End Of Life Concerns With Metastatic Breast Cancer
Despite encouraging advances in breast cancer treatment that have dramatically prolonged survival even when diagnosed at a metastatic stage, there still is a significant group of less fortunate patients that die from this condition every year.
The usual scenario goes like this: People with metastatic breast cancer want to talk about these concerns, but are afraid to upset their loved onesso they stay quiet. On the other side, loved ones are afraid of upsetting you by talking about the end of life issuesso they say nothing.
The same holds true even for patients and oncologists, and studies tell us that these conversations take place much less often than they should.
Many people fear these discussions are a sign of giving up. However, talking about your wishes does not mean you are giving up at all. It does not mean that you have lost hope that you will be one of the people who live for decades with stage 4 breast cancer. What it means, instead, is that you want your decisions to be thought out, and not left to chance. It’s a way to communicate your wishes before circumstances may force you to do so.
The best place to start is with the most important step. How can you begin these discussions with your loved ones?
Can Exercise Help Reduce My Risk Of Developing Breast Cancer
Exercise is a big part of a healthy lifestyle. It can also be a useful way to reduce your risk of developing breast cancer in your postmenopausal years. Women often gain weight and body fat during menopause. People with higher amounts of body fat can be at a higher risk of breast cancer. However, by reducing your body fat through exercise, you may be able to lower your risk of developing breast cancer.
The general recommendation for regular exercise is about 150 minutes each week. This would mean that you work out for about 30 minutes, five days each week. However, doubling the amount of weekly exercise to 300 minutes can greatly benefit postmenopausal women. The longer duration of exercise allows for you to burn more fat and improve your heart and lung function.
The type of exercise you do can vary the main goal is get your heart rate up as you exercise. Its recommended that your heart rate is raised about 65 to 75% of your maximum heart rate during exercise. You can figure out your maximum heart rate by subtracting your current age from 220. If you are 65, for example, your maximum heart rate is 155.
Aerobic exercise is a great way to improve your heart and lung function, as well as burn fat. Some aerobic exercises you can try include:
Remember, there are many benefits to working more exercise into your weekly routine. Some benefits of aerobic exercise can include:
Treatment For Stage 1 Breast Cancer
Doctors can offer a variety of treatment options for stage 1 breast cancer, although surgery is the primary treatment.
A lumpectomy or mastectomy are both viable surgical options for people with stage 1 breast cancer. A doctor will decide what surgery is most appropriate depending on the location of the primary tumor, how large it is, the size of the breast, family history, genetics, and the persons preference.
Radiation therapy is a standard treatment for stage 1 breast cancer. However, a doctor may not recommend radiation therapy for people over 70 years old, particularly if hormone therapy is suitable.
If the breast cancer is ER+ or PR+, hormone therapy may be effective. Hormone therapy works by preventing the growth of estrogen, which helps cancer grow. Hormone therapy can reach cancer cells in the breast as well as other areas of the body and reduces the risk of the cancer coming back.
Before recommending chemotherapy, a doctor will test to see whether the cancer is hormone receptive.
If the test results show that the cancer is not receptive to estrogen and progesterone or to another protein called human epidermal growth factor receptor 2 , it is known as triple-negative breast cancer .
Hormone therapy is ineffective against this cancer type, and people who have TNBC will usually need chemotherapy.
Stage 2 breast cancer also has subcategories known as 2A and 2B.
Stage 2A breast cancer is an invasive cancer where:
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Possible Changes In Consciousness
- More sleeping during the day
- Hard to wake or rouse from sleep
- Confusion about time, place, or people
- Restless, might pick or pull at bed linen
- May talk about things unrelated to the events or people present
- May have more anxiety, restlessness, fear, and loneliness at night
- After a period of sleepiness and confusion, may have a short time when he or she is mentally clear before going back into semi-consciousness
How To Check Yourself For Breast Cancer At Home
Breast cancer is one of the most commonly diagnosed cancers among women. Knowing how to check yourself for it can aid in early detection.
About one in eight women in the US will develop breast cancer during her lifetime and aside from skin cancer, breast cancer is the most commonly diagnosed cancer in women. Although death rates from breast cancer have thankfully declined over the last several years, its still important to check yourself for breast cancer.
Because even in a world with high-tech doctors offices and plenty of ways to talk to a doctor online, taking care of yourself starts with you. By setting aside just five minutes every month to do a self exam, you can increase the likelihood of early detection if you do have cancer. The earlier you detect cancer, the earlier a doctor can treat it. And when it comes to breast cancer, early treatment is the key to a good prognosis.
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How Will Hospice Help
Many people are amazed at the help available when hospice is instituted. In addition to care from the team, hospice most often provides a hospital bed, oxygen, and any equipment or medications needed. This can save a lot of running around for your family and make you as comfortable as possible.
Many people want to spend their last days at home, surrounded by loved ones. With hospice care, the police do not need to be called, as they typically do with any “unattended death.” Your family can spend time with you until they wish to call the funeral home.
Breast Cancer Surgery Options
Surgery is usually the first line of treatment for breast cancer unless the tumor is very large or has spread to other parts of the body, in which case chemotherapy may be needed first. The surgical options for breast cancer include breast-conserving surgery and mastectomy. Lumpectomy removes the tumor and some surrounding normal breast tissue, whereas mastectomy removes the entire breast. Which option is best depends on tumor size, breast size, and personal preference, as well as other aspects of the medical history. If mastectomy is performed, breast reconstruction can be done during the same surgery or at a later time.
During the lumpectomy or mastectomy, some of the lymph nodes in the armpit will likely be removed to determine if the cancer has spread . For early breast cancers, sentinel lymph node biopsy is a technique in which the lymph nodes that first drain the breast are identified and sampled. If cancer is not found in the “sentinel” nodes, no additional lymph nodes need to be removed. This has the advantage of faster recovery and less risk of lymphedema .
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Being Recalled To The Breast Clinic Following A Routine Screening Mammogram
About four women in a hundred are called back to a breast clinic following routine screening because they need more tests. This happens more often after a womans first mammogram, usually because there are no other mammograms to compare with. Something that may look unusual on your mammogram may be entirely normal for you, and most women who are recalled for assessment will not have breast cancer.
Sometimes you may be recalled because the image taken isnt clear and needs to be repeated. This is called a technical recall and should be made clear in your letter.
If youve been recalled to a breast clinic after a routine mammogram as part of a national breast screening programme, you should receive a letter within two weeks of your mammogram explaining when your breast clinic appointment will be.
What Are The Different Options For Surgery
Surgery is the most common treatment for breast cancer. Procedures may include:
- Mastectomy: This surgery removes one or both breasts, including the breast tissue, nipple, areola and skin.
- Lumpectomy: Also known as breast-conserving surgery, this operation removes only the cancerous breast tissue while leaving as much healthy tissue as possible. A lumpectomy is not an option for every breast cancer patient.
- Sentinel node biopsy: This is the removal of one or a few of the first draining lymph nodes to determine whether cancer cells have spread beyond the breast.
- Oncoplastic and breast reconstruction surgery: This reconstructive technique reshapes the breast and also may be used to prevent scarring and deformation of the breast.
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How Does The Doctor Know I Have Breast Cancer
A change seen on your mammogram may be the first sign of breast cancer. Or you may have found a lump or other change in your breast.
The doctor will ask you questions about your health and will do a physical exam. A breast exam is done to look for changes in the nipples or the skin of your breasts. The doctor will also check the lymph nodes under your arm and above your collarbone. Swollen or hard lymph nodes might mean breast cancer has spread there.
If signs are pointing to breast cancer, more tests will be done. Here are some of the tests you may need:
Mammogram: This is an x-ray of the breast. Mammograms are mostly used to find breast cancer early. But another mammogram might be done to look more closely at the breast problem you might have.
MRI scan: MRIs use radio waves and strong magnets instead of x-rays to make detailed pictures. MRIs can be used to learn more about the size of the cancer and look for other tumors in the breast.
Breast ultrasound: For this test, a small wand is moved around on your skin. It gives off sound waves and picks up the echoes as they bounce off tissues. The echoes are made into a picture that you can see on a computer screen. Ultrasound can help the doctor see if a lump is a fluid-filled cyst , or if it’s a tumor that could be cancer.
Nipple discharge exam: If you have fluid coming from your nipple, some of it may be sent to a lab. There, it will be checked to see if there are cancer cells in it.
What Are The Cosmetic Results Of Breast Conservation Therapy
Eighty percent to 90 percent of women treated with modern surgery and radiotherapy techniques have excellent or good cosmetic results that is, little or no change in the treated breast in size, shape, texture or appearance compared with what it was like before treatment.
Patients with large breasts seem to have greater shrinkage of the breast after radiation therapy than do patients with smaller breasts. However, this problem usually can be overcome with the use of higher x-ray energies or with IMRT. Partial breast radiation using brachytherapy can also be considered if the patient has a small early-stage tumor. This treatment is still undergoing clinical investigation. Certain single institution studies on brachytherapy and intraoperative radiation have shown some promising results. You would need to discuss this with your doctor before or shortly after surgery to determine if you qualify for partial breast radiation.
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Do I Need Additional Treatment After A Lumpectomy
Cancer doctors typically recommend that women under 70 who opt for a lumpectomy also receive radiation therapy to the affected breast. This is to kill any stray breast cancer cells that remain after surgery and to prevent the cancer from coming back. This approach, also known as breast conservation therapy, has been show to be equally as effective at treating early-stage breast cancer as mastectomy.
MSKs radiation therapy teams are highly experienced in caring for women with breast cancer. We are one of just a few centers with a dedicated and specialized radiation team focused solely on treating breast cancer.
Many women also benefit from drug therapies such as chemotherapy, targeted therapy, or hormone therapy. The goal of all of these treatments is to reduce the risk of breast cancer recurring or metastasizing .
Your doctors recommendations for drug therapy are based on the molecular characteristics of your breast cancer.
Can Cancer Form In Other Parts Of The Breast
Cancers can also form in other parts of the breast, but these types of cancer are less common. These can include:
- Angiosarcomas. This type of cancer begins in the cells that make up the lining of blood or lymph vessels. These cancers can start in breast tissue or breast skin. They are rare.
- Inflammatory breast cancer. This type of cancer is rare and different from other types of breast cancer. It is caused by obstructive cancer cells in the skins lymph vessels.
- Paget disease of the breast, also known as Paget disease of the nipple. This cancer affects the skin of the nipple and areola .
- Phyllodes tumors. These are rare, and most of these masses are not cancer. However, some are cancerous. These tumors begin in the breasts connective tissue, which is called the stroma.
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Transportation Lodging Child Care And Elder Care Assistance
You may not live near the hospital where youll have your surgery.
Sometimes, there are programs that help with local or long-distance transportation and lodging. Some also offer transportation and lodging for a friend or family member going with you.
There are also programs to help with child care and elder care costs.
Learn about transportation, lodging, child care and elder care assistance programs.
SUSAN G. KOMEN® SUPPORT RESOURCES
Breast Cancer Survival Rate
Breast cancer survival rates vary widely based on many factors.
Two of the most important factors are the type of cancer you have and the stage of the cancer at the time you receive a diagnosis. Other factors that may play a role include your age, gender, and race.
shows theres a higher mortality rate in non-white people diagnosed with breast cancer compared with white people. One reason for this may be healthcare disparities.
The good news is breast cancer survival rates are improving.
According to the ACS , in 1975, the 5-year survival rate for breast cancer in women was 75.2 percent. But for women diagnosed between 2008 and 2014, it was 90.6 percent.
Five-year survival rates for breast cancer differ depending on stage at diagnosis, ranging from 99 percent for localized, early stage cancers to 27 percent for advanced, metastatic cancers.
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Treatment For Stage 0 Breast Cancer
There is a variety of treatment options for stage 0 breast cancer, including:
A lumpectomy involves removing cancerous cells from the breast. It is an option when the cells remain in one area. This is a relatively short and simple procedure, and a person should be able to go home after the surgery on the same day.
If cancerous cells appear throughout the breast, the doctor may recommend a mastectomy, which involves removing the entire breast. Plastic surgeons can rebuild the breast at the same time or a later date.
Radiation therapy can help kill cancer cells and inhibit them from spreading. A person will typically undergo radiation therapy once the breast surgery site has healed. This is usually 4-6 weeks after surgery.
The hormone estrogen, found naturally in the body, can impact some types of breast cancer. If a person has estrogen receptor-positive or progesterone receptor-positive breast cancer, a doctor may suggest hormone treatment in addition to surgery.
The person may also require radiation therapy to manage the levels of these hormones in the body.
Stage 1 breast cancer means the cancerous cells are invading the surrounding breast tissue. Stage 1 breast cancer has two subcategories 1A and 1B.
People with stage 1A breast cancer have breast cancer with:
- A tumor measuring no more than 2 centimeters in diameter that has not spread outside the breast.
Breast Cancer Survivors: Life After The Treatments End
The breast cancer treatments are over. Now what? Here’s how to return to your “new normal.”
Life after breast cancer means returning to some familiar things and also making some new choices.
The song says “It ain’t over ’til it’s over,” but when you’ve had breast cancer, you discover that it’s not even over when it’s over.
After a marathon of breast cancer diagnosis and treatment that may last six months to a year, you can hardly wait to get back to a normal life again. But the day of your last radiation treatment or chemotherapy infusion doesn’t mark the end of your journey with breast cancer.
Instead, you’re about to embark on another leg of the trip. This one is all about adjusting to life as a breast cancer survivor. In many ways, it will be a lot like the life you had before, but in other ways, it will be very different. Call it your “new normal.”
From your relationships with your family and your spouse to eating habits and exercise, breast cancer will change your life in ways that last well after treatment ends. How do you fight lingering fatigue? What should you eat to help prevent a breastcancer recurrence? Will you ever have a regular sex life again? These are just a few of the questions that may nag at you as you make the transition from breast cancer treatment to breast cancer survival.
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