The Role of Oncologist For Breast Cancer

Oncology is certainly the most quickly growing sub-specialty in the field of medicine, and breast cancer is one of the most crucial problems of oncology. It is the principal cause of death of women in lots of countries and is really a multidisciplinary problem with no geographic constraints.

It is the most usual cancer of women in the US, affecting approximately one in eight as long as their life span. It affects men, but it is rare, accounting for less than 1 percent of all cases. In 2007, roughly 200,000 women and 1,600 men in the US had the disease. As a person ages, the possibility of getting breast cancer rises.

To treat breast cancer well, many medical professionals with various specialties are required. Every diagnosis is distinctive and treated in a different way. A number of women might visit a cancer center where a group of physicians who focus in breast disease (radiologist, oncologist, surgeon, etc.) collaborate to settle on treatment. Other women are referred to cancer specialists by their principal care physician (family practitioner, gynecologist).

Medical professionals engaged in breast cancer diagnosis and treatment might include: Gynecologist or OB/GYN, Radiologist, Oncologist (general, medical, radiation, surgical), Nurse/oncology nurse specialist, Oncology social worker, Surgeon, Radiation therapy oncologist, Radiation therapy technologist, Radiation therapy physicist, Pathologist, and Reconstructive/plastic surgeon.

An oncologist is a medical doctor who trains in the diagnosis and also treatment of cancer. If a radiologist identifies breast cancer, a woman might be referred to an oncologist for treatment. Medical oncologists concentrate in the use of chemotherapy and other drugs to care for cancer. Radiation oncologists focus in the usage of x-rays and other radiation techniques to eradicate tumors.

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How Effective Is Chemotherapy For Breast Cancer?

After mastectomy, women are sent to see the oncologists, and they are often told to go for chemotherapy. This treatment is like an "insurance" against future problems. Chemotherapy can kill all the remaining cancer cells in the body. In this way the cancer can be cured. Chemotherapy can also stop cancer from spreading to other parts of the body. Or at the very least it slows the cancer growth. To the oncologists, chemotherapy is the proven way to go, other ways are hocus pocus!

These points are often well taken by women in general. The fear of recurrence is sufficient enough to make women go through chemotherapy. To them, the sufferings of the treatment are worth enduring for the promise of cure at the end of the adventure. What some oncologists don't tell their patients is that not all the cancer cells are killed by the treatment. There is no way that a hundred percent of the cancer cells can be wiped by chemotherapy. Add to that, even the good healthy cells are killed and the immune system destroyed.

Patients, on the other hand don't ask these questions: Will there truly be a cure? If indeed the promise of cure is real, can we put it in terms of real numbers or percentage? To put it bluntly, how effective is chemotherapy for breast cancer? I wonder how many women ask their oncologists these questions, and if they do, what would the answers be like?

a) Without chemotherapy what percentage of people died or would die from breast cancer?

b) With chemotherapy what percentage of people are cured or would be cured?

c) What is meant by cure?

Try and search the answers from the internet and see if you can get anything. There is a great chance that you will go on a merry go round trip! I experienced exactly just that and was terribly disappointed. Thousands of articles are written about breast cancer but I fail to find the clear-cut answers to the above questions. Perhaps they are not important? Or something that women do not need to know before they embark on their treatment? Women just need to have full faith and trust in the experts and everything would turn out fine. Few women realize that such attitude may just be the beginning of more problems to come.

Let me try to share what I have gathered from the medical literature.

Karin Stabiner in her book (To dance with the devil) wrote: "Breast cancer takes the life of an American woman every twelve minutes. There is no sure cure for the disease, no known way to prevent it and no means of predicting." With all the advances in science and technology, may I ask, how could this be? Why such high degree of uncertainty?

Chantal Bernard-Marty, Fatima Cardoso, Martine J. Piccart of Jules Bordet Institute, Brussels, Belgium (The Oncologist 9: 617-632, Nov. 2004) wrote: "20%-85% of patients ... who are diagnosed with early breast cancer will later develop recurrent and/or metastatic disease. Despite more than 3 decades of research, metastatic breast cancer remains essentially incurable." Women are told that "catching" breast cancer early is a sure way of saving life. But how is it that even after early detection, twenty to eighty-five percent of patients still go on to develop more serious cancer that is incurable? Has the treatment protocols got anything to do with such failures?

How effective is chemotherapy?

Writing in Clinical Oncology (2004. 16: 549-560), three Australian doctors: Graeme Morgan, Robyn Ward & Michael Baton noted that in Australia, of the 10,661 people who had breast cancer only 164 people survived five years due to chemotherapy. This works out to 1.5% contribution of chemotherapy to survival. In their paper, they concluded that "overall contribution of curative and adjuvant chemotherapy to five-year survival in adults was estimated to be 2.3% in Australia and 2.1% in the USA."

Professor Michael Boyer, head of Medical Oncology of the Sydney Cancer Centre, Royal Prince Alfred Hospital disputed this 2% figure. He said: "It's not correct for a number of reasons. The 2% figure is achieved by including a whole series of diseases in which chemotherapy would never be used." To the professor the more "correct" figures should be 5% or 6%. Okay, let us accept that new figures -- how do women feel about it -- going for chemotherapy to achieve a five to six percent success?

In the editorial of the Australian Prescriber (2006. 29:2-3), Eva Segelov wrote: "Chemotherapy has been oversold. Chemotherapy has improved survival by less than 3% in adults with cancer."

Veroort et al. from the Netherlands (British J. Cancer. 2004. 91: 242-247) in their study on the role of tamoxifen and chemotherapy for breast cancer concluded that "breast cancer mortality reduction caused by present-day practice of adjuvant tamoxifen and chemotherapy is 7%. Tamoxifen contributes most to the mortality reduction. The overall effect of chemotherapy on mortality is very small." Take note that the contribution of chemotherapy to breast cancer survival is very small - what is very small? To be sure it has to be much, much less than 7%.

Guy Faguet, after spending numerous years of research on cancer, came to this startling conclusion (The War on Cancer: An anatomy of failure, a blueprint for the future. Springer, 2005): "An objective analysis of cancer chemotherapy outcomes over the last three decades reveals that, despite vast human and financial expenditures, the cell-killing paradigm had failed to achieve its objective ... the conquest of cancer remains a distant and elusive goal." Chemotherapy for cancer is based on "flawed premises with an unattainable goal, cytotoxic chemotherapy in its present form will neither eradicate cancer not alleviate suffering."

Cured of Breast Cancer?

In a study of 1,547 breast cancer patients at the University of Chicago Hospital, USA, from 1945 to 1987, Theodore Karrison et al. (J. Nat. Cancer Inst. 1999. 91:80-85) observed that for patients who underwent mastectomy but without chemotherapy or radiotherapy, most recurrences occurred within the first ten years after mastectomy. Recurrences were rare after 20 to 25 years. Patients surviving to this time without evidence of recurrence are probably cured.

Women are often told that if they survive five years after their diagnosis of breast cancer, they are considered cured of breast cancer. Based on the work of Karrison et al. this assumption is presumptuous and is not true at all. Women perhaps need to be reminded of what Guy Faguet wrote: "We must recognize that "cure" is not an absolute term because minimal residual or slowly recurrent disease that causes no symptoms can persist and remain undetected for years." Take note, the cancer can remain dormant in the body for years not just five years!

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How Effective Are Annual Mammograms?

Many doctors believe an annual mammogram is mandatory for women over thirty-five. However, an increasing number of doctors are refuting the claim that annual mammograms decrease women's risk of dying from breast cancer.

Dr. Peter Gotzsche, a Danish researcher, was the first to make this claim in a study published in "The Lancet" in October 2006. Gotzsche re-analyzed the original studies done on the benefits of mammograms and found them unconvincing.

Subsequently, other doctors have asserted that in addition to failing to offer protection, mammograms, which involve exposing women to radiation, may, in fact, increase a risk of cancer.

Dr. Michael Baum of University College in London, stated, "The latest evidence shifts the balance towards harm and away from benefits." Canadian columnist Dr. W. Gifford -Jones, wrote that women between the ages of 40 and 49 who have regular mammograms are twice as likely to die from breast cancer as women who are not screened. "Experts say you have to screen 2,000 women for 10 years for one benefit," he stated.

Gifford-Jones points to other risks, from the physical to the psychological. Many authorities believe that, squeezing women's breasts during mammograms may rupture blood vessels, causing cancer to spread and thus increasing a woman's risk of death.

Gifford-Jones pointed to the emotional trauma suffered by women who receive false positives from a mammogram, and to the dangerous sense of security engendered by those who receive false negatives.

Studies reveal that mammograms fail to detect cancer 30 percent of the time in women aged 40 to 49. Furthermore, it can take as long as eight years before a breast tumor is large enough to detect, by which time the cancer could have spread to other parts of the body.

"Mammograms actually harm far more women than they help," Mike Adams, author, "The Healing Power of Sunlight and Vitamin D," a free report that teaches prevention strategies for breast and prostate cancer. Adams believes, "They are used more as a recruiting tool to ensnare women into a system of medical control based on false diagnosis and fear tactics. Most women then give in to chemotherapy, surgery or radiation treatments that may ultimately harm them or even kill them."

So what is one to do, since, mammograms are only 70% accurate and seldom detect cancer in an early stage?

There are other tools for cancer detection--albeit the medical and pharmaceutical industry does not want you to know.

A medical intuitive can see the emotional patterns and beliefs that affect your body. How does a medical intuitive work? Some form a mental picture of an illness by visualizing organs in the person's body, even if this person is thousands of miles away. Many need only the name and age of a person to do a reading and recommend remedies.

Iridology also offers a highly effective detection system. Iridology is the science of analyzing the delicate structures of the iris of the eye. It reveals inflammation, where located, and in what stage it is manifesting. The iris reveals body constitution, inherent weaknesses, levels of health, and the transitions that take place in a person's body according to the way he/she lives. The eyes have been proclaimed throughout the ages as the windows of the soul. We now acknowledge them as the mirrors of the body.

In knowing nutritional, vitamin and mineral imbalances the person can readily remedy these imbalances before an illness or disease takes root.

Dorothy M. Neddermeyer, PhD, Life Coach, Hypnotherapist, Author, "101 Great Ways To Improve Your Life." Mind, Body, Spirit healing and Physical/Sexual Abuse Prevention and Recovery. As an inspirational leader, Dr. Neddermeyer empowers people to view life's challenges as an opportunity for Personal/Professional Growth and Spiritual Awakening. http://www.drdorothy.net

DRUGS FOR BREAST CANCER TREATMENT AND PREVENTION
TAMOXIFEN
Tamoxifen is a drug used to treat breast cancer. It was approved by the United States food and drug administration (FDA) in 1998 for the treatment of breast cancer. For years tamoxifen has being used to treat women who are diagnosed with breast cancer, However, tamoxifen carries with it life threaten side effects, including risk of uterine cancer and blood clots. As reported by the United States national cancer institute (NCI) on April 6, 1998.
Tamoxifen is a drug that can prevent breast cancer from reoccurring in women who have suffered from breast cancer in the past. tamoxifen has also be shown to reduced the risk of breast cancer in women caring a mutation in the BRCA2 gene which produces tumors that require estrogen to grow (estrogen is a hormone found in women)
Although tamoxifen does not reduce risk of breast cancer in women caring the BRCA1 gene which producing tumors that is not affected by estrogen.
Tamoxifen may also prevent new cancer from forming in the other breast of the patient. Though tamoxifen is valuable to some patients, doctors are advised by FDA to weigh the benefits and the risk of tamoxifen before the patient can use the drug.
More to come.

RALOXIFEN
Raloxifen is another breast cancer preventive drug; it’s very effective because on like tamoxifen, raloxifen reduces the risk of breast cancer. Interestingly raloxifen is not only effective in the treatment of breast cancer but also in other diseases such as osteoporosis (osteoporosis is the a bone degenerative condition)
Both tamoxifen and ramoxifen belong to new class of drug know as selective estrogen receptors modulators (SERMs). This drug imitates the effects of estrogen. Estrogen which has being linked to breast cancer growth.
Ultimately the use of these drugs depends on the type of breast cancer and the current staging period.

FACTORS THAT COULD INFLUENCE THE DEVELOPMENT OF BREAST CANCER
1) Advancing age
2) A family history of the diseases
3) A personal history of noncancerous lumps.
4) Giving birth for the first time after 30 years.

SURGRY AND BREAST CANCER TREATMENT AND BREAST CANCER TREATMENT AND PREVENTION

There are various forms of breast cancer surgery, treatment, and prevention methods. A few of them are listed below.

1) Simple mastectomy
2) Radical mastectomy or halted radical mastectomy
3) Lumpectomy
4) Prophylactic mastectomy
5) Modified radical mastectomy

SIMPLE MASTECTOMY
Simple mastectomy is a surgery that only the breast cancer is removed.

HALTED RADICAL MASTECTOMY
Radical mastectomy is a surgery that involves the removal of the breast tissue and the muscles surrounding the breast and nearby lymph nodes.

LUMPECTOMY
This surgery removes only the cancerous regions of the breast. This surgery is usually accompanied by radiation therapy. Lumpectomy helps the patient avoid the physical and emotional trauma of removing the complete breast. But this surgery carries with it a risk that all the cancerous cells may not have being removed.

PROPHYLACTIC MASTECTOMY
In this surgery surgeons remove both breasts before any sign of breast cancer is detected. This is done to remove the vulnerable tissue before cancer can emerge.

MODIFIED RADICAL MASTECTOMY
This surgery removes major parts of the cancerous cells and the complete breast affected by cancer along with certain lymph nodes under the arm and the chest muscle lining is also removed by this surgery.

After breast cancer surgery, to kill any cancer cell that remains treatments such as chemotherapy, hormone therapy of radiation therapy. This treatment helps to prevent the re-occurrence of breast cancer in the patient.

CHEMOTHERAPY
Chemotherapy treatment is accomplished by using chemical agents to treat diseases, infections or order disorders especially cancer. Chemotherapy alone or in the combination with other forms of therapy, has achieved significant results against breast cancer ovary and bladder cancer.
More to come.

ESTROGEN AND BREAST CANCER

ESTROGEN AND BREAST CANCER
Female secondary sex characteristic in girls at puberty is stimulated by the hormones called estrogen.
Among the better know estrogen estrone, ethnyl, estriol, two synthetic estrogen are respectively five and ten times as potent as estrone, their activities are similar to natural estrogen.
Estrogen in hormone replacement therapy carries risks which include breast or uterine cancer or cardiovascular disease. To be frank scientist are not able to understand at present what causes breast cancer. Studies suggest that several categories of women are at risk of having the disease The categories include.

1) Women with a long menstrual history. That is a menstrual period that started before age 12 after ages 50.
2) Those who never gave birth or who had their first child at 30 years.

Cancer researchers have found that about 5 percent of all breast cancer cases are associated with inherited mutations in genes. These genes include the BRCA2 and p53.
The protein HER – 2 (Also called HER2/ neu) produced by oncogenes is present in about one third of all breast cancer patients.

ESTROGEN AND ENDOMETRIAL CANCER
Women who develop endometrial cancer seem to relate to the estrogen hormone. Early or later menopause increases a women risk of having endometrial cancer probably by increasing the number of years during which the endometrial is exposed to estrogen.
Other things that can increase the risk of women having endometrial cancer include.

1) OBESITY
Obesity also increases the risk of endometrial cancer, probably because excess fat can increase the production of estrogen in a woman’s body.


2) DRUGS:
Drugs used to remedy other cancer related diseases may help increase the risk of women having endometrial cancer. Drugs such as tamoxifene used in preventing breast cancer, acts like an estrogen on cells of the endometrial cancer and raises the risk of endometrial cancer.

More to come

MAMMOGRAM

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MAMMOGRAM

In recent times physicians use mammogram to detect and evaluate breast abnormalities mammography is performed on women who do not have symptoms of breast cancer. Mammogram can detect breast cancer in its early stages, and that is when treatment is very effective. The procedure can spot a breast abnormity when it is very small as 0.5 cm (0.2in) the mammogram is beneficial because doctors would not be able to detect a very small emergence of breast cancer which the mammogram can detect.

HOW ACCURATE IS THE MAMMOGRAM

It’s sad to note that mammograms do not always find indications of breast cancer when it is present. Scientist estimate that mammogram miss about 25 percent of breast cancer in women who are 40 to 49 years old and approximately 10 percent of breast cancer in older women. Further, an abnormal mammogram may not necessarily indicate the presence of breast cancer. In fact, only about 3 percent of women aged 40 to 49 years and about 13 percent of women aged 50 to 69 years who have an abnormal mammogram actually may have breast cancer. And in other cases of abnormal mammogram is later identified as a normal tissue.

The inaccuracy of mammogram raises concerns in experts, who wonder about the potential of harmful misleading results the mammogram, gives. As stated earlier a normal mammogram result may show that a patient does not have breast cancer, falsely assuring the patient and which could cause the patient to be less vigilant about any further breast cancer screening. And an abnormal mammogram may result in a woman who may turn out not have breast cancer, but may cause her to undergo unnecessary biopsies and other diagnostic tests. The inaccuracy of the mammogram may cause the patient to experience great anxiety about a mammogram result.

  

The United States preventive task force and independent panel co-ordinate by the department of health and human services recommends that women have a screening mammogram every one or two years beginning at age 40. Also the American cancer society also recommends that women over age 40 have a mammogram every year.

Doctors advise that, if there is a family history of breast cancer for the patient, she should begin mammography early.

MORE TO COME ON THIS RESEARCH