Breast cancer: Looking toward the future
Breast cancer treatment has come a long way in the past 100 years.
At the beginning of the 20th century, it was believed that breast cancer was an infectious disease whose spread was expedited by surgery. One of the prominent surgeons of the day, James Syme (1799-1870) from Edinburgh, believed that surgery shouldn’t be attempted for breast cancer because the result was unfavorable.
According to a recently published report from the American Cancer Society, breast cancer is the most common cancer for women, accounting for 30 percent of all female cancer cases. The good news is the rate of breast cancer deaths in the U.S. has dramatically declined since 1950. As of 2018, the death rate from cancer had dropped from 31.9 to 19.7 per 100,000 population.
The rising survival rate for female breast cancer has improved approximately 40 percent in the last 30 years and has one of the highest survival rates of any cancer. This is due in part to screening and advances in technology such as digital mammography, however improvements to cancer treatment itself have likely had the biggest impact on survival.
Treatment for breast cancer involves a combination of surgery, radiation and chemotherapy, although not all women need all three. Research has shifted cancer treatments making it more personalized. Two women with the same type of cancer might not receive the same treatment.
Implementing personalized treatment is a relatively new way to approach cancer care. There are other changes that are improving care for those diagnosed with breast cancer:
• Surgical Advances
Surgical techniques focus on removing the tumor and affected lymph nodes while preserving healthy tissue. This precise care allows doctors to treat cancer with fewer complications.
There are also advances in breast reconstruction. New methods can possibly preserve the skin and nipple of the breast during surgery, so reconstruction looks and feels more natural.
• Targeted Radiation
In the past, radiation therapy was recommended daily for seven weeks for most breast cancer patients. Targeted radiation treatments can now be customized to the patient minimizing the effect on surrounding internal organs and muscle.
• Genetic Testing
Genetic testing for hereditary cancers can help identify risk factors for future cancer. Oncologists may also use genetic testing to help guide treatment decisions. Testing can help determine a woman’s risk of the breast cancer recurring and the effectiveness of chemotherapy on the cancer.
• Clinical Trials
Participating in clinical trials gives patients access to the most cutting-edge treatments available and gives patients and doctors access to the newest protocols. As researchers discover more about the biology of cancer, treatment will continue to evolve.
While there is no sure way to prevent breast cancer, there are some measures that women can take to reduce their risks.
1. Healthy Diet
People who follow a healthy diet are less likely to develop obesity, and as a result, this leads to a lower rate of cancer and heart disease. Consuming more vegetables and fruits and limiting carbohydrate intake are steps every person can take to lead a healthier life.
2. Saying no to alcohol
According to BreastCancer.org, alcohol can increase estrogen levels and other hormones associated with hormone-receptor-positive breast cancer. Alcohol also damages DNA cells. Women who have three drinks per week have a 15 percent higher chance of having breast cancer than those who do not drink. Experts say that one drink is equivalent to a 10 percent increased risk of breast cancer.
3. Watch your stress levels
According to the National Center for Biotechnology Information, stress is an imminent risk factor with a documented negative impact on neuro-endocrine and immune system.
Managing stress levels can help improve a person’s quality of life.
Making time for reading, walking, yoga, meditation, prayer or doing something you love eases stress and boosts energy.
4. Exercise
The Centers for Disease Control and Prevention (CDC) state that people should do a 150-minute moderate-intensity or 75-minute vigorous activity every week. They should also combine these with muscle-strengthening exercises at least twice a week.
Regular exercise can reduce the risk of first-time breast cancer or recurrences and be beneficial in those who have received treatment for breast cancer. This is because exercise can reduce stress, fatigue and promote brain health.
5. Taking Supplements
Can supplements help prevent breast cancer? While the subject is controversial, many find various dietary supplements such as vitamins, minerals, botanicals or herbs helps to fill in the nutritional gaps of their diet.
It’s important to keep in mind that breast cancer prevention supplements or other types of supplements do not fully treat, cure or prevent cancer. That said, some may help in reducing the risk of cancer or assist in recovery.
Studies show that the curcumin in turmeric can kill breast cancer cells and those that develop in the prostate or colon and according to BreastCancer.org, people who have low Vitamin D levels have a higher risk of developing breast cancers.
6. Family History
Women with close relatives who’ve been diagnosed with breast cancer have a higher risk of developing the disease. If your mother or sister has had breast cancer, you may have an increased risk of developing cancer yourself. This is because you may have the BRCA1 or BRCA2 gene that can lead to breast cancer.
7. Regular Self-exams and Mammograms
Screening mammograms are recommended every year and self-exams should be performed once a month. If you are experiencing breast cancer symptoms such as nipple discharge, pain, or swelling, a diagnostic mammogram is recommended.
8. Hormonal therapy medicines
Four hormonal therapy medicines have been shown to reduce the risk of developing hormone-receptor-positive breast cancer in women at high risk. The SERMs (selective estrogen receptor modulators) tamoxifen and Evista (chemical name: raloxifene) and the aromatase inhibitors Aromasin (chemical name: exemestane) and Arimidex (chemical name: anastrozole) are the four medicines used in this way.
While we have not reached the goal of eliminating breast cancer, doctors have made huge strides in the last hundred years in breast cancer prevention and treatment. Thanks to advances in research, targeted therapies and a more personalized approach to treating patients diagnosed with breast cancer, there is greater hope for breast cancer patients than ever before.
