Breast Cancer
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.
Side effect of other treatments
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.
To those cancer patients, to make treatment plan is not the only problem they meet.
One of the problems is loose of confidence. When they are diagnosed with breast
cancer, they usually scare of the disease. In the next section I will talk about how to
manage the fear to breast cancer.
Manage of breast cancer fear
To most of the cancer patient, the hardest thing is not surgery or the anguished
treatment but the truth that they have got cancer. Some patients 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
Scenario memo
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.