Cancer Interview

      I had the privilege to interview a former breast cancer patient. She is currently 50 years old, and her cancer was diagnosed when she was 44. She first noticed that she had cancer when she noticed a pea-sized lump during a self-examination. She later confirmed it was cancer with a mammogram, ultrasound, and biopsy. She also had an MRI to ensure that the cancer had not spread. Other than the lump, she had no symptoms. Her initial reaction was terror, followed by extensive amounts of research. Her treatments included lumpectomy, bilateral mastectomy, lymph node biopsy, 6 weeks of radiation, and hormonal treatment with tamoxifen. The radiation killed leftover cells on her chest, and the tamoxifen is a systemic treatment that binds with estrogen receptors on the cancer cells which then prevents cancer cells from growing. Side effects from her tamoxifen were leg cramps and hot flashes which caused sleep disruption. She also had slight memory problems caused by the tamoxifen. Through her entire cancer ordeal, she learned to appreciate time with family and friends more, and she grew closer to those who supported her. Some misconceptions about cancer are that cancer is always curable and the idea that people must have done something wrong to get cancer. Another big misconception is that mammograms can detect all breast cancer. Her piece of advice is to check your family history and if cancer runs in the family, you need to be getting periodic MRI scans because mammograms sometimes can’t detect cancer in younger women. Also it is crucial to get exercise, eat vegetables, drink alcohol moderately if at all and avoid smoking. 

Then, I did some research. I learned that there are two main types of breast cancer:

1. Ductal carcinoma in situ (DCIS). This is the most common type of non-invasive breast cancer. The word "ductal" refers to the location that the cancer starts, the milk ducts (as seen in the picture below). "Carcinoma" refers to all types on cancer that occurs in the tissue that lines organs. "In situ" means "in its original place." This type of cancer is label "non-invasive" because it is only in the milk ducts, and hasn't begin to spread to the rest of the breast. DCIS by itself isn't life-threatening, but it has a risk of developing into an intrusive cancer, which is very life threatening. Also, DCIS patients are at higher risk of the cancer returning, which is why my interviewee opted for a mastectomy.
2. Invasive (or infiltrating) ductal carcinoma. This type of breast cancer is the overall most common and is the type that afflicted my interviewee. Again, this cancer starts in the milk ducts, but unlike non-invasive, the cancerous cells tear through the ducts and grow into the fatty tissue in the breast. From there, it can spread to other parts of the body and be possibly fatal. This is why my interviewee must take tamoxifen for 10 years after her surgery: to prevent the cancer from metastasizing in other organ tissues such as bones or liver. Some patients with more aggressive forms of cancer must also undergo chemotherapy treatments. Chemotherapy is effectually a poison that targets fast growing cells such as cancerous ones. Unfortunately, chemotherapy can have terrible side-effects that can danger the life of the patient. Fortunately, my interviewee had a cancer that was determined through an Oncotype DX test of the tumor to not require chemotherapy.

Some breast cancer is hereditary, which means it is inherited. There are genetic tests that can detect only a limited number of those hereditary types, specifically those associated with the brca I and brca 2 genes. Other than having it in your genes, there are no clear causes of breast cancer, it is mostly bad luck. It could be generated by random mutations during cell division.  The reason people get breast cancer is because of the cell cycle. All cells in the body are regulated by the cell cycle, so if something goes wrong during the cell cycle, it can cause immense damage. The breast tissue of women are extremely sensitive to cancer causing agents. During the cell cycle, a cancer causing agent inflicts damage upon the DNA, or "mutates" it. The result can be a DNA strand with missing base pairs. These missing bases can lead to cancer. Another mutation that occurs is when the cancer causing agent takes over a base, causing an incorrect pairing. As my interviewee stated, the best prevention of breast cancer is to get exercise, have a heathy diet, and avoid smoking and alcohol.

Some other interesting and alarming facts regarding epidemiology I learned about breast cancer include:

• Breast cancer is the most commonly diagnosed in women, but men are still susceptible, with 2,150 men diagnosed and 410 dead because of it each year
• Breast cancer is the 2nd biggest cause of death in women, heart disease being 1st
• Of the 220,000 women diagnosed with breast cancer each year, 40,000 will die of it

But HAVE FAITH! Deaths due to breast cancer have been slowly decreasing since 1990 due to better detections and treatments, and is expected to decrease more as technology improves.

This experience was very eye-opening to me, because I never realized how much cancer effects someone's life. I am also very thankful that my interviewee was able to discover her cancer before it was serious. Cancer, now more than ever,  acts as an enormous dissuasion for me to stay away from not only smoking, but also alcohol.


Sources:

http://www.nationalbreastcancer.org/
http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-breast-cancer-types
http://www.breastcancer.org/