Breast cancer is bad news but manageable

Imagine you’re a fulfilled middle-aged woman, having practically everything life could offer. Everything is going great until you feel a lump in your breast. Your doctor performs a needle biopsy, and when the results come a few days later, your doctor tells you in a compassionate tone: "You have breast cancer."

Every woman dreads the thought of ever having to be diagnosed to have breast cancer. According to the National Cancer Institute of the National Institutes of Health (NCI-NIH) of the United States, every woman has some chance of developing breast cancer during her lifetime, and this chance increases as a woman gets older. Breast cancer is the most frequently diagnosed cancer in women, with more than half a million women worldwide diagnosed annually to have this type of cancer.

There are several types of breast cancer, depending on the tissues where they originate. The most common is ductal carcinoma, which begins in the lining of the milk ducts of the breast. Another type, lobular carcinoma, begins in the lobules where breast milk is produced. If the cancer cells invade nearby tissue, it is known as infiltrating or invasive cancer.

When cancer cells invade surrounding tissues, they usually destroy them. Cancer cells can also enter the bloodstream or the lymphatic system, spreading the cancer throughout the body. When breast cancer spreads outside the breast, cancer cells often are found in the lymph nodes under the arm. Cancer cells may spread beyond the breast such as to other lymph nodes, the bones, liver, or lungs. This spread of cancer cells is called metastasis.

Therefore, when breast cancer spreads, it is called metastatic breast cancer even though it is found in another part of the body, such as in the lungs, bones or brain. For example, breast cancer that has spread to the lungs is called metastatic breast cancer, not lung cancer.

The exact cause of breast cancer is still a mystery, although medical researchers are now learning what happens inside cells that may lead to cancer. Breast cancer usually begins in a single cell that changes from normal to cancerous over a period of time.

Accepted Treatments

There are several types of accepted treatments for breast cancer. When caught at an early stage, breast cancer may be completely eradicated. According to the NCI-NIH, these treatmentsare:

1) Surgery: Taking out the cancer in an operation.

2) Radiation therapy: Using high-dose X-rays to kill cancer cells or keep them from dividing and growing.

3) Chemotherapy: Using anticancer drugs to kill or stop the growth of cancer cells.

4) High-dose chemotherapy: Using high doses of anticancer drugs to kill cancer cells. High-dose drug treatments with peripheral stem cell transplantation and bone marrow transplantation are being tested in clinical trials.

5) Hormone therapy: Using hormones to stop cancer cells from growing.

6) Biological therapy (immunotherapy): Using the immune system to fight cancer or to lessen the side effects that may be caused by some cancer treatments. Many biological therapies are being tested in clinical trials.

7) Breast reconstruction: Surgery to rebuild a breast’s shape.

Treated patients with breast cancer, who had already undergone surgery and chemotherapy, have to live with that lingering fear that the cancer might come back with a vengeance.

Breakthrough Study

A new breakthrough study showed the beneficial effect of letrozole (Femara) in postmenopausal women with early breast cancer. A dramatic 43-percent reduction in risk of recurrence and significantly improved, disease-free survival were reported when the drug is taken after the patient’s usual course of tamoxifen therapy.

The markedly favorable results, reported online recently in the New England Journal of Medicine, prompted the independent medical investigators to prematurely terminate the study so patients in the placebo arm of the trial could switch to letrozole.

This international study was coordinated by the prestigious National Cancer Institute of Canada Clinical Trials Group in Kingston, Ontario.

The researchers concluded that postmenopausal women with early breast cancer who completed five years of post-surgical hormonal therapy with tamoxifen benefited significantly from extended additive treatment with letrozole.

"Historically, there has been no proven post-tamoxifen therapy to address the significant ongoing risk of recurrent breast cancer," said Paul Goss, MD, director of Breast Cancer Prevention and Research, Princess Margaret Hospital, Toronto, Canada. "The data provide the first clinical evidence that extended adjuvant drug therapy with letrozole, following five years of treatment with tamoxifen, may have a substantial impact on the overall treatment outcome for menopausal breast cancer patients."

Dr. Goss was the principal researcher and was the international chair of the clinical trial.

Being diagnosed with breast cancer can lead to varying degrees of anxiety, depression and other psychological problems in many patients. Some try to recall what they might have done in the past that led to their breast cancer. These misconceptions about its cause only add to the anxiety. The NIH-NCI give these patients these words of advice:

• You should not feel guilty. You haven’t done anything wrong in your life that caused breast cancer.

• You cannot "catch" breast cancer from other women who have the disease. It is not contagious. Breast cancer is not caused by stress, wearing tight brassieres, or by an injury to the breast.

Breast cancer will always be bad news in any language. But with modern therapies and a healthy positive disposition, patients can still look forward to spending many more meaningful years with their families and, perhaps, take are of their children’s children, too. — Fame Health Bureau