Breast Cancer: End of the Road is Further Away than You Think

October 28, 2019

Unfortunately, “Cancer” has become such a common word today.  Especially in women, “breast cancer” is the most common cancer globally, to the point that one eighth for women have a chance to face this type of cancer sometimes in their lives. However, modern advances in diagnostics, improved treatment methods, and better management of side-effects have come together, so that cancer will not be the end of the road for most people.

“Cancer” is a scary word for most people. But among women, the words “breast cancer” may be even scarier as it affects anatomy especially associated with womanhood. Having said that, breast cancer can also occur among men, though the chances of that happening are one in a thousand, compared with one eighth for women.

Because breasts are located near lymph glands and lungs, the chances of it being fatal was very high. But survival rates have been much improved through awareness programs that encourage women to perform breast self-exams. The improved survival rates can also be credited to more women aged 40 and above (or from the age of 30 if there is a family history of breast cancer before menopause) having mammogram or ultrasound tests done regularly. Statistics from the USA have shown that breast cancer mortality has dropped by a third in the past 20 years (from 29.4 per 100,000 women in 1996 to 20.0 per 100,000 women in 2016).

Currently, being clear of breast cancer for five years is enough to be considered a survivor. The survival rate of 89.9 percent for breast cancer is among the highest of all cancer types (2009 - 2015 statistics). Lumpectomy (partial breast removal has since replaced mastectomy (total breast removal) as the main treatment approach, although the latter might still be required in some cases. If the entire breast must be removed, the patient also has the option of a breast prosthesis or tissue reconstruction. Radiotherapy and chemotherapy also have an important part to play in the treatment of breast cancer, as medical advances have greatly reduced the impact of their side effects.

One reason for the increase in survival rates is the discovery that breast cancer cells are reactive to certain hormones and proteins. Medicines which inhibit the growth of breast cancer cells by controlling and blocking these hormones and proteins have been developed. But the specific characteristics and reactiveness of the cancer cells vary from patient to patient, and are dependent on many factors. It is therefore necessary to perform tests to determine which medicines to use:

Testing for the presence of hormone receptors on the cancer cells. Cancer cells which are hormone receptor positive (HR+) are susceptible to medication which inhibits their ability to be stimulated by hormones.
Testing for the presence of human epidermal growth factor receptor-2 (HER2). Cancer cells that have this receptor (HER2+) tend to spread faster than cancer cells that don’t.

Physicians consider both factors when evaluating which treatment path to take. For example, if the cells are HR positive but are HER2 negative (HR+/HER2-) – which is the most common scenario and has the lowest chance of relapse – hormone therapy will be viable for the patient. But if the cancer cells are HR negative and HER2 positive (HR-/HER2+) then hormone therapy will be inappropriate. Instead, HER2-targeted therapy will be prescribed. If both are found to be positive then the patient may undergo both types of treatment.

For triple negative patients – those with both HR negative and HER2 negative cancer cells – the chances of survival used to be very low. However, recent advances in targeted therapy are fast closing that gap. The chances of survival for all types of cancer patients are now even higher. It can be said that the chances of complete remission, and a return to normal life are now much higher than the chances of incurable cancer.

As effective as modern treatments are, it still stands that the earlier the cancer is detected, the easier the treatment will be. Women should still perform breast self-examinations regularly. The best time to do this is seven days after menstruation. If abnormal lumps are found in the breasts, the areolae, or the skin of the breasts, a physician should be seen immediately.

It is not necessary to wait until you turn 40, these self-examinations can be performed at any age. But at the age of 40, the chances of breast cancer occurring are much higher. It is therefore recommended that a mammogram test be performed, with or without a family history of cancer.

Lastly, taking care of your overall health is a good way to minimize the factors which cause cancer in the first place: whether in the form of regular exercise, maintaining suitable bodyweight, staying physically active, or avoiding alcohol. But if the cancer has already found its way to the patient, then the behavior of the patient and moral support from their nearest and dearest will play a crucial role in defeating the cancer. Staying positive and mentally strong is the key to living to be with your loved ones for a long time.

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