduces the causes of any cancer and then shows some specific elements that will trigger breast cancer.
Then it mentions some treatments for breast cancer, including surgery, chemical therapy, hormonal and so on. In order to encourage breast cancer patients to fight against this disease, I also discuss ways to manage patients’ fear in the project, such as learn more about breast cancer and join the breast cancer organization. It is not enough if people only know how to face breast cancer. Thus, at the end of the project,
I give some suggestions to reduce the risk of getting breast cancer, such as stop smoking, maintain weight and so on.
After reading the whole project, readers may get some basic knowledge about breast cancer. For those breast cancer patients, I hope they can get some encouragements from this project. They should believe that life is in their own hands. If they try to fight, they get chance to win. For those healthy people, I hope them can take care of their body and get away from breast cancer.
Reference
Breast Cancer Organization
Symptoms and diagnosis
Retrieved from Dec.5, 2008 http://www.breastcancer.org/symptoms/
Breast Cancer Organization
Treatments and side effects
Retrieved from Dec.5, 2008 http://www.breastcancer.org/treatment/

Breast Cancer Organization
Lower your risk
Retrieved Dec.5, 2008 from http://www.breastcancer.org/risk/
Andrew Weil, MD
Does attitude affect cancer survival
Retrieved Dec.10 from http://www.drweil.com/drw/u/id/QAA326565
I am invited by breast cancer organization, and they want to me to give a speech to breast cancer patients and some healthy people. They hope that the speech can give some advises to those patients, and also encourage them not to give up. Also, they want healthy people to know more about breast cancer and reduce the risk of getting it.
During the speech, I will show some background about cancer, such as their definition and tumor stages. This may help audience to understand what I am going to talk about next—breast cancer. Then I will introduce element that will cause breast cancer.
Before talking about risk elements I will answer a question that most of people are misunderstand—if breast cancer can inherited. Actually, most of people think breast cancer can be inherited. Some healthy people even remove their breast just because their mother or grandmother has breast cancer.
In order to give audience the right answer, I will show some research data and the situation that may cause the inheritance. I hope audience may have a right opinion about breast cancer, and be not too afraid if they have breast cancer history in their family. Then I will discuss the elements may cause breast cancer, such as age, hormonal (estrogen) and so on.
After knowing causes of breast cancer, audience may wonder what kind of treatment is appropriate if they get cancer. Thus, in the next section, I will talk about some basic treatment for breast cancer.
Here, I will point out an incorrect thought about surgery. Some people say surgery is the best treatment for breast cancer. This idea is not completely right because some research show that recurrent rate is relatively high after surgery.
However, from some point, surgery is the quickest way to remove cancer cell. To make the answer clear, I will show disadvantages and advantages of two types of surgery. Also, I will introduce some appropriate way to treat breast cancer.

The third thing I will mention is the side effects of some treatments. For breast cancer patients, they should also know what kind of side effect each treatment may have.
Some patients may think the more the treatments they take the better the results will be. Actually, this though is wrong, and may cause dangerous if patient really do that. I think, by knowing side effect of treatment may help patients to make right decision for make their treatment plan.
Consider that most patients may be scared when they diagnosed with breast cancer, I will give them suggestions about how to manage their fear. Though some research show that attitude will not affect the results of the treatment. However, I always believe that confidence and courage is the first step to win. If patients are afraid to accept they get this disease how can they fight for themselves? To manage fear, I will suggest them to get more information about breast cancer, talk to their doctor often, and relax themselves.
It is not enough if audience just know how to face breast cancer after they get this disease. For those healthy people, the most important thing is reduce the risk of getting breast cancer. So, in this section I will show some way to decrease the risk and arouse people to take care of their body.
At last, I will invite one audience (who has had breast caner) to share her experience with us. Audience can ask questions or share their story with us as well.