Archive for the ‘breast cancer screening’ Category

Living With Cancer: What to Expect After the Diagnosis

Wednesday, May 25th, 2011

Alicia Staley - Cancer Survivor - Visual (Image from her site - awesomecancersurvivor.com

About a million and a half people will be diagnosed with cancer in the U.S. this year. The devastating truth about cancer is that about one-third of these people will die from cancer at some point. For most, the diagnosis is unexpected and completely overwhelming.The cancer does not just affect how one feels, it undermines all sense of security and stability. It changes lifestyles and redefines relationships. So often the emotional trauma is equally shared among family members and loved ones.

Needless to say, the original cancer diagnosis marks the beginning of a difficult, frightening and frustrating experience. For this reason, it is critical not to despair. One must always remain hopeful, adjust, and prepare for the way to recovery. A fundamental step in this process is gaining an understanding and familiarity with the impending medical treatment and associated lifestyle changes. A good deal of stress can be avoided by simply understanding what to expect. While cancer treatment varies depending on the type of cancer and the individual characteristics of the patient, the patient should generally be aware of the following:

Chemotherapy

The vast majority of cancer patients will receive some degree of chemotherapy. This may consist of one or more chemotherapy cycles.  Each cycle can be as long as 3-6 months. Chemotherapy involves the administration of various chemical agents called antineoplastic drugs in order to stop cancerous cells from dividing. Antineoplastic drugs are designed to attack and kill cells that divide in an uncontrolled or rapid matter. Antineoplastic drugs, however, are not able to discriminate between cancerous cells and normal cells. Therefore, cells that divide rapidly as part of their normal life cycle are also attacked. Chemotherapy may cure the cancer entirely or control its growth. Many times, chemotherapy is used in conjunction with other treatments. Some associated complications of chemotherapy include:

  • Anemia
  • Hair Loss
  • Lethargy
  • Nausea and loss of appetite
  • Kidney damage
  • Liver damage
  • Heart damage
  • Deterioration of pre-existing medical conditions such as osteoarthritis, among other things.

Radiation Therapy

In addition to chemotherapy, a patient may also receive radiation therapy. Radiation therapy involves exposing cancerous tissue to ionizing radiation (electromagnetic waves), which tends to destabilize the molecular structure of cancerous cells. In essence, the electromagnetic waves will ionize the atoms of the cancerous cells, by displacing electrons within the inherent structure of the atom. In turn, this process destabilizes the molecules of the cancerous cells, causing them to die.

Surgery

In a number of instances, cancer patients will also require surgery to treat their cancer. Often times, the malignant tumor is identifiable and localized (as opposed to metastasized). In such instances, timely surgery is preferred. Chemotherapy of radiation therapy may follow the surgery. The type of surgery  will vary depending on the type of cancer and how advanced it is. For example, a woman with ovarian cancer will likely undergo a total hysterectomy, including the removal of the ovaries. A patient with intestinal cancer may undergo a laparotomy with dissection of the cancerous tissue. Generally speaking, the sooner the cancer is identified, the less extensive the surgery.

Monitoring

After surgery and chemotherapy/radiation therapy, each cancer patient/cancer survivor should establish a systematic and well developed course of monitoring and supportive care with his/her physician. This will often involve a number of other health care providers such as physicians, nurses, and physical therapists. For example, a patient who has undergone treatment for ovarian cancer may require monitoring by an oncologist, a surgical oncologist, an internist (primary care physician), a gynecologist, and even a urologist. One must then factor in the extent to which the cancer treatment resulted in additional complications or the extent to which pre-existing medical conditions deteriorated as a result of the cancer treatment. As such, the patient may require the involvement of additional specialists to address and monitor the side effects of the cancer treatment. It is very important that the patient maintain a healthy nutrition and exercise regimen, if and as prescribed by the physician.

The bottom line is that cancer patients will invariably have a long and difficult road to recovery, which may take months or even years. Drastic lifestyle changes may be necessary, and patience as well as perseverance are essential. A cancer patient must know what to expect and be proactive to create support structures involving health care providers and family members/loved ones.

Helping Others in Need

If you or someone you know is a cancer patient/survivor, I encourage you to share your story with our readers. What helped you most to cope and persevere on your way to recovery?

Related Posts:

Ovarian Cancer: Five Tips to Get the Medical Care You Need

Ovarian Cancer: Early Intervention is Key – What You Must Know…

Breast Cancer: What You Need to Know About Digital vs. Film Mammograms

Warning to Women of Menopausal Age: HRT Linked to Increase in Death From Breast Cancer

What you need to know about digital vs. film mammograms

Tuesday, February 22nd, 2011

In a recent report published in the journal Radiology, the findings of a research group from Barcelona, Spain, provided women and the medical community with some key information about the use and efficacy of digital mammography. As reported in DoctorsLounge, the researchers, headed by Maria Sala, M.D., Ph.D, concluded that digital mammography had a lower false-positive rate than screen-film mammograms; however, there was “no significant difference in the cancer detection rate between the two, according to [the] study.”

If you are unfamiliar with this new technology, here’s a video presented by WellSpan HealthSource. See what they believe some of the benefits are for digital mammography.

httpv://www.youtube.com/watch?v=_TLhjsFeQDg

Here’s the statistical information regarding false-positive and detection rates between these two modalities of mammograms.

The researchers found no significant difference in the cancer detection rate between the two modalities, with the screen-film detection rate at 0.45 percent and digital at 0.43 percent. The false-positive rate for screen-film mammography was 7.6 percent but for digital mammography the rate was 5.7 percent. Digital mammography also had lower recall rates and was less likely to result in a false-positive result leading to an invasive procedure. The lower false-positive risk remained even after results were adjusted for women’s characteristics, screening program characteristics, and time trends.

Who should undergo digital mammography?

Dr. Michael Wu, of the Palo Alto Medical Foundation, has an informative post on the issue of who the best candidates are for digital versus film mammography. He gives a synopsis of the groups, as reported by The New England Journal of Medicine, who are the best candidates to undergo digital mammograms.

Those who benefited:

  • Women < 50
  • Women with dense breast tissue
  • Women who were premenopausal or perimenopausal.
  • Those who did not appear to benefit:

  • Women > 50
  • Women post-menopausal
  • Those without dense breast tissue
  • Dr. Wu’s post also addresses issues such as cost effectiveness and radiation exposure differences between the two methods of digital and film mammograms. What may be of interest to many women is that the actual technique (which I understand can be painful for many women) is the same. Perhaps further development of devices and systems will lower this problem – hopefully – in the future. Needless to say, the discomfort for 20 – 30 seconds is far outweighed by the benefits of early detection of breast cancer.

    3-D Mammogram recently approved by FDA

    It was also recently reported by PRNewswire that the FDA recently approved the first 3-D digital mammogram (tomosynthesis scans) system. Hologic, Inc., a leader in the development, manufacturing and distribution of medical devices, including medical imaging systems and the company whose system won this approval, ran a series of clinical trials using this new 3-D mammography system.

    Undoubtedly beaming with joy over having his company’s product be the first to be approved, Rob Cascella, President and CEO of Hologic, has this to say about this new medical weapon in the fight against breast cancer:

    Our Dimensions 3-D takes advantage of all of the benefits of digital mammography and quite simply makes it better with the combination of fast, high quality 3-D breast imaging. We believe tomosynthesis has the potential to change how screening and diagnostic mammography is performed, and over time will prove invaluable to the earliest possible detection of breast cancer and in the reduction of unnecessary diagnostic interventions.

    it will be very interesting to see if the recent study in Spain by Dr. Sala and his colleagues is taken further by his group or other researches to examine whether this newer 3-D technology will further change the landscape in lowering false-positive rates or – even more important – increasing the early detection rate for breast cancer.

    Some basic, highly disturbing facts about breast cancer:

    The PRNewswire release also provides the following information about breast cancer:

    One in eight American women will develop breast cancer sometime in her lifetime. In 2009, an estimated 192,370 new cases of invasive breast cancer were diagnosed among American women, as well as an estimated 62,280 additional cases of in situ breast cancer. Over 40,000 American women died from breast cancer in 2009. Only lung cancer accounts for more cancer deaths in American women. The stage at which breast cancer is detected influences a woman’s chance of survival. If detected early, the five-year survival rate is 98 percent. At this time, there is no sure way to prevent breast cancer, which is why regular mammograms starting for most women at age 40 are so important.

    This video by one of the country’s premier institutions for cancer treatment, MD Anderson Cancer Center, provides some very useful information and some excellent suggestions for undergoing a mammogram.

    httpv://www.youtube.com/watch?v=Y-GmNmPeqHQ

    Readers’ Information

    There is no doubt that many physicians, researchers and women have exceedingly superior knowledge of these techniques, systems, risks and benefits, and the like. Have any of you been involved in this research? Have you  had or do you know someone who has undergone digital mammography? What information can you share with our readers about this new technology? We invite you to share this information and spread the word by sharing this post with you friends. As we always say, being an informed patient is essential to improving your health and survival.

    CT Scans – Are You Being Properly Protected Against Radiation?

    Thursday, December 2nd, 2010

    According to new research presented at the annual meeting of the Radiological Society of North America, breast shields should be used for men and women undergoing CT scans of the chest/lungs. According to Terry Healey, M.D., Director of thoracic radiation at Alpert Medical School of Brown University, the breast shield is capable of reducing the level of radiation by about 30%.  This is significant considering that radiation can cause or contribute to the development of various malignancies (e.g. breast cancer, lung cancer, esophageal cancer).

    Although some physicians argue that the use of breast shields may impact the quality of the CT scan (i.e., by producing artifacts such as streaks or lines making the interpretation of the study more difficult), this new research suggests that the use of breast shields does not impact the diagnostic quality of the CT scan. A breast shield is nothing more than a thin piece of heavy metal placed in front of the chest during the CT scan procedure.

    Researchers studied 50 patients, who needed CT scans of the chest. Most of the patients were undergoing the study to rule-out lung cancer.  For some patient the shield was placed directly on the chest. For other patients, the shield was slightly elevated from the chest surface. Overall, some artifact was present in about 2/3 of the cases. However, in the opinion of the researchers, there were no instances where the artifact interfered with the diagnostic quality of the radiographic study.

    According to Judy Yee, M.D., vice chair of radiology at the University of California: ”[T]here’s no good reason not to use breast shields. The cost is relatively low and the benefit large.”

    Perhaps a larger patient population is needed for the results of this research to be more widely accepted by the radiology community. We’d appreciate anyone who has experience in this field to share their thoughts on this topic. Do such shields cause artifact that makes the study less accurate and potentially dangerous to a patient? Does the accuracy of the scan, when a shield is used, depend on which type of scanner is used or which generation of scanner is being used? Are there other techniques that can be used to protect a patient yet not run the risk of artifact “mis-read”? We’re not physicians or radiology technicians, so we welcome any insights those who are might have on this topic.

    If you are concerned about excessive radiation and need to undergo a chest CT, ask your radiologist if a protective shield can be used during your CT scan. Discuss the issue and – as we always stress – take charge of your own medical care. Be an informed patient and be responsible for your own health and safety. Know what the issues, risks and benefits are and discuss it with your doctor. Then – and only then – make an informed decision.

    Image from emedicine.medscape.com

    Mammography the “Australian Way” – Why aren’t we doing this in the US?

    Wednesday, November 17th, 2010

    I came across an online article today by Marianne Betts of heraldsun.com.au that there was a problem regarding mammogram reports that had gone out to over 5,000 women who recently had this test performed. There was apparently a breakdown in their review process, which required massive notifications to the women involved.

    While this is no doubt very serious business for all concerned, I decided to post this blog for an entirely different reason. I simply was not aware that in Australia, two radiologists read mammograms independent of each other as a normal practice.

    A senior radiologist, Professor Jenny Crawson, is quoted as saying that this standard practice of two separate, independent radiology reads (i.e. interpretations) is standard practice in Australia was a “proven success.”

    The article goes on to report that with this practice, if both radiologists agree the images are “clear” (no evidence of detectable suspicious lesions/cancer), then the patient is given the “all clear” notification. However, if they disagree, the opinion of a third radiologist is sought.

    Dr. Cawson is then quoted to say:

    There’s a lot of  scientific evidence that if you have two radiologists reading mammograms you have a higher detection rate of breast cancer than if you have one radiologist.

    So it’s a quality assurance mechanism to maximise cancer detection.

    Have any of you heard of this practice being followed anywhere else? Anywhere in the United States? Is anyone aware if this program or practice has been studied in the United States or elsewhere in terms of effective higher detection of breast cancers? If we are not doing this (which I’ve never heard of) here in the US, why not? Cost?

    I would really like to hear what you know about such a practice.

    Image from norwalkradiology.com

    Wrapping-up Breast Cancer Awareness Month – It’s a Year-Long Battle – Don’t Forget!

    Friday, October 29th, 2010

    This year we saw the NFL and White House go pink in honor of Breast Cancer Awareness month.  As the 25th year of Breast Cancer Awareness month comes to close, it’s incredible to look back and see how far we have come over the past 25 years in promoting awareness and early detection as well as in the advances in treatment of this disease.

    Cases of breast cancer are documented throughout history with the earliest reports dating back to Ancient Egypt in 1600 BC.  However, it wasn’t until the 17th Century in Europe that an understanding of the disease began to take place.  It was during this time that the first surgeries to remove the breast tumor, breast muscle and lymph nodes were performed to eradicate the disease from the body.  In 1882, William Stewart Halsted performed the first mastectomy, the Halstead Radical Mastectomy, which remained a popular treatment up until the 1970’s.  While this form of surgical treatment is rarely used today, there are three variations of Halstead’s procedure performed to remove breast tumors: partial mastectomy (also called lumpectomy), modified radical mastectomy, and the rarely used total simple mastectomy.

    The movement to increase breast cancer research and awareness did not take off until the 20th century.  It was in 1952 that the American Cancer Society created the Reach to Recovery program, a group of women who would travel to hospitals to support patients who had mastectomies performed. This program remains in effect today.

    By the 1970’s, breast cancer advocacy began to increase rapidly as more non-profit organizations and governmental organizations formed to increase knowledge and awareness as well as to sponsor research to aid in eradication of the disease. Over the last two decades, major breakthroughs in detection and treatment modalities have been made.

    The first step to early detection was the development of modern mammography in 1969, when the first x-ray units dedicated to breast imaging were available. By 1976, mammography as a screening device became standard practice.  Mammograms are the best radiographic method available today as they can detect tumors that are too small to be felt. To increase early detection the Mammography Quality Standards Act was passed by Congress in 1992 to ensure that all women have equal access to quality mammography for detection of breast cancer in its earliest and most treatable stages as well as to improve the quality of mammography facilities. When breast cancer is detected, modern treatment typically involves a combination of surgery and medical treatment with chemotherapy, radiation therapy and/or hormone therapy.  Advances in such treatments have resulted in increased five year survival rates.  Patients who get treatment in the early stages of breast cancer have a five year survival rate of 80% or better. Despite treatment advances, the most important thing for breast cancer survival is early detection through monthly self-checks and yearly mammogram examinations in women over the age of 40.  Lastly, advances in reconstructive surgery have helped women to feel more comfortable with their body image as well as restore confidence in their sexuality.

    Despite these advances, every 69 seconds someone’s mother, sister, daughter or friend loses their life to breast cancer somewhere in the world.  While major advances in breast cancer detection and treatment have reduced the mortality rate from the disease, we still have a long way to go.

    As Breast Cancer Awareness month comes to a close, we should take a moment to honor and remember those that have battled the disease by reminding ourselves and encouraging our loved ones to perform monthly self-checks and to obtain a yearly mammogram.

    Breast cancer is not a one month a year disease. We need to encourage all women to fight breast cancer twelve months a year.