Cervical Cancer

Cervical Cancer has been attributed to infection with HUMAN PAPILLOMA VIRUS (HPV). HPV infection is usually transmitted sexually.

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…..to her, she was doing this to help her only child whom she gave birth to while in the penultimate year of secondary school.  Regrettably, she said, ‘ i had aborted a couple of pregnancies and had sex with several men while in secondary school and by then i was seventeen because i had to fend for myself as an orphan who had no one to help me, but this child just could not be aborted’.     … that is the result the doctor said. She has stage III cervical cancer at age forty-five…

Overview

Womanhood is a world on its own and it takes patience, knowledge, and pity sometimes for one to dabble into such world. They have their own peculiarities in every sphere of life. In the medical world, as cancer remains one monster to deal with, peculiar to women are some cancers like breast, cervical cancer. In this article, I would focus on cervical cancer which from my own little experience most women don’t know about until they come down with it.

Cervical Cancer

The cervix ( pronounced: saviks) is the neck or narrow portion of the uterus(womb) where it joins with the vagina. Cancer is simply when cells of a particular tissue undergo uncontrolled (and often rapid) growth. Thus cervical cancer is the cancer of the cervix.

Cervical cancer is the second commonest malignancy after cancer of the breast in women in developing countries ( Nigeria inclusive) and it remains the leading cause of death in these countries but the third commonest cancer in women in the world. Peak age when women present in Nigeria is 45 to 55 years. However, it is diagnosed in any woman of reproductive age group.

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The causes have been attributed to

  • Genital infection with human papilloma virus
  • Sex at a young age
  • Multiple sexual partners
  • Promiscus male partners
  • One who had or has a sexually transmitted infections. It is important to point out that HIV infection is associated with a very high increase in risk of cervical cancer.
  • Also, a patient with cervical intra-epithelial neoplasia can progress to cervical cancer

What makes the Doctor think A patient has it

*Though, there are some that may not have any symptom but will come to the hospital with abnormal Papanicolaou (Pap smear) result. This is in those that do screening

* abnormal bleeding from the vagina, majorly after sex

* bleeding from the vagina between menstrual period or after menopause

*offensive vaginal discharge which is characteristic

*pain on pelvic side

For those women that present late, they may have in addition

  • Backache
  • Leg pain/ swelling
  • Blood in the urine or bloody urine

Or the doctor investigates by looking at the cervix called colposcopy

How does the Gynaecologist treat

The treatment modality depends on the stage of cancer the patient presents with.

  • It may be surgery if it is at the early stage or
  • The use of radiation and chemotherapy for the more advanced cases
  • Or the use of chemotherapy or radiation for palliation for cases that have developed other things from it

Survival

There is a similar 5-year survival rates for radiotherapy or surgery for someone with the cancer. This survival also depends on the stage of the cancer. If stage I there is 70-80% survival rate but stage IV has 18% survival rate.

What is in this for YOU! 

The major cause of this disease has been attributed to infection with HUMAN PAPILLOMA VIRUS (HPV). HPV infection is usually transmitted sexually. Condom use may not prevent the transmission. The HPV 16 and 18 are the major serotypes of the cause. Thus, a lady or woman who has been introduced to sex life should get screened two years into sex life and every 3-5 years. In essence, those who should have PAP SMEAR done are

  • Ladies who have started having sex
  • Or above age 21

The American Cancer Society, American College of Obstetricians and Gynaecologist recommend that

  • 21-29 years should have pap smear alone every 3 years
  • 30- 65 years pap smear every 3 years or HPV and cytology testing every 5 years
  • Greater than 65 years no screening recommended
  • Less than 25 no screening recommended because women aged 21-24 are at low risk for invasive cervical cancer but they are at high risk for HPV exposure and associated lesions.

Any Vaccine.

The joy here is that, one could be vaccinated against the Human Papilloma Virus (which is not only for girls but also available for boys) but for girls majorly. The vaccine is useful in those who have not had the disease and no usefulness in one who already had it. The two HPV vaccines approved in the United States of America are Gardasil and Cervarix.

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THE GIST HERE is, please go and get PAP SMEAR done today and tell others about it. It is for your future, in other to live a meaningful life insha Allaah. So please present YOURSELF at any Government health care facility for details.

…. her sex partners were no longer patronizing her since they got to know about her disease as she even was no longer interested in that. She was no more lively, seems no hope for her. Her Chemotherapy drug has made her loose her hair, no beauty to display any longer. The radiotherapy also played it own part on the pelvis. At last, she gave up the ghost with a repentant soul. Don’t ask me if God would accept such repentance.  I leave YOU TO JUDGE…. this woman, this cervical cancer.

I.O Dada (Haniif ibn Toyin)

WHEN CANCER ATTACKS THE OVARIES

The ovaries consist of different cell types, performing different functions. Any of these cells can develop into cancer

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Ovarian cancer is the leading cause of death from gynecological cancers in the UK and USA. It is the 5th most common cause of cancer deaths in women (after lung, breast, colorectal and pancreatic cancers). Up to 20,000 new cases are diagnosed yearly in the US. The peak incidence is in women aged 75 – 84 years, but it can occur in younger women, and even (rarely) in prepubescent girls too.

 

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CLASSIFICATION 

The ovaries consist of different cell types, performing different functions. Any of these cells can develop into cancer, but 90% arise from the epithelial (outermost) cells. Ovarian cancers are classified based on the cluster of cells they originate from:

  • Epithelial
  • Sex cord-stromal
  • Germ cells

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Different subclasses have been described and each has similar features but different growth behavior and response to treatment.

RISK FACTORS

Like most cancers, direct causal factors are largely unknown, but various risk factors have been identified:

  • Nulliparity (no previous viable pregnancy)
  • Early menarche (age at onset of menstruation <11 years)
  • Late menopause (age at cessation of menstruation >52 years)
  • Family history of ovarian, breast or colorectal (bowel) cancers
  • Family history of genetic mutations ( BRCA1, BRCA2, and HNPCC)
  • Previous history of ovarian, breast, endometrial and colorectal cancers (treated)

 SCREENING FOR OVARIAN CANCER

Not routinely done unless one has strong risk factors.

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SIGNS AND SYMPTOMS

Ovarian cancer is a great mimicker as it doesn’t show any specific sign until an advanced stage as been reached. Early symptoms are no different from those attributable to other common diseases. These are:

  • Abdominal pain
  • Abdominal distension and bloating
  • Loss of appetite
  • Constipation or diarrhea (or alternation of both)
  • Abnormal menses or vaginal bleeding

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Late Symptoms include;

 

  • Abdominal/pelvic mass – detected by palpation and confirmed by radiological tests
  • Significant weight loss
  • Difficulty in passing urine
  • Significant abdominal distension (ascites or solid mass)
  • Generalized body swelling (edema or anasarca)
  • Signs of spread to distant organs – uterus and tubes, urinary tract, bowel, stomach, lymph nodes, etc.

 

INVESTIGATIONS

After taking a full history and physical examination, specific tests must be done to confirm the diagnosis, determine the extent of the disease and work up for definitive treatment.

  • Full blood count
  • Kidney function test
  • Liver function test
  • Tumor markers – CA125, CEA, CA19.9, etc.
  • Imaging: ultrasound, CT scan, MRI, chest x-ray, etc

 

MANAGEMENT 

  1. SURGERY: This is both diagnostic and therapeutic. In early stages, the ovaries, uterus, tubes and adjacent lymph nodes will be removed at once. In advanced stages, initial surgery is done to “stage” cancer (to know what stage it is). Subsequent operations may be needed depending on the result of the first surgery and response or recurrence.
  2. CHEMOTHERAPY: The different combination of anti-cancer drugs are available depending on the cell types involved. The platinum-based therapy is given in up to 6 cycles every 3 weeks. Side effects of the drugs include severe vomiting, hair loss, kidney damage, diarrhea etc. These can also be managed and ameliorated.
  3. NOVEL AGENTS: New drugs are being investigated through clinical trials. These include antibodies against cancer-promoting factors in the body (VEGF, EGFR and TKI’s)
  4. SUPPORTIVE TREATMENT: These are palliative measures put in place to alleviate the excruciating pain and suffering associated with advanced ovarian cancer. Such as drainage of ascites, painkillers (strong opioids usually, morphine), emotional support, hospice care, etc.

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FOLLOW UP IS OFTEN CONTINUED LIFELONG.

5-year survival rate ranges from 90% to less than 20% depending on the stage of cancer before treatment is commenced.
PREVENTION 

It is said that the only way to not have cancer is not to be born. Ovarian cancer can not be predicted 100% but individuals with strong risk factors can be followed closely so as to detect the disease early. They can also opt for prophylactic oophorectomy (removal of the ovaries) after completing their reproductive career (cf. Angelina Jolie). For younger women, eggs can be harvested, frozen and used for IVF when they’re ready to get pregnant later.

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General healthy lifestyle helps to prevent cancer among other things – healthy diet, regular exercise, quitting alcohol and smoking, etc.

Childhood Cancers

To nurse one child in Nigeria with cancer, you need about N2 million on the average in a period of about two years

By Drs. Azeezah Shopeyin and Ajayi Abass 

Childhood cancers occur in children less than 15 years. They are devastating not only to the children but their entire family. In Nigeria, it creates a huge financial burden on the family as there is no supportive treatment plan for children and the cost of treatment is very high.

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Cancer leads to abandonment of treatment and consequently death of children. Hence, prevention of childhood cancers cannot be over emphasized. It’s important to note that in most fields of medicine, pediatrics have been found to be of significant challenge, because of communication challenges, and caregiver support.

Burden to public health

The international agency for research on cancer stated in 2004 that worldwide 160,000 children under 15 years get childhood cancers and 90,000 will die from it every year. In 2007, 71.2 of every 1 million Nigerian children below 15 years had childhood cancers.

Due to the lack of data in Nigeria, and the paucity of studies on childhood cancers, it is not easy to appreciate the burden of childhood cancers, this might be due to the preoccupation with infectious diseases which are said to cause about 25% of childhood deaths.

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In an 11year retrospective study conducted in northern Nigeria, by A. Mohammed and A.U Aliyu, it was noticed that childhood cancers were 8.44% of cancers diagnosed within that period. A male: female ratio of 1.5:1.

In 2014, Consultant Paediatrician, Oncology/Haematology Unit of the Lagos University Teaching Hospital, LUTH, Dr. Adebola Akinsulirie, said about four or five cases of childhood cancer are seen monthly at the LUTH. That will give you about 50 children in a year. That is big as far as cancer in children is concerned in Nigeria. To nurse one child with cancer, you need about N2 million on the average in a period of about two years.

Types of childhood cancers

The most common childhood cancers accounting for childhood deaths in Lagos  include kidney cancer (nephroblastoma) and blood cancer (Acute lymphoblastic leukemia and Acute myeloid leukemia)

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Lymphomas (solid cancer of white blood cells) are also quite common childhood malignancies and neuroblastoma (cancer of nerve cells), others include leukemias, bone and muscle tumors.

Causal or pre-disposing factors

The cause of most childhood cancers are unknown in about 75-90% of cases, 5-15% are due to familial and genetic factors( intrauterine viral infections, parental occupational/ radiation exposures, war-torn regions and disasters, elderly maternal age above 35, parental especially maternal smoking and alcohol consumption.

 

and <5-10 % are due to known environmental exposures and exogenous factors (food, radiation, dyes, infections like intrauterine viral infection Epstein-Barr virus and leukemias/ lymphomas etc). It’s important though to note that cancers generally are caused by a variety of factors and are not limited to a single causative agent.

How to recognize childhood cancers early

Complaints about any of the following that does not go away in a child:

  • Feeling of an unusual lump or swelling
  • Unexpected paleness and loss of energy
  • Easy Bruising
  • An ongoing pain in one area of the body
  • Limping
  • Unexplained fever or illness that doesn’t go away
  • Frequent headaches, often with vomiting
  • Sudden eye or vision changes
  • Sudden unexplained weight loss

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Prevention of childhood cancers

  1. Avoidance of chewing or smoking tobacco.
  2. Protection from sunlight.
  3. Limiting fats in diet
  4. A healthy diet with at least 5 portions of fruits and vegetables per day.

Management of childhood cancers

Childhood cancers are managed by a team of specialized pediatric cancer care specialists, including pediatric oncologists, pathologists, radiologists, surgeons, radiotherapists, nurses and support staff include the nutritionist, social workers, pharmacists and other medical specialists. First, a correct diagnosis is made; depending on the stage of the disease from Investigations carried out, the child is given drugs,  and surgical intervention or radiation therapy may be necessary.

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The challenges in pediatric cancer are numerous but surmountable if there is the will. These are

  1. Recognition of symptoms by parents
  2. Time of presentation/ late presentation
  3. Lack of funds by caregivers
  4. Limited diagnostic equipment/ facilities
  5. High cost of diagnostic investigations
  6. High cost of treatment
  7. Effects of cytotoxic drugs/radiation therapy
  8. Lack of political standing of their own as such children are forgotten in most policies.

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The above challenges can be solved if

  1. Adequate awareness is provided about childhood cancers
  2. Children are exclusively included in the NHIS
  3. Funding is provided for research into childhood cancers
  4. Facilities for diagnosis and treatment are provided.
  5. Provision of psychological support and social welfare services.

In summary

Childhood cancers are a source of significant burden to the child, parents, and caregivers; as such a lot of support is needed; financial, psychological, and spiritual. The distress from the disease, the financial implications, and stress of accessing treatment including the toxicity of the cytotoxic agents is of significant concern, however, children are more likely to recover from cancers when they are detected early and commenced on therapy as quick as possible.

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Dr. Azeezah Shopeyin graduated from the University of Lagos, college of medicine.With several years experience, she also has a master degree in public health. She’s interested in health education and promotion. She’s a wife and mother of two kids and she enjoys making people happy,

Dr. Ajayi Abass Oluwaseyi graduated from Ahmadu Bello University in Zaria. Also known as Juggernaut bn Yusuf, he is also a writer, an aspiring Neurosurgeon, and a Farmer. He currently works at the federal teaching hospital in Gombe.

ENGAGING CANCER

Cancer starts from errors in coding as a result of mutations which could occur naturally by heredity when cells are multiplying or induced by an external agent

Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. Not all tumors are cancerous and benign tumors do not spread to other parts of the body.

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Today, millions of people will march all over the world to commemorate the world cancer day. Irrespective of our religion, tribe, nation and political views, this is the day we highlight to fight this menace that has claimed the lives of millions and shattered the hope of many families.

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To explain cancer in simpler terms, biology has taught us all living things are made up of cells, be it unicellular (one) as the case of some microorganisms and multicellular (plenty) as the case of humans. The cell is the basic unit of life. Our cells contain the genetic material “genes” located in the DNA. These genes are made up of simple coding which defines the function of the cell.

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 The interactions of these gene replaces cells when they are damaged or need to grow. These lead to the formation and functionality of tissues, organs and different systems in our body. Just like a computer, made up with various coding and algorithms which help different softwares to work and at the long run function in tandem as a computer.

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Cancer starts from errors in these coding as a result of mutations which could occur naturally by heredity when cells are multiplying or induced by an external agent. Basically, these mutations could occur in genes that control the way cells grow; tumour suppressor genes (TSG) and oncogenes (ONC).

Tumour suppressor genes function like a break system in a car, it halts the growing of cells while oncogenes function like the accelerator of a car, maintaining the speed or rate at which cells multiply. When either of TSG and ONC is affected, what will happen is either cells multiplying at an abnormal speed leading to the formation of tumour in an organ. This occur due to the inability of TSG ‘brakes’ to reduce the speed or cells multiplying excessively due to much pressure on the accelerator, the ONC.

Causes of cancer

Some cancers develop when an individual inherits a bad gene with mutations, an oncogene or a tumour suppressor gene from parents. As the person grows, the mutations increase and finally cancer develops at a particular stage in life. It is like buying a bad computer which eventually develops fault during use.

Some viruses induce mutations in the coding in these genes leading to cancer. Similar to the way viruses attack our computers leading to the deletion of some important files on the desktop leading to software malfunction and sometimes might affect the hardware.

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Carcinogens, chemical agents like benzene that can cause cancer when inhaled or consumed can also induce mutations. It is like using a computer to visit bad websites with malwares, installing fake applications or software that is incompatible with your computer. Also, some environmental factors like exposure to radiation can lead to cancer.

Life style, practices such as smoking can contribute to the induction most cancers. This is similar to personal choices you make with your computer at your own risk, removing a flash drive inappropriately, shutting down your computer unexpectedly or using your computer in an environment where liquids could spill on it. These practices can crash your computer just as a smoker is liable to die young either by lung cancer or other respiratory disorders.

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Another key risk factor that could initiate cancer is aging. The processes that control cell reproduction malfunctions. This lead to accumulation of toxic reactive oxygen species that damage mitochondria (cell engine). For example, reactive oxygen species above normal levels can oxidize our DNA.

The cure, Our Hope

Although we have been blessed with an immune system that could detect and destroy cancer cells, many cancer cells are well equipped to survive and evade these cells. Scientists are left with the option of finding cures for cancer, however, every cancer seems to be different, making it difficult to cure all cancers with one drug. Also, cancers can be well-managed and prevented, telling us cancer is not a death sentence.

Early detection, you can revive a computer which is dragging or slow as a result of malware or viruses. Install an antivirus as quick as possible, there you go. Taking your car to a mechanic when it flashes check engine, when you notice the grip of the brake has reduced or when the clutch smells will definitely prevent a sudden disaster when driving.

As well, early detection of cancers will significantly increase the chances of survival. Doctors would administer different form of therapies just like an antivirus in a computer. Cancerous cells would die and in many cases total remission could occur. However, successfully scanning and deleting the virus on your computer does not assure you your computer can not be infected again, hence, Cancer patients who are in remission can also have reoccurrence.

Some cancers are gender specific, some are age specific, like prostrate cancer and there are recommendations for when to start detecting them.

Positive lifestyle, practices such as eating fruits and vegetables, exercising, quitting smoking, maintaining a clean environment and avoiding junks can reduce the risk of cancer. Recent studies have discovered that processed meats, canned foods, over cooking food such as brown bread could cause cancer.

The Future, Cancer will one day be treated like any other disease with significantly reduced mortality rate. The approach to getting a cure is like traffic rules, using camera speed checkers on the road to prevent excessive speeding of cars and arrest those who over-sped by giving them a surprise ticket when they get home. We would one day detect and arrest rouge cells before the progression of cancers. The use of bumps on roads to prevent over-speeding and also slow down drivers, we are already slowing down the rate at which ONC drive our cells to induce cancer. In the nearest future, our immune system will boosted and trained to apprehend bad drivers of our genes.

Mahmud Abdullah Opekitan attended Obafemi Awolowo University, Ile-Ife, Osun state, Nigeria between 2008 and 2011 bagging a B.Sc Hons Microbiology with a Second Class, Upper Division. He Also has a Master of Biomedical Science degree in Biomolecular Science- With Distinction. He’s currently wrapping up his Phd in Cancer Biology from Strathclyde Institute Of Pharmacy And Biomedical Sciences. 

Breast cancer

What is breast cancer?

Breast cancer starts when cells in the breast begin to grow out of control. These cells form a tumor that can be seen via radiological imaging or felt as a lump. The tumor is malignant (cancerous) if the cells can grow into (invade) surrounding tissues or spread (metastasize) to distant areas of the body. It is said to be benign if it cannot grow beyond the breast.  Breast cancer occurs almost entirely in women, but men can get it, too.

A woman’s chance of being diagnosed with breast cancer is about 1 in 233 when she’s in her 30s and rises to 1 in 8 by the time she’s reached 85. There’s no connection between the size of your breasts and your risk of getting breast cancer, however, women with dense breast tissues tend to present with advanced stages of cancer due to more difficulty in detecting it earlier with clinical breast exams and even mammograms. But all women, regardless of breast size, should commit to routine screenings and checkups.

Types

Most breast cancers begin in the ducts that carry milk to the nipple (ductal cancers). Some start in the glands that make breast milk (lobular cancers)

Roughly 80% of lumps in women’s breasts are caused by benign (noncancerous) changes, cysts, or other conditions. Doctors encourage women to report any changes at all, however, because catching breast cancer early is so beneficial. Your doctor may recommend a mammogram, ultrasound, MRI and/or biopsy to determine whether a lump is cancerous.

Signs and Symptoms

A lump may indicate breast cancer (or one of many benign breast conditions), but women should also be on the alert for other kinds of changes that may be signs of cancer. These include:

  • Swelling
  • Skin irritation or dimpling
  • Breast or nipple pain
  • Nipple retraction (turning inward)
  • Redness, scaliness, or thickening of the nipple or breast skin
  • Discharge (other than breast milk during late pregnancy and lactation) 

Spreading

Breast cancer can spread to underarm lymph nodes and cause swelling there before a tumor in the breast is large enough to be felt. On the other hand, a mammogram may pick up breast cancer that has no outward symptoms at all.

If cancer cells have spread to your lymph nodes, there is a higher chance that the cells could have spread (metastasized) to other sites in your body. The more lymph nodes with breast cancer cells, the more likely it is that the cancer may be found in other organs as well. Because of this, finding cancer in one or more lymph nodes often affects your treatment plan. Usually, a biopsy (surgery to remove one or more lymph nodes) will be needed to know whether the cancer has spread there.

Still, not all women with cancer cells in their lymph nodes develop metastases, and some women can have no cancer cells in their lymph nodes and later develop metastases.

In those with distant spread of the disease to the bones, lymph nodes, lungs or liver, there may be bone pain, swollen lymph nodes, shortness of breath, or yellow skin and eyes respectively 

Family History

Most women diagnosed with breast cancer have no identifiable risk factors for the disease. But the family-history risks are these: If a first-degree relative (a parent, sibling, or child) has had or has breast cancer, your risk of developing the disease approximately doubles. Having two first-degree relatives with the disease increases your risk even more.

Risk factors

  • Linkages have been noted between exposure to artificial light at night (LAN), suppression of pineal melatonin production and breast & prostate cancers (BC&PC) in humans
  • Chemicals; polychlorinated biphenyls, polycyclic aromatic hydrocarbons, organic solvents
  • obesity
  • lack of physical exercise
  • drinking alcohol
  • hormone replacement therapy during menopause
  • ionizing radiation
  • early age at first menstruation (<11 years) 
  • Late menopause (>52 years) 
  • having children late (>30 years at first full-term pregnancy) or not at all
  • older age
  • Family history. About 5–10% of cases are due to genes inherited from a person’s parents, including BRCA1 and BRCA2 among others

Myths debunked

  • Claims that underwire bras compress the lymphatic system of the breast, causing toxins to accumulate and cause breast cancer, have been widely debunked as unscientific.
  • Annual mammograms expose you to radiation that can increase your risk of cancer. While it’s true that radiation is used in mammography; the amount is so small that any associated risks are tiny when compared to the huge preventive benefits reaped from the test.
  • Despite their importance for breast cancer screening and diagnosis, mammograms fail to detect around 10% to 20% of breast cancers. This is why clinical breast exams and, to some extent, breast self-exams are crucial pieces of the screening process.
  • Having an abortion does not raise your risk of getting breast cancer. Because abortion is believed to disrupt hormone cycles during pregnancy and breast cancer is linked to hormone levels, numerous studies have investigated a causal link—but found no conclusive evidence for one.
  • Breast cancer is not really preventable. Although it is possible to identify risk factors (such as family history and inherited gene mutations) and make lifestyle changes that can lower your risk (reducing or eliminating alcohol consumption, losing weight, getting regular exercise and screenings, and quitting smoking), roughly 70% of women diagnosed with breast cancer have no identifiable risk factors, meaning that the disease occurs largely by chance and according to as-yet-unexplained factors.

Screening

  • Women who are 50 to 74 years old and are at average risk for breast cancer get a mammogram every two years.
  • Women who are 40 to 49 years old should talk to their doctor or other health care professional about when to start and how often to get a mammogram. Women should weigh the benefits and risks of screening tests when deciding whether to begin getting mammograms at age 40.
  • Self breast examinations

 

Pregnancy

Breast cancers can occur during pregnancy at the same rate as breast cancers in non-pregnant women of the same age. Postpartum breast cancer has worse outcomes including an increased risk of distant spread of disease and mortality.

Diagnosing a new cancer in a pregnant woman is difficult, in part because any symptoms are commonly assumed to be a normal discomfort associated with pregnancy.  As a result, cancer is typically discovered at a somewhat later stage than average in many pregnant or recently pregnant women.

Treatment is generally the same except for radiation which is avoided during pregnancy. Elective abortions are not required and do not improve the likelihood of the mother surviving or being cured.

Psychological aspects

The emotional impact of cancer diagnosis, symptoms, treatment, and related issues can be severe. Cancer support groups which provide a supportive environment to help patients cope and gain perspective from cancer survivors are very important.

Not all breast cancer patients experience their illness in the same manner. Factors such as age can have a significant impact on the way a patient copes with a breast cancer diagnosis.

Management

The management of breast cancer depends on various factors, including the stage of the cancer and the age of the patient. Increasingly aggressive treatments are employed in accordance with the poorer the patient’s prognosis and the higher the risk of recurrence of the cancer following treatment.

Breast cancer is usually treated with

  • Surgery with any or combination of the two below
  • Chemotherapy including  Hormone therapy
  • Radiation therapy
  • Immune modulators

A multidisciplinary approach is preferable and usually employed.

Surgery involves the physical removal of the tumor, typically along with some of the surrounding tissue.

Standard surgeries include:

  • Mastectomy: Removal of the whole breast.
  • Quadrantectomy: Removal of one quarter of the breast.
  • Lumpectomy: Removal of a small part of the breast.

Once the tumor has been removed, if the patient desires, breast reconstruction surgery, a type of plastic surgery, may then be performed to improve the aesthetic appearance of the treated site. Alternatively, women use breast prostheses to simulate a breast under clothing, or choose a flat chest. Nipple prosthesis can be used at any time following the mastectomy.