Breast Cancer: The most important facts

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Sometimes, it can seem as though breast cancer is everywhere: everyone knows someone, everyone’s family is touched by it. The chord struck by breast cancer is evident in the avalanche of pink ribbons that’s everywhere from the Internet to our streets, and the many stories of those who have survived as well as tributes to those who did not. There are many spin-offs from this high level of public awareness, and one of them is ready funding for more research, which is showing great results. But even though the general public may be more aware of “breast cancer” than is true for most other forms of cancer, international research shows that most women who have been treated for breast cancer, do not know what kind of tumour they had. Yet from any doctor’s point of view, this is first-ranking information! Momentum Health’s JUMP magazine recently interviewed some top South African breast cancer specialists to find out what they regard as the most important facts about breast cancer (see Issue 1, 2015). So here’s what you should know: * Don’t panic. The great majority of lumps that appear in breast tissue are not cancer. But don’t ignore a lump either – expert advice is needed to determine whether or not you need further treatment. * Like any other cell, a cancer cell has its own specific programming which tells it how to behave: its genetic material or DNA. This includes the likelihood of spreading to other organs, the speed at which it grows and divides to form new cancer cells, and even how it will respond to various forms of treatment. That’s another reason to get immediate expert help, because no matter how small it may be, an aggressive tumour will soon become a much worse problem. * Patients should know about the four main types of breast cancer and the treatment you can expect for each one – if you are able to catch it at an early stage. 1. Luminal A: The most common type affecting around 70% of patients and especially older women. Treatment is by cutting off the supply of oestrogen (female hormone) that feeds it; you’ll be on anti-oestrogen medication for up to five years but you won’t need chemotherapy or any other treatment. 2. Luminal B: This less common type also needs oestrogen to thrive but can continue to grow without oestrogen, so in addition to anti-oestrogen medication you will be offered a course of chemotherapy to achieve a better result. 3. HER2: This is a form of breast cancer that usually has a family history. It is treated – with much success – by a combination of chemotherapy and “molecular therapy” targeted specifically...

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Know your cancer, beat your cancer

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Breast cancer patients tend to be a well informed bunch, who turn up to medical appointments with print outs and well considered questions. However, a recent study in California found that only a small minority of breast cancer patients understood all the key aspects of their tumours. The stage, grade and sensitivity of your tumour determines the type of treatment you will have. Whilst thorough patient education would not necessarily change the outcome of the treatment in a direct way, it is likely to improve the patient’s experience of that treatment as well as her ability to stick with it. All of this key information is available soon after you have your first surgery. Staging indicates the spread of the tumour – how big it has grown as a single clump of cells, and/or how much it has been able to travel to other areas. Sensitivity to Oestrogen (Estrogen in America), to Progesterone and to Epithelial Growth Hormone or HER-2 is a key element of treatment because if cancer cells need these hormones for “fuel” then by blocking the hormones the growth of the cancer cell will also be blocked. Grading refers to the general aggressiveness of a tumour. If it’s made up of cells that are fairly similar to the healthy cells around it, but different to cells in other body organs, that is a low grade, less aggressive cancer. Cells that are more abnormal – more dedicated to being a cancer cell than to the function of the tissue they’re in – are higher grade and more aggressive. Knowing more about your cancer enables you to feel “part of the team” and to take more responsibility for your treatment, as well as to know what questions you want to ask (or not ask). This will ease your stress – you’ll feel much less helpless – and may help you deal with difficult side effects of the treatment such as hormone changes or chemo side effects. For most people today, the idea that “doctor knows best” is no longer enough. We want our doctors to be experts but we want to be knowledgeable as well! For doctors, this means that patient education is an important part of the treatment, time consuming as it may be. Just a treatment is individual – there is no “one size fits all” in breast cancer – so patient education also needs to be individualised. The level of explanation that is helpful for a University professor isn’t likely to be as helpful for a domestic worker, but both women need to be as informed as they can about what’s going on with the cancer and the process of treatment. There’s good news for...

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Dr Linda Whitelock-Jones

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Dr Linda Whitelock-Jones MBChB (UCT) FCS.SA MMed Surg Linda is a surgeon practising in Port Elizabeth with a regular clinic in Jeffrey’s Bay. She has a special interest in medically indicated breast surgery (including reconstructions) and management of burn injuries. Her consulting rooms are at 5 How Avenue, Centrahil, Port Elizabeth and you can contact her on 041 450 0196 or by email Linda (dot) Whitelock-Jones (at) breastsurgeonpe (dot) com. Linda is married with two children and lives in Port Elizabeth. Read Posts by Linda...

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Sally Davies

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Sally Davies is a registered Clinical Psychologist and an accredited Divorce Mediator. She offers individual, couple and family therapy.  She has a special interest in Health Psychology and consults with people undergoing surgery or with chronic pain. She also runs individual and group sessions (Living Light) for those struggling with eating, body image or weight issues. Her consulting rooms are at 5 How Avenue, Central, Port Elizabeth and you can contact her on 041 450 0196 or at help@sallydavies.co.za.   Her website is http://www.sallydavies.co.za. Read Posts by...

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