Take Charge of Your Health
An article by Dr. Kirtland Culmer

Breast Cancer
In one of my previous articles, I made a few suggestions about breast cancer and lifestyle. Since next month, October, is Breast Cancer Awareness Month, and this is such an important topic for the ladies, I thought that I would give you a jump-start in thinking about how to TAKE CHARGE of this formidable foe.

This cancer is the leading cause of cancer deaths for women between the ages of 35 and 54, and we do not really know what causes it. There are many factors which have been associated with an increased risk of developing breast cancer. These include: *previous history of breast cancer; *increasing age; *a close relative (mother, sister or daughter) with breast cancer; *suspicious biopsy of fast-growing tissue; *previous radiation to the breast; *no children at age 40 or older; *early first period (aged 15 or younger); *late menopause (aged 50 or older); history of cancer of the ovary or lining of the womb; *obesity in postmenopausal women; *evidence of genetic susceptibility; *hormone replacement therapy. All these factors are significant in no more than 30% of breast cancers. In 1994, a gene was shown to be changed in 5% of 180,000 breast cancer patients. Relatives of breast cancer patients who carry this modified gene have a higher rate of developing breast cancer. So genetics may play a part, but the scientists have no way of treating the folks in whom they find these defective genes.

The most common types of breast cancer are ductal cancer, lobular cancer and inflammatory breast cancer. Each breast has 15 to 20 sections called lobes, with many smaller sections called lobules. Each section is connected by thin tubes called ducts. The most common type of breast cancer is called ductal cancer. Cancer that begins in the lobes are called lobular cancer. A rare type of breast cancer may present as swelling, redness, heat in the breast, and a pitted appearance of the skin. This is inflammatory breast cancer, and it tends to spread very quickly.

Treatment of breast cancer varies with the individual, and the decision of the specialists. The type of treatment and the chance of recovery depend on a number of factors such as: the stage of the cancer, the type of breast cancer, characteristics of the cancer cells, your age and weight, your menopausal status, and your overall state of health. The basic stages of breast cancer are as follows:

Stage I - The cancer is no wider than 2 centimeters and has not spread outside of the breast.

Stage II - The tumour is more than 2 centimeters, but less than 5 centimeters in diameter.

Stage III - The tumour is greater than 5 centmeters in diameter

Stage IV - A tumour of any size with growth extending to the chest wall or skin.

The common types of breast cancer have already been described. A specialist called a pathologist can look at the characteristics of the cancer cells, and determine to some extent the degree of malignancy and potential for the speed of growth and spread.

When it is considered that breast cancer occurs in one in ten women who reach the age of 74, and that this incidence is rising, it is very imperative that individuals and the medical community do as much as possible with regard to prevention and recovery. It is important that females as early as age 30 begin to familiarize themselves with the screening methods which promote early detection. They should learn and do breast self-examination. They should report anything unusual about their breasts to their doctor. They should begin having their annual mammograms either at age 35 or 40..depending on their doctor’s recommendation. They should be aware of the other investigative modalities such as sonography, needle and surgical biopsies and CT scans.

Once the disease is discovered, the treatment may consist of lumpectomy (limited surgery which removes the cancer but not the entire breast, mastectomy (surgical removal of the breast.), chemotherapy and hormone therapy. Biological therapy, using the body’s own immune system to fight the cancer, and bone marrow transplantation are still in the clinical trial stage. Two or more of these treatments may be combined.

This devastating disease calls for constant, sincere and persevering support from family members, physicians and friends. Patients should be aware, and physicians should be mindful that the doctor usually underestimates the amount of information the patient requires and overestimates the amount that he gives. Communication is the key. Once diagnosed, patients should opt for the best available specialist care, and seek a second opinion if there is a feeling of uncertainty. Some patients seek healing in alternative medicine. Most who do so use them as an adjunct to scientific medicine, while some do so instead of using scientific medicine. They use these unproven therapies for a number of reasons, including: a wish to retain control of decision-making; lack of faith in conventional medicine, belief that alternative medicines have been proven to be effective; alternative belief systems; or a willingness to try anything. It is essential, for safety reasons, that doctors are aware of any alternative therapies their patients may be using. One way to achieve this is to offer to discuss any alternative therapies their patient or her family wishes to talk about. In this way, such therapies can be checked for safety. This preserves the health of the woman while assuring the maintenance of the doctor-patient relationship. In time, scientists may find cause and cure for this disease.

In the meantime, I urge you to seek all the available information that you can, and use it to TAKE CHARGE to the best of your ability.