Now what? Dealing with a Breast Cancer Diagnosis
A Woman's Guide to Navigating her Treatment Options
© Anne Meade Stockdell-Giesler
Sep 5, 2008
American women are very familiar with the pink ribbon that symbolizes breast cancer research. In fact, most American women know of someone affected by the deadly disease. But when the diagnosis comes, there are sure to be questions. This article discusses some important questions each woman needs to have answered by her doctors to ensure that she is informed about her care.
First: what kind of cancer is it? There's more than once kind of breast cancer, and treatment varies. The most common kind is invasive ductal carcinoma, which accounts for 70 percent or more of all breast cancers, according to the Mayo Clinic (http://www.mayoclinic.com/health/breast-cancer/HQ00348). Also, whether a cancer is estrogen-receptive or HER-2 positive will affect treatment choices.
Second: what surgical options are there? Radical mastectomy is becoming increasingly less common. Many women will be able to have a lumpectomy, which simply removes the cancerous lump and spares much of the breast tissue. Some women will have a mastectomy (full removal of the breast), some will have lumpectomy, and still others, depending on family history and stage of the disease, may have a bilateral mastectomy.
Third: what stage is the cancer? This is usually not determined for sure until after surgery (whether it's lumpectomy or mastectomy). Stages vary from 1 to 4, with 4 being the most severe. Stage 4 cancers have metastasized (spread to other parts of the body). Stage 1 cancers are generally thought to be in the earliest phases and are the easiest to treat and cure. As the cells become more poorly differentiated and tumors grow, the stage number increases. What stage your cancer it is--how widespread and advanced it is--will have a bearing on treatment options.
Fourth: what happens after surgery? Breast cancer is dealt with in three primary ways (though not every patient will have all three treatments): surgery, chemotherapy, and radiation. Surgery treats the tumors where they live and removes them from the body. Chemotherapy, which often goes on for 4-6 cycles, works by introducing drugs which will travel the bloodstream, killing fast-growing cells which include cancer cells, as well as hair growth cells (which is why so many chemo patients lose their hair!). Sometimes chemo is administered every one to three week, or orally, over a period of months. Radiation is a bit more localized than chemotherapy, where x-ray technology is used to treat the areas around the breast (such as lymph nodes and chest wall) to kill off any stray cancer "seeds" that may have been traveling from the tumor site. Radiation treatment happens daily (5 days/week) for a number of weeks. Patients who have more advanced cancers, or those who are young, will frequently have all three of these treatments.
Fifth: what about after treatment? Depending on the type of breast cancer, patients may be treated with other drugs such as hormone-blockers that prevent the patient from producing estrogen (for those with estrogen-sensitive cancer). These drugs will initiate menopause in pre-menopausal women.
These are just a few of the important questions that women with a breast cancer diagnosis should ask. Perhaps even more important is the support system--the medical team, family, and friends who will help the patient through the various phases of treatment, which can be lengthy and tiring. The good news is that treatment for breast cancer is getting better all the time, and patients who arm themselves with information and a good support system will be primed for many years of life after cancer.
