Dfgds Essay, Research Paper

Breast Cancer Treatment

Only lung cancer kills more women each year in the United States than

breast cancer does. The American Cancer Society (ACS) estimates that over

184,000 new cases of breast cancer were diagnosed in women in 1996 (ACS Breast).

Although these statistics are alarming, there are a number of treatment options

available for those that are diagnosed with breast cancer.

The best way to treat any disease is to prevent it. Since little is

known about breast cancer, there are no established rules for prevention. The

ACS recommends that women age twenty and older perform monthly breast self-exams,

and it also suggests clinical examinations every three years (ACS Breast).

Mammography is also a wonderful tool for detecting tumors; however, there is

conflicting data on when and how often women should have mammograms. What is

known is that mammography is the best way to determine if a palpable lump is

actually cancerous or not.

Treatment methods for breast cancer can be lumped in two major

categories; local or systemic. Local treatments are used to destroy or control

the cancer cells in a specific area of the body. Surgery and radiation therapy

are considered local treatments. Systemic treatments are used to destroy or

control cancer cells anywhere in the body. Chemotherapy and hormonal therapy

are considered systemic treatments.

Surgery is the most common treatment for breast cancer. Although there

are many different types of breast cancer surgery, they all fit into a few basic

categories. An operation that aims to remove most or all of the breast is

called a mastectomy. If at all possible, doctors shy away from mastectomies due

to the side effects which include loss of strength in the closest arm, swelling

of the arm, and limitation of shoulder movement. If a mastectomy must be

performed, the physician will often suggest post surgical reconstruction of the

breast (Kushner 37).

Another type of breast cancer surgery is called breast-sparing surgery.

This category would include lumpectomies and segmental mastectomies. In this

situation, doctors remove only the tumor and make an attempt at sparing the rest

of the breast tissue. These procedures are often followed by radiation therapy

to destroy any cancer cells that may remain in the area. In most cases, the

surgeon also removes lymph nodes under the arm to help determine whether cancer

cells have entered the lymphatic system.

Radiation therapy is another common treatment for breast cancer.

Radiation involves the use of high-energy x-rays to damage cancer cells and

retard further growth. The radiation may come from a radioactive source outside

the body, or it can come from radioactive pellets placed directly in the breasts.

It is not uncommon for a patient to receive both internal and external

radiation. For external radiation, patients must visit the hospital or clinic

each day. When this regimen follows breast-sparing surgery, the treatments are

given five days a week for five to six weeks. At the end of that time, an extra

?boost? of radiation is often given to the place where the tumor was removed.

Hospital stays are required for implant radiation. Some common side effects of

radiation therapy include swelling of the breast and dry skin at the radiation

site.

Chemotherapy is one of the systemic therapies doctors use to fight

breast cancer. Chemotherapy uses drugs to kill cancer cells, and it usually

involves a combination of those drugs. Traditional chemotherapy is administered

in cycles; a treatment period followed by a recovery period, then another

treatment, and so on (NIH 23). Like radiation therapy, chemotherapy can be

administered on an outpatient basis. Although chemotherapy works to kill cancer

cells, some of the side effects almost make treatment unbearable. Common side

effects include nausea, decrease of appetite, hair loss, vaginal sores,

infertility, and fatigue (ACS For Women 32). Most of these effects, except

infertility, cease when the treatment is over.

There are many other possible treatments for breast cancer that are

currently under study. One of the biggest clinical trials involves hormone

therapy. This treatment uses medication to prevent the tumors from getting the

hormones, such as estrogen, that they need to thrive. Removal of the ovaries

and other hormone producing glands may also be prescribed. Another treatment

option being studied is bone marrow transplantation. The bone marrow can be

taken from healthy parts of the patient’s own body or from other donors.

Although this treatment idea is still in its early stages, the results seem

promising.

Because there are so many varied treatment options, treatment decisions

are complex. These decisions are often affected by the judgment of the doctors

involved and the desires of the patient. A patient’s treatment options depend

on a number of factors. These factors include age, menopausal status, general

health, the location of the tumor, and the size of the breasts (ACS Breast).

Certain features of the tumor cells, such as whether they depend on hormones to

grow, are also considered. The most important factor in determining treatment

is the stage of the disease. Stages are based on the size of the tumor and

whether it has spread to other tissues.

Stage I and stage II are considered the early stages of breast cancer.

Stage I implies that cancer cells have not spread beyond the breast and the

tumor is no more than an inch in diameter. Stage II means that the cancer has

spread to underarm lymph nodes and/or the tumor in the breast is one to two

inches in diameter.

Women with early stage breast cancer may have breast-sparing surgery

followed by radiation as their primary local treatment, or they may have a

mastectomy. These approaches are equally effective in treating early stage

cancers. The choice of breast-sparing surgery or mastectomy depends mostly on

the size and location of the tumor, the size of the patient’s breast, certain

features of the mammogram, and how the patient feels about preserving her breast.

With either approach, lymph nodes under the arm generally are removed. Some

patients with stage I and most with stage II breast cancer have chemotherapy

and/or hormonal therapy. This added treatment is called adjuvant therapy, and

is given to prevent the cancer from recurring (LaTour 131).

Stage III is known as locally advanced cancer. The tumor in this

situation measures more than two inches in diameter and has invaded other

tissues near the breast (131). Patients with stage III breast cancer usually

have both local treatment to destroy the tumor and systemic treatment to keep

the cancer from spreading further. Systemic treatment can consist of

chemotherapy, hormonal therapy, or both.

Stage IV is called metastatic cancer, which implies the cancer has

spread to other organs in the body (ACS Breast). Patients who have stage IV

breast cancer receive chemotherapy and hormonal therapy to shrink the tumor, and

radiation to control the spread of the cancer throughout the body. Clinical

trials are also underway to determine if bone marrow transplants are effective

in treating stage IV patients.

Contrary to the negative press commonly attributed to breast cancer,

there are viable treatment options for those diagnosed with this terrible

affliction. The push for increased research in breast cancer is even coming

from the White House. President Bill Clinton mentioned his support for

increased funding for research and prevention in his recent State of the Union

Address, and he urged insurance companies to pay for more mammograms. Hopefully,

with the support from the White House, new treatments can be found for breast

cancer, and maybe with a little luck we will have a cure by the turn of the

century.

Works Cited

American Cancer Society. Breast Cancer. Document 004070.

American Cancer Society. For Women Facing Breast Cancer. 1995.

Kushner, Rose. If You’ve Thought About Breast Cancer. Kensington, MD: Rose

Kushner Breast Cancer Advisory Center, 1994.

LaTour, Kathy. The Breast Cancer Companion. New York: William Morrow and

Company, Inc., 1993.

National Institutes of Health. National Cancer