Breast Cancer is a disease that originates from breast tissue in the inner lining of milk ducts, which supply the ducts with milk. Breast Cancer cells move from their site and invade the bones of the patient, thus decreasing the chances of survival. Cancer is a terminal disease and the article tries to explain how it forms.
The article Tracking breast cancer cells on the move by Gomis is important since it explains how breast cancer cells invade bones. The article serves the purpose of examining the role of NOG, a gene that is essential in bone development and its role in breast cancer. The materials in the article help to show the role of NOG.
When cancer cells that cause brain tumors are on the move, they attack the human body leading to the development of tumors. NOG does this in two ways. Firstly,
The process of increasing the total number of osteoclasts does the escalation of bone degeneration. This provides enough space for the metastatic cells that cause cancer to reside. Secondly, the brain cancer causing cells are kept in a stem-cell-like state. This ensures that they propagate thus forming new tumors (Gomis 2012). The questions that arise are; why is it difficult to get a cure for cancer? Can breast cancer affect men? Is breast cancer heredity?
Works Cited
Gomis, Roger. Tracking breast cancer cells on the move. 2012. Biology News Net. Web.
Cancer is the uncontrolled growth of abnormal cells in the body (Carlson et al., 2009). Cancerous cells are also referred to as malignant cells. Cells act as the building blocks of organisms (Carlson et al., 2009). Under normal circumstances, cells will undergo cell division depending on the bodys needs, and then die once their function ends.
In addition, malignant cells divide very fast and sometimes fail to die. Cancer develops in different tissues and organs of the body. Cancerous cells have the characteristic of spreading from their source to other parts of the body (invasive). Cancerous cells that remain at their source are said to be noninvasive. The breast is one common organ that cancer affects. Breast cancer occurs in two main categories (Carlson, et al., 2009). Ductal malignancy: this is the most common type of cancer.
This type of breast cancer manifests itself in the tubes/ducts which form the channel for transporting milk from the breast to the nipple. Lobular carcinoma: this type of cancer usually begins in the milk producing regions of the breast (lobules) (Breast cancer, 2011). Rarely does cancer develop from other parts of the breast. Breast cancer is known to occur in invasive or noninvasive form (Breast cancer 2011). Thus, cancerous cells in the breast may metastasize to other parts of the breast from their source.
The prevalence and causes of cancer vary. Cancer biologists have discovered that most breast carcinomas are sensitive to the hormone estrogen (Breast cancer, 2011). The hormone causes the cancerous cells to grow. The breast cancer cells that respond to estrogen have estrogen receptors on their surfaces (Breast cancer, 2011).
Cancer biologists refer to these estrogen receptor possessing breast cancer cells as receptor-positive/EP-positive cancer cells. Scientists have discovered a certain gene called HER2 that helps breast cancer cells to multiply and repair themselves. It has also been noted that women with this type of gene have a severe breast cancer than their female counterparts who lack it.
In addition, HER2 bearers have a higher risk of breast cancer reoccurrence. Generally, chances of developing cancer increase with age. The older one becomes, the higher the risk. Women above 50 years have advanced breast cancer cases. Women are twice more likely to develop breast cancer than men. Family history plays a central role in dictating the chances of someone developing breast cancer.
Persons whose close relatives had ovarian, uterine, breast or colon cancer are at a high-risk of developing breast cancer. Scientists have also discovered that women who experience very early periods (before the age of 12), and those who continue to experience periods through menopause (after age 55) have a higher risk of developing breast cancer. Moreover, excessive alcohol (for adults) and radiation therapy around the chest area in children present a risk of developing breast cancer.
Women who have received hormone replacement therapy with estrogen and those that used diethylstilbestrol (DES) are at a higher risk. Child birth has also been found to have an effect on breast cancer. Bearing several children and at an early age, reduces the risk. On the other hand, women who bear children after the age of 30 or those who do not bear children at all poses a great risk of developing breast cancer (Giuliano et al. 2011).
Breast cancer at an early stage does not present any symptoms (Hayes, 2007). That is why experts encourage women to go for regular checkups. However, after it has progressed it may present the following symptoms. A hard lump in the breast or armpit that does not induce pain is an indicator of breast cancer.
The lump has uneven edges. Change in the appearance (size and shape) of the nipple may be another indicator. The nipple may show some reddening, dimpling or puckering. The nipple may also produce a discharge. The fluid could be bloody, clear, and yellow or appear like pus. Symptoms of advanced breast cancer are bone pain, breast pain and discomfort, skin ulcers, weight loss and swelling of one arm next to the breast with cancer (Breast cancer, 2011).
The treatment of cancer depends on the type, stage, sensitivity to certain hormones or whether the cancer over expresses HER2/neu gene (Carlson et al., 2009). Doctors usually conduct certain tests before deciding the type of treatment to give. Such tests include breast MRI, biopsy, ultrasound, mammography, sentinel lymph node biopsy or CT/PET scans. Three options may be employed. Chemotherapy or radiation therapy (to kill cancer cells) and surgery to remove the cancerous tissue (could be lumpectomy or mastectomy).
Hormone therapy may be prescribed to women with ER positive breast cancer to inhibit certain hormones that cause uncontrolled cell division. Newer strategies include biologic/targeted therapy and immunotherapy (Carlson et al., 2009). In targeted therapy, anticancer drugs are used to recognize and inhibit certain changes in cells that may lead to cancer (Breast cancer, 2009). Immunotherapy utilizes activated immune system cells to treat cancer cells. More research is being carried out to shade more light on the use of immunotherapy.
References
Breast Cancer (2009). Breast Cancer. Web.
Breast Cancer (2011). Breast Cancer. Web.
Carlson, R. et al. (2009). Breast Cancer: Clinical Practice Guidelines in Oncology. Journal of Comprehensive Cancer Network, 7(2), 122-92.
Giuliano, A. et al. (2011). Axillary Dissection vs no Axillary Dissection in Women with Invasive Breast Cancer and Sentinel Node Metastasis: A Randomized Controll Trial. Journal of the American Association (JAMA), 305(6), 569-75.
Hayes, D. (2007). Clinical Practice: Folow-up of Patients with Early Breast Cancer. The New England Journal of Medicine, 356(24), 2505-13.
Today, most women experience unique health issues. Although both men and women have almost similar health issues, women react differently to diverse health issues. Due to this disparity, scholars do their research to find solutions to the most prevalent health issues affecting women. The womens health problem on breast cancer is the most researched as it affects countless women worldwide.
Women Health Research Article
New research suggests that it is possible to reduce the spread of breast cancer by turning off a gene (Ohio State University, 2014). This strategy provides a breakthrough for medical practitioners in their attempt to find a cure for breast cancer. The study from Ohio University reveals that a myoferlin, a protein linked to cancer, can significantly reduce the metastasis of breast cancer. It suggests that lowering the proteins level makes the genes that enable the cells to spread remain huddled together in the primary tumor. The lowering of myoferlin affects breast cancer cells in two major ways. Reducing the levels of myoferlin alters the breast cancer cells mechanical properties, as it is evident from the fact that the shape and ability of breast cancer cells to spread is low with reduced production of myoferlin. Thus, metastasis does not occur because the cells cannot change the mechanical properties that would fuel them to invade. Also, low levels of myoferlin cause a change to the activation of many genes, making them have normal cell behavior.
The new research on the breast cancer issue draws my attention as many women lose their lives due to the metastasis of cancer. The breakthrough occurs at a time when many young women are screened positive for breast cancer. My main interest in the topic is the fact that it is possible to reduce the spread of breast cancer. How the reduction of myoferlin prevents the metastasis of breast cancer cells is fascinating with the recent tests on mice. Scholars, through their mouse experiments, confirm that silencing the gene lowers the metastasis of breast cancer cells, limiting it to the initial tumor (Ohio State University, 2014).
The research shows the possibility of healing breast cancer because the tumor can be surgically removed once the cells accumulate at the initial tumor. This intervention is like a dream come true for the many women fighting breast cancer. In my opinion, the topic in the article provides hope in the war against the most common type of cancer in women. Due to the lifestyle changes and eating habits of many women, the risk of breast cancer has rapidly increased. Women, especially those at the reproductive stages, are at the highest risk of diagnosing positively with breast cancer. Due to this situation, the issue on how to lower the metastasis of breast cancer cells is of interest since breast cancer is real in society today. With continuous research, scholars will eventually invent a way of preventing and destroying the initial cancerous cells that result in breast cancer.
Conclusion
An understanding of the functioning of the female body is vital in the study of the unique health issues affecting women. Breakthroughs like the silencing of a gene to prevent the spread of breast cancer are essential in solving the unique health problems relating to women. Breast cancer, being a prevalent issue among many women today, should capture the attention of researchers in determining its control. Research indicates that most women related health issues are chronic and deserve early detection, prevention as well as the correct treatment. It is only through research and creating awareness that women health concerns can be resolved.
Breast cancer cases have shown an increasing trend over the last few decades. It is a disease that is common to women. However, some men have developed breast cancer but the rates of incidence of the disease are very low compared with that exhibited in women. In the US, breast cancer has been one of the fatal diseases that have affected a significant proportion of the female population. Breast cancer affect women from all races, ethnic groups, ages, geographic locales as well as socioeconomic strata.
Over the past several decades, epidemiological research has shown that there have been widespread ethnic disparities as far as the disease is concerned. It has been well documented that different ethnic groups have different rates of the incidence of breast cancer. This paper explores the different rates of breast cancer incidence as far as the different ethnic groups in the US are concerned as well as the most probable way of reducing the rates of incidence across all the groups.
The Incidence of breast cancer among different ethnic groups
One of the tools used in monitoring the incidence of breast cancer in the United States is the report card. The card was developed by key bodies in the American health care system. They include the American Cancer Society, National Center for Health Statistics, the National Cancer Institute and the Center for Disease Control and Prevention.
The initial release of the report card was in 1998. It showed that there had been a continual decline in the incidence of breast cancer in the American population. However, the report card also showed that there was disproportionate incidence of breast cancer as well as mortality rates of African American Women compared with their white counterparts.
The report noted that among the African women, there was an increasing trend of both the incidence of breast cancer and the mortality rates associated with the disease. According to the report, African American women also tended to present with a later stage at diagnosis (Jones, and Chilton 341). The African American women have not been successful in their fight against breast cancer since study has shown that they have the highest breast cancer death rates.
From 2000-2003, the white non-Hispanic Americans recorded the highest rates of breast cancer incidence i.e. 141 women in every 100,000 had developed cancer. The second highest rate was exhibited by the African Americans with 118 breast cancer patients per every 100, 000.
The third and fourth positions were taken by the Asian American and the Hispanics respectively. In 2008, the CDC released the latest data showing the incidence of the disease among different ethnic groups. American white women still had the highest incidence rate followed by the African Americans.
The third group that had significantly a high incidence rate was the Hispanic followed by Asian/Pacific Islanders and the Asian Americans. However, the mortality rates due to the disease differed significantly. Research has shown that the African American women exhibited the highest mortality rates followed by the White women.
Following the report issued in 1998 via the report card, the American Cancer Society embarked on a more detailed research to unveil the cancer problems specific to each of the ethnic groups with much emphasis on the African American women since the breast cancer mortality rates were highest in this group. The National Cancer Institute has played a pivotal role in the reduction of the effects of cancer across all the ethnic groups in the US.
Its sole responsibility is to conduct research on the detection, treatment and control of the disease. Additionally, it conducts research on the prevention of cancer. To achieve its goal, it has sponsored several research agencies an aspect that has led to the discovery of many aspects as far as breast cancer is concerned. The research has led to the discovery of more breast cancer detection and diagnosis techniques.
It has also led to the development of better programs as far as better supportive care and improved treatment for patients is concerned. The development of the new technologies assisted in the reduction of the severity of the disease among the different ethnic groups. According to Jones and Chilton, the discoveries have not equally benefitted the various ethnic groups since the African American women are still endangered by the disease (539).
For instance, between the African American women and white women, there has been a great disparity in the rate of breast cancer survival for decades. With the exception of the African American women, the other groups had a positive response to the new mode of technology. African American women have continued to be disproportionately affected by the fatal disease.
The incidence and effect of breast cancer among some specific groups
As aforementioned African American women are disproportionately affected by the disease. Research has shown that it has been one of the leading causes of death among the women in this particular ethnic group.
Besides the impact of the disease in the society, women and their immediate family members have to endure the deep emotional effect imposed by not only the disease but also its treatment. Families also dread the recurrence of breast cancer. The incidence of the disease has been increasing over the last several decades (Cunningham et al 4).
For instance, from 1973 to 1998, the incidence of breast cancer among black women increased by over 40%. Despite all the efforts that the health system has made in the fight against breast cancer, African American women still continue to suffer from the effects of the disease. Research has shown that breast cancer is the second leading cause of cancer related death Among the African American women-the first cause is lung cancer (Jones, and Chilton 540).
Different ethnic groups consist of several sub-groups. Research has shown that, these subgroups exhibit different rates of breast cancer. As aforementioned, the Asian Americans have a relatively low rate of the breast cancer incidence as far as the ethnic groups in the US are concerned. Within the Asian ethnic group, the rates of breast cancer incidence vary by specific ethnicity with the Japanese women recording the highest rates while the Laotian women have the lowest rate.
Additionally, the place of birth of the members of a given ethnic group also determines their risk of developing breast cancer. For instance, during the period between 1988 and 2004, the breast cancer rates were higher for the US-born Filipina and Chinese women than their foreign-born counterparts (Gomez et al. 126). This trend was also true for the US borne and Foreign-born Japanese. However, the US-born Filipina recorded the highest rates of breast cancer incidence during that period-80%.
Factors that cause the differences in breast cancer incidence among ethnic groups
Socioeconomic factors vary among the various ethnic groups. This includes aspects such as the average income level of the members of a given ethnic group, lack of proper infrastructure e.g. poor means of transportation as well as lack of proper healthcare facilities.
This also includes the availability of screening programs within the available healthcare facilities. For instance, African American women have poorer socioeconomic status among the African Americans than the whites. African American women also have reduced access to health care services.
As compared to White women, African American women have a lower frequency of mammography with delayed diagnosis. Additionally, they tend to have reduced chemotherapy dosage which is associated with underlying neutropenia. For both White and African American women who have access to the same health care facilities and programs, other factors contribute to the high mortality rates among the African Americans due to the disease (Chen et al. 440).
Furthermore, the African Americans tend to have a much higher rate of high-grade cancers than the white women. In most cases, the breast cancer among the African American women tends to be ER negative posing a great danger to the victims. Several socioeconomic factors hinder the ability of the ethnic groups to access routine preventive health care programs.
Different ethnic groups differ in their ability to access routine preventive health care programs. A relatively high percentage of African Americans and Hispanics do not have access to proper health care. In some cases, they do not have a primary care provider.
The importance of a primary care provider is to enhance proper preventive care through the provision of routine check-ups and breast cancer screenings. Preventive care enables the detection of breast cancer at an early stage, which can be easily treated as opposed to the advanced stage-less treatable.
One of the factors that contribute to such is a strong belief, cultural or religious, related to their health and their health care. Some of the ethnic groups have strong beliefs in some supernatural healing and miracles. Religious/cultural beliefs impair individuals from participating in the routine preventive programs offered in the health care sector.
Women who hold such strong beliefs in healing and miracles do not have faith or rather do not trust the health care system. In most cases, they end up as breast cancer patients since they will only turn to the health care system probably at the advanced cancer stages. Generally such women in the group or sub-group do not participate in any form of routine preventive health care increasing the rate of breast cancer incidence in the ethnic group.
Communication barrier, the inability to understand another persons language, impairs an individuals ability to seek medical assistance. Consequently, women may fail to discuss their health concerns with medical practitioners impairing the preventive program since. In some cases, the interpreter may not be able to enhance comprehensive communication between the two parties in question. This might lead to lack of proper health care for the patient.
Most people lack the knowledge or rather the understanding of not only the symptoms but also the health care risks associated with breast cancer. Research has shown that most of the women who seek medical attention only during the advanced cases of breast cancer lack the knowledge of the symptoms of breast cancer in the early stages. Most American Hispanic Women are less aware of the risks of breast cancer. This prevents them from seeking medical attention in advance.
Some of the ethnic groups are deeply rooted in cultural practices. Such practices include traditional medicine that they believe are capable of addressing all their healthcare needs. In such groups, women who experience abnormalities in their breasts give first priority to the cultural practices rather than doctors. Owing to this, the fail to get proper medical assistance in time an aspect that puts their life at a great danger.
Reduction of the rates breast cancer incidence in all the ethnic groups
The rates of breast cancer can be reduced by the reduction of the main causative of the disease. Research has shown that the high prevalence of obesity is associated with breast cancer across all the ethnic groups. America has recorded the highest rates of obesity in the world.
According to Blackburn and Walker, 74.6% of Americans are obese with obesity being one of the leading causes of death in the nation (207). Obesity is one of the diseases that have led to the current crisis in the American healthcare system especially by causing other diseases among which is breast cancer. The medical expenditures associated with obesity in the nation are approximately $70 billion, which translates to more than a quarter of the American healthcare systems expenditure.
Wolf and Colditz argue that America has suffered a loss of 40 million productive workdays and an additional 63 million days due to the frequent visits that obese individuals make to the doctor(s) (100). In an attempt to curb breast cancer and other forms of cancer associated with obesity, the American healthcare system has developed the CARE policy whereby CARE stands for Communication, Action, Research and Evaluation.
The policy aims to increase life expectancy by increasing both the quality and the years of healthy living of the Americans. Some of the key issues that the policy seeks to attain are improvement of the nutritional value of foods in major educational institutions; ensure the availability of physical education facilities not only in schools but also in public recreation centers; ensure more intensified research on the causes of the disease and bringing the findings to public attention.
The policy also advocates for education of healthcare professionals and students on the prevention, management and the treatment of the disease together with its related conditions such as breast cancer. Moreover, the policy incorporates the need for more research on the prevention and the treatment of obesity.
This paves way for new methods of dealing with the epidemic in the nation. It also calls for the promotion of health and nutrition related curriculums in high schools besides raising awareness of the two diseases and preventive screening of all individuals in America. The policy addresses the special needs of the elderly obese individuals in the nation in one of its initiatives-Healthy ageing initiative: Eating better and moving more.
Conclusion
Different ethnic groups have different rates of breast cancer incidence. As aforementioned, the white women have the highest incidence rates followed by the African American women. The Hispanics and Asian Americans have relatively low rates of breast cancer incidence.
However, African American women have the highest mortality rates associated with breast cancer. As discussed above, the specific groups within a given ethnic group also have different breast cancer incidence rates. Additionally, the place of birth of an individual also determines his/her ability to develop breast cancer. For instance, among the Asian American women during the period between 1988 and 2004, the breast cancer rates were higher for the US-born Filipina and Chinese women than their foreign-born counterparts.
There are many causes of the variation of breast cancer incidences across different ethnic groups. However, research is yet to establish the exact cause of the variation. Most researchers have attributed the variation to diet and lifestyle, genetic make-up and socioeconomic status. The American healthcare system has embarked on addressing obesity, which cuts across all the ethnic groups, in an attempt to curb the disease.
Annotated Bibliography
Cunningham, Ruth, et al. Ethnic and Socioeconomic Trends in Breast Cancer Incidence in New Zealand. BMC Cancer, 10. 694(2010): 1-10. Print.
The article includes a study of the incidence of breast cancer in New Zealand. It utilizes data from the New Zealand cancer registry for the period between 1981 and 2004.
The authors also compare the trend of the rates of the breast cancer incidence of the groups in New Zealand with those of the same groups in other parts of the world with a bias on the U.S. It also explains some of the socioeconomic factors that influence the breast cancer incidences in the different ethnic groups.
Gomez, Scarlet et al. Hidden Breast Cancer Disparities in Asian Women: Disaggregating Incidence Rates by Ethnicity and Immigrant Status. American Journal of Public Health, 100.1 (2010): 125-131. Print.
It focuses on the breast cancer incidences for specific Asian Populations in California. The data employed in this study was obtained from the Californian Cancer Registry for the period between 1998 and 2004. The information also included the immigration details of the sample group. The data was used to determine the rates of breast cancer incidences within the specific groups of the Asian Americans. It is a good source of information since California is the home of the largest number of Asian Americans in the U.S.
Jones, Lovel, and Chilton, Janice. Effect of Breast Cancer on African American Women: Priority Areas for Research in the Next Decade. American Journal of Public Health, 92. 4(2002): 539-542. Print.
It compares the rates of incidence of breast cancer incidence between the African American women and white women. It utilizes data for the Center of Disease Control and the National cancer Institute in giving the trend of the rates among the two groups of women. It also gives some of the causes of the disparities obtained from a research conducted by the National Cancer Institute.
Works Cited
Blackburn, Lawrence, and Walker, Williams. Science-based Solutions to Obesity: What Are The Roles of Academia, Government, Industry and Healthcare? The American Journal of Clinical Nutrition, 82.1. (2005): 207-210. Print.
Chen, Zao et al. Ethnicity and Breast Cancer: Factors Influencing Differences In Incidence and outcome. Journal of the National Cancer Institute, 97. 6 (2011): 439-448. Print.
Cunningham, Ruth, et al. Ethnic and Socioeconomic Trends in Breast Cancer Incidence in New Zealand. BMC Cancer, 10. 694(2010): 1-10. Print.
Gomez, Scarlet et al. Hidden Breast Cancer Disparities in Asian Women: Disaggregating Incidence Rates by Ethnicity and Immigrant Status. American Journal of Public Health, 100.1 (2010): 125-131. Print.
Jones, Lovel, and Chilton, Janice. Effect of Breast Cancer on African American Women: Priority Areas for Research in the Next Decade. American Journal of Public Health, 92. 4(2002): 539-542. Print.
Wolf, Arnold., and Colditz, Gregory. Current Estimates of the Economic Cost of Obesity In the US. Progress in Obesity Research, 6 (1998): 97-106. Print.
Breast cancer is a serious health issue associated with a significant mortality rate of the affected population. It is noteworthy that women are often unaware of all of the major signs and features of this disease, as well as the various treatment opportunities available to them (Sulik, 2012). Therefore, a focus on breast cancer awareness as a part of a companys corporate social responsibility (CSR) strategy can be beneficial.
Version 1
CSR campaigns aimed at raising breast cancer awareness often focus on females, who make up much of the affected population. However, at the same time, making males aware of the issue can also be helpful as they can encourage women to learn more about the disease and its treatment. Therefore, the campaign for employees as internal stakeholders will target all employees, regardless of gender, age, or ethnicity. This campaign may involve the use of posters and leaflets with relevant images and information. The information provided will be designed to address such areas as facts about the disease, statistics, personal stories, support options, available treatments, and so on. The campaign will also involve a number of discussions with breast cancer survivors. Finally, the campaign will include free screening for all female employees and the wives of employees.
Version 2
The second campaign will target the companys customers. Amazeen (2012) notes that such campaigns can be beneficial for the companys image and profitable as well. It is necessary to note that the corporations customers are mainly Emirati males between 30 and 50 years old. Therefore, it is advisable to focus on this population. The breast cancer awareness campaign may involve the development of new advertisements (e.g., videos and visuals) that focus on the health issue in question rather than the companys products. Benetton Corporation started using this strategy in the 1980s, and it has proved to be effective (Sulik, 2012). The advertisement may address many similar topics, but the focus should be on the males role as one who cares, supports, and encourages the women in their lives to have check-ups, receive treatment, and so on. The visuals will primarily be used in online communication (e.g., on the companys website, social networks, and so on). It is also possible to invite some celebrities to take part in the campaign. They can be featured in the advertisements or the visuals. The companys official website should contain a section devoted to this health issue and the campaign. It can also be effective to note that all company employees have been given the opportunity to check their health or the health conditions of their loved ones.
Recommendations
It is necessary to note that Version 2 requires a larger investment. It may also need more time to be implemented as the development of the advertisement, and all visuals will take time. At the same time, this version is also associated with a larger impact. It will raise the breast cancer awareness of customers and their families as well as the entire country; moreover, the company may develop a favorable image while simultaneously promoting its products. However, the Version 1 campaign will be easier to implement and beneficial for the development of the company, as employee motivation levels might increase as a result. Therefore, it is recommended to start with the implementation of the Version 1 campaign. The campaign can be developed by the companys employees, which would reduce costs. When recommending healthcare facilities, it is necessary to negotiate significant discounts or even free services as the facility will be publicized through the companys official website and social networks.
References
Amazeen, M. (2012). Just window dressing? The gap (RED) campaign. In S. May (Ed.), Case studies in organizational communication: Ethical perspectives and practices (pp. 73-85). Thousand Oaks, CA: SAGE Publications.
Sulik, G. A. (2012). Pink ribbon blues. New York, NY: OUP USA.
Both men and women have breasts. Considering the case of females, the breasts consist of the milk glands. A milk gland is made up of lobules in which milk is formed and it also consists of ducts which are tubes that facilitate the movement of milk to the breast nipples. On the other hand, considering the case in men, suppressing of lobule development by testosterone during the puberty stage can be observed.
The breasts in both men and women have supportive fibrous tissues and fatty tissues (Cancer Council, 2011, p.6). Some of the breast tissues go up to the armpit. Armpits have a set of the lymph nodes that make up a part of the lymphatic system (Cancer Council, 2011, p.6). The lymphatic system forms a part of the bodys immune system and serves to offer protection to the body against diseases and infections (Cancer Council, 2011, p.6).
Definition of Breast Cancer
Breast cancer comes about at the time the breast ducts or lobules cells grow in an abnormal way. There can be formation of a tumour within the breast lobules or ducts. The breast tissue is made up mainly of fat, glandular tissue, milk ducts and connective tissue (Garvan Institute of Medical Research, 2010, p.1). In most of the invasive breast cancers , development of the tumour starts within the milk ducts lining (Cancer Council, 2011).
If it is not detected, these affected cells may also move to the rest of the parts of the breast and to the lymph nodes in the armpit and to other body parts as well. It is important to point out that breast cancer can develop not only in women but in men as well, though its occurrence is very rare among men. However, the breast cancer symptoms in both men and women are quite common (Cancer Council, 2011).
It has also been noted that breast cancer is not just one single disease (Garvan Institute of Medical Research, 2010, p.1) but takes a large number of different forms marked as differences in disease aggression and response to treatment (Garvan Institute of Medical Research, 2010, p.1).
There are various types of breast cancers. In the case where the cells which appear like breast cancer are still confined to the ducts or lobules of the breast, it is called pre-invasive breast cancer (Cancer Council, 2011, p.8). The most widespread pre-invasive type of breast cancer is ductal carcinoma in-situ (Cancer Council, 2011, p.8).
A large number of the breast cancer types are identified at the point they are found to be invasive. This implies that there is spreading of the breast cancer into the tissue around from the breast lobules or ducts. The types that are commonly found include invasive ductal cancer and invasive lobular cancer (Cancer Council, 2011, p.8).
Facts about Breast Cancer
Considering the case in Australia, breast cancer is found to be the most widespread form of cancer among women. It is also found to be the second most widespread cause of death that is related to cancer; the most common cause being lung cancer (Watson, et al.,1998).
It has also been found out that one Australian woman in every nine of them will be found to have breast cancer and one woman in every thirty eight of them will end up being killed by this disease by the age of eighty five years. Every year, more than twelve thousand of Australian women are diagnosed with the disease (Garvan Institute of Medical Research, 2010, p.1).
Due to the presence of the ageing population in Australia, breast cancer cases in this region remain to be on the increase. But on the other hand, at the present, breast cancer survival rate among the Australian women is increasing more than it has ever been in the past.
It has been found out that the 1 year survival rate is 97% and 88% of women diagnosed with breast cancer can expect to be still alive 5 years after diagnosis (Garvan Institute of Medical Research, 2010, p.1). Remarkable advances realized in the early detection as well as treatment of this disease imply that a larger number of women are surviving the disease than ever before (Garvan Institute of Medical Research, 2010, p.1).
The Risks of Developing Breast Cancer
According to Queensland Government, breast cancer has been found to be the most commonly reported form of cancer for women in Australia. It is also reported that among the greatest risk factors is the increasing age (Queensland Government, 2011). The risk is found to be approximately one in two hundred and fifty for a woman in Australia who is in her 30s.
But on the other hand, an Australian woman who is about 70 years or above, the risk is about one woman in every thirty. Diagnosis of a larger number of the breast cancers is made after menopause, having approximately three quarters of the total number of cases taking place among those women who are fifty and above (Cancer Australia, 2013).
However, it is imperative to bear in mind that all females are at risk of developing breast cancer, regardless of the risk category to which one may belong (Donegan, 2002). Among women who are at a higher risk, there are those who never end up developing breast cancer.
On the other hand, among the women who may be classified as being at a low risk, there are those who end up developing this disease. Other than an increase in age, there are also other factors that may increase the risk of this disease (Miller, Boyer & Dunn, 1995). These factors are family history, specific genetic profile, breast diseases such as ductal carcinoma in situ and lobular carcinoma in situ, hormonal factors and body weight and size (Queensland Government, 2011, p.1).
Moreover, the lifestyle factors may also increase the risk and such factors include; taking of alcohol, lack of physical activity, and getting exposed to the ionization radiation. It is pointed out that a large number of risk factors like breast cancer family history, ageing, and genetic condition are factors that are not readily modifiable (Queensland Government, 201, p.1).
Symptoms of Breast Cancer
Every woman may become aware of a change in her breast or her doctor may detect an extraordinary change in the course of carrying out an examination. There are a number of signs which may indicate the presence breast cancer. Some of them include;
Lumpiness or thickening in the breast.
Changes occurring on the nipple.
Changes in the breast skin like dimpling and strange redness of the skin among other changes.
An enlargement or reduction in the breast size.
An alteration in the breast shape.
A swell in the armpit.
Continual, strange pain which is not related to a womans menstrual cycle, stays after the period and happens in just one breast.
It is important to point out that the changes that may occur in ones breast do not essentially imply that one has developed breast cancer. But on the other hand, if a person has developed any of the symptoms linked to this disease, she needs to have these symptoms examined by a medical expert in the soonest time possible. It is has also been found out that there are women who might not be having any symptoms and the breast cancer is detected by a screening mammogram (Cancer Council Australia, 2013).
Detecting Breast Cancer
In the case where detection of breast cancer is made early, women have higher chances of receiving effective treatment and for a larger number of them, the disease will not return after receiving treatment. At the present, screening mammograms are found to be the most excellent method that is available and can be used to detect breast cancer at an early stage.
The mammograms may detect a breast cancer that is too minute to be felt. Mammograms refer to low dose x-rays of a womans breasts (Cancer Council Australia, 2013, p.1). The performance of screening mammograms is carried out on those women who do not have any symptoms of this disease. They are offered at no cost based on the BreastScreen Australia program (Cancer Council Australia, 2013). For the women who are more than fifty years old, recommendations have been made. (National Breast Cancer Center, 2001).
A biopsy can also be used to detect breast cancer. A medical expert may recommend a biopsy in a situation where a strange or abnormal tissue area is identified in ones breast. When a biopsy is carried out, a small quantity of tissue from ones breast is to be removed. The removed tissue is carefully checked by a pathologist to see whether there are any cancer cells. In order to check it, a microscope can be used. A person may be required to go through more than just one biopsy (Cancer Council, 2011).
Breast Self-Examination
As it has already been found out, the survival rate for breast cancer is higher if its detection is carried out earlier. One of the most excellent and effective ways of identifying breast lumps is to undertake a breast examination on a monthly basis (Sterrett, et al., 1994). In spite of this, it is reported that around thirty three percent of women in Australia carry out regular breast self-examinations (Womens & Breast Imaging, 2013).
After surveying women in Western Australia on breast cancer self-examination, it was found out that just about seventeen percent of the women in the region performed the self-exams on a monthly basis (Womens & Breast Imaging, 2013). The findings from the survey also indicated that only about thirty percent of the respondents had never performed breast cancer self-examination (Womens & Breast Imaging, 2013).
A breast self-examination comprises of the manual exam either lying down or standing and a visual examination in the mirror (Womens & Breast Imaging, 2013, p.1). This should be performed on a monthly basis. A female person has to be aware of what is supposed to be normal for her breast and carrying out a breast self-exam will assist her in detecting any changes that may have occurred in her breast (Womens & Breast Imaging, 2013).
Breast Cancer History
Human beings have known the breast cancer disease since the ancient times (De Moulin, 1983; Papac, 2002). Due to the symptoms that can be clearly seen, particularly during the later stages the lumps that progress to tumours have been recorded by physicians from early times (Mandal, 2013, p.1).
However, during the early times, this was regarded as a taboo and a cause of shame and this implied that diagnosis and detection of this disease was very rare (Yalom, 1997). Having more women involved in revealing the breast cancer in an open way is an occurrence that came up about forty years ago. In the course of the last decade of the 20th century, the pink ribbon , which is a breast cancer symbol, introduced a revolution against this form of cancer (Mandal, 2013).
By the mid 1990s, following the introduction of modern medicine, the number of women who had a mastectomy had gone below ten percent. At this point, new therapies for the disease including hormone treatments, surgeries and biological therapies have been set up (Mandal, 2013, p.1). There was also development of mammography and since that time, the early detection of breast cancer has become possible (Mandal, 2013).
Treatment of Breast Cancer
Breast cancer treatment may include surgery, radiotherapy, chemotherapy, hormone therapy and targeted therapies (Cancer Council, 2011, p.24). In most cases, more than one treatment for breast cancer can be used at a time. The doctors advice are required regarding the best breast cancer treatment that any particular person may require.
The kind of treatment to be given will depend on a number of factors and these include the patients test results, where the cancer is located, the patients general health and age, the patients preferences, and the extent to which the cancer has moved among other factors.
Looking at surgery, it can be of two kinds: mastectomy and breast conserving surgery. The breast conserving surgery involves removing some portion of the breast that has the cancer cells. This type of surgery is carried out when the size of cancer is smaller than the breasts size. The doctor undertakes the removal of the most minimal amount of breast tissues possible. On the other hand, mastectomy involves the removal of the entire breast (Hartmann, 1999).
However the chest muscles are not removed. Some of the lymph nodes or even all of them, found under the arm, which are very close to the breast having the cancer, may be removed as well (Lee et al. 1992). This kind of surgery may be performed if the size of cancer is bigger than that of the breast or if the cancer is found in multiple areas (Hartmann, 1999).
Another breast cancer treatment method is radiotherapy. This one makes use of high-energy x-rays in killing the cancer cells or stopping the growth of these cells (Cancer Council, 2011).
Recommendation for radiotherapy is made by the doctor for a patient after she has gone through breast conserving surgery in order to assist in destroying any remaining cancer cells and to bring down the level of chance of having the cancer returning. Sometimes, this kind of treatment is also given to patients who have gone through a mastectomy. Some of the side effects of radiotherapy include tiredness, dry and red skin, and blistering and inflammation of skin.
Chemotherapy is another method of breast cancer treatment. It involves the use of drugs to either kill or slow down the rate of growth of the cancer cells (Bonadonna, et al., 1976). This method may be used when the chances of the cancer coming back are high, when the cancer is back after performing surgery or even radiotherapy and the method may also be used in case the cancer does not show any response to the hormone therapy (Pierce, 1993).
There is a number of drugs that are used in this treatment of the cancer and some of them include carboplatic, docetaxel and fluorouracil drugs among many others (Harris &Swain, 1996).
The drug gives a specific drug combination to the patient depending on the kind of breast cancer she is having and the kind of treatment she has already gone through. In most cases, chemotherapy is administered via a vein and the patient will have approximately four to six sessions of chemotherapy in the course of every two to three weeks over a period of several months.
The side effects associated with this treatment are dependent on the kind of drugs that have been used but some of these effects include nausea and vomiting, changes in weight, loss of hair and tiredness among other effects.
Hormone therapy is also used for breast cancer treatment. This method of treatment is applied to the patients that have ER+ hormone receptors on their breast cancer cells (Cancer Council, 2011, p.36). The main objective of this method is to slow down or put a halt to the growth of hormone receptor positive cancer cells (Cancer Council, 2011, p.36).
References
Bonadonna G., Brusamolino E., Valagussa P., Rossi A., et al. (1976). Combination chemotherapy as an adjuvant treatment in operable breast cancer. N Engl J Med, 294(1),40510.
Cancer Australia, (2013) Breast cancer risk factors a review of the evidence. Web.
Cancer Council, (2011). Understanding breast cancer. Web.
Cancer Council Australia, (2013). Early detection of breast cancer. Web.
De Moulin, D. (1983). A short history of breast cancer. New York, N.Y: Oxford University Press.
Donegan, W. L. Staging and prognosis . In: Donegan W. L, Spratt J. S, eds. Cancer of the breast, 5th ed. Philadelphia: W.B. Saunders Co; 2002. p. 478.
Garvan Institute of Medical Research, ( 2010). Breast Cancer. Web.
Harris, L. & Swain S. M. (1996). The role of primary chemotherapy in early breast cancer. Semin Oncol, 23(1), 3142.
Hartmann, L. C, et al. (1999). Efficacy of bilateral prophylactic mastectomy in women with a family history of breast cancer. N Engl J Med 340(1), 7784.
Lee, M. S, et al., (1992). Mastectomy or conservation for early breast cancer: psychological morbidity. Eur J Cancer, 28(1), 13404.
Miller, M. J, Boyer.J, & Dunn, S. M. (1995). Why do Australian cancer patients use unproven treatments? Proceedings of the American Society of Clinical Oncology 22(1), 76.
National Breast Cancer Center, (2001). Management of early breast cancer. Adelaide, Australia: Commonwealth of Australia.
Papac, R. J. (2002). Origins of cancer therapy. Yale J Biol and Med, 74(2), 3918.
Pierce, P. F. (1993). Deciding on breast cancer treatment: a description of decision behavior. Nurs Res 42(1),228.
Queensland Government, (2011). Risk of breast cancer in Australian women. Web.
Sterrett G, et al. (1994) Breast cancer in Western Australia in 1989 III. Accuracy of FNA cytology in diagnosis. Aust N Z J Surg, 64(1)7459.
Breast cancer is a tumor that affects lobules and milk ducts, which form part of the breast tissue. Depending on the site of occurrence, breast cancer can form ductal carcinomas and lobular carcinomas if they occur in the ducts and lobules of the breast, respectively. Breast cancer is prevalent among women, and it is the major cause of death in the United States. The prevalence rates and epidemiology of breast cancer indicate that it is a challenging disease, which the health care systems across the world are struggling to diagnose, treat, manage, and prevent. According to Lin and Pan (2012), breast cancer is the most common malignancy in women, with approximately 1.38 million new patients, and 459,000 deaths per year worldwide, (p. 1). The malignancy and treatment of breast cancer disable patients, as it causes great pain, shoulder dysfunction, lymphedema, hormone disorder, neuropathy, and psychological disorders. To enhance understanding of breast cancer, this paper assesses a literature review to determine treatment and rehabilitation options, performs a functional assessment, and establishes residual functional capacity of patients.
Literature Review
Breast cancer is dominant cancer among women, and it contributes to the high mortality rates. The health care system utilizes chemotherapy, radiotherapy, and surgery in the treatment of breast cancer. Since breast cancer has disabling effects, it requires effective treatment and rehabilitative interventions. According to Silver (2007), pain-relieving, fatigue reduction, physical exercise, and psychotherapy are some of the rehabilitation methods applicable to the management of cancer. However, a few numbers of patients usually undergo the process of rehabilitation; hence, increasing their risk of disabling effects of cancer (Lin, & Pan, 2012). Therefore, many women are grappling with the impacts of breast cancer and the adverse effects of therapies.
Breast cancer and treatment methods have significant effects on the health of patients. Studies show that breast cancer and its treatment methods cause motor, sensory, cognitive, emotional/behavioral, and adaptive dysfunctions (Perry, Kowalski, & Chang, 2007). Motor and sensory dysfunctions occur due to chronic pain that has a paralyzing effect. Chemotherapy and radiotherapy cause fatigue and increase physical disability among patients with breast cancer. In the emotional/behavioral aspect, breast cancer and its treatment reduce libido, thus causing sexual dysfunction (Melisko, Goldman, & Rugo, 2010). Functional analysis shows that breast cancer and its treatment methods have significant disabling effects that require effective treatment and rehabilitative interventions.
Treatment and Rehabilitation Options
Depending on the nature and stage of breast cancer, surgery, chemotherapy, and radiotherapy are available treatment options. Surgery involves the excision of the benign or malignant cells that are present in the breast. If surgery entails the excision of benign cells, the patient experience minimal disability. However, cases of malignancy always lead to mastectomy, which involves complete removal of the whole breast. Usually, patients who undergo mastectomy require breast reconstruction to replace their breasts. The use of chemotherapy and reconstruction procedure determines the disabling nature of mastectomy. Chemotherapy is an effective treatment that therapists apply in both long-term and short-term treatment of breast cancer.
It entails the destruction of cancerous cells using drugs, hormones, and antibodies (Silver, 2007). Chemotherapy is applicable in reducing the growth of cancer and preventing breast cancer cells from metastasizing into other tissues in the body. Radiotherapy is also an effective therapy that aids in the destruction of cancerous cells after surgery. A combination of surgery, chemotherapy, and radiotherapy provides enhanced treatment of breast cancer.
Breast cancer malignancy and treatment cause great disability, which influences the ability of patients to perform their daily activities. One of the rehabilitation options for people with breast cancer is physical therapy. Physiotherapy enhances the treatment of breast cancer because it promotes the normal functioning of the physiological processes in the body. Physical and occupational therapy can help increase shoulder range of motion, promote upper extremity strengths, decrease pain, and reduce swelling (Silver, 2007, p. 529). Hence, physical therapy has cascading effects that aid in the treatment and management of disabilities associated with breast cancer. Relieving pain is another method of rehabilitating patients with breast cancer. The malignancy and adverse effects of treatment cause great pain, which has disabling effects on the patients. Silver (2007) states that acupuncture, massage, analgesics, and occupational therapy are some of the ways that patients can use in relieving pain. With reduced pain, patients are able to perform their duties without undue interference by breast cancer.
Reducing fatigue is a rehabilitation option that people with breast cancer can use in overcoming disabling effects of breast cancer. Studies examining the prevalence of fatigue among breast cancer patients have found that up 99% experience some level of fatigue during the course of radiation and/or chemotherapy (Bower, Ganz, Desmond, Rowland, Meyetrowitz, & Belin, 2011, p. 743). Moreover, patients experience higher fatigue than healthy individuals do. This means that breast cancer and treatment method determine the extent of fatigue that individual experiences. Since fatigue occurs due to physical or emotional impacts of breast cancer, exercise, pain-relieving, and psychotherapy can help in reducing its impact.
Functional Assessment
Breast cancer and treatment have some disabling effects on patients. The functional assessment indicates that breast cancer affects motor functions, sensory functions, emotional/behavioral functions, cognitive functions, and adaptive functions of patients. Breast cancer and its treatment have significant impacts on the ability of patients to function effectively because they cause chronic pain, shoulder dysfunction, hormone disorder, psychological problems, and neuropathy (Lin, & Pan, 2012, p. 1). Each of these impacts has disabling effects on patients. Pain associated with breast cancer is chronic and emanates from the malignancy of cancer and adverse impacts of therapies such as chemotherapy, radiotherapy, and surgery.
According to Silver (2007), pain causes musculoskeletal disorders such as arthritis, cellulitis, edema, neuroma, brachial plexopathy, deep vein thrombosis, epicondylitis, and tendinitis, amongst other complications that contribute to physical disability. Additionally, breast cancer causes shoulder dysfunction, which prevents patients from lifting objects or performing heavy tasks using their hands. Thus, chronic pain and shoulder dysfunctions comprise a motor and sensory dysfunctions that patients of breast cancer exhibit.
Breast cancer also causes hormonal imbalance among patients and leads to serious emotional/behavioral dysfunctions. A combination of radiotherapy, surgery, and chemotherapy causes hormonal imbalance and consequent sexual dysfunction. Sexual issues identified in breast cancer survivors include changes in body image associated with the loss of a breast or weight gain, decreased libido, vaginal dryness, and dyspareunia, difficulty with arousal and orgasm, and concern over fertility (Melisko, Goldman, & Rugo, 2010, p. 248). Thus, sexual dysfunction is an emotional/behavioral dysfunction, which contributes to sexual disorders that patients with breast cancer are struggling to overcome.
In the aspect of cognitive function, breast cancer causes depression. According to Perry, Kowalski, and Chang (2007), breast cancer causes psychosocial distress, which affects cognitive functions and results in depression. Breast cancer threatens patients and causes a lot of anxiety because it leads to loss of breast and eventually death in some instances. However, despite enduring numerous disabling effects of breast cancer, patients exhibit adaptive functions such as adhering to therapeutic and rehabilitative interventions and thus improving their quality of life.
Residual Functional Capacity and Job Options
Since breast cancer affects sensory and motor functions, patients with breast cancer can perform light duties and walk short distances. Patients with breast cancer are unable to perform heavy duties and walk long distances because they experience fatigue. There is growing evidence to suggest that fatigue may persist for months or even years after completion of breast cancer treatment, particularly among patients who have received adjuvant chemotherapy (Bower, Ganz, Desmond, Rowland, Meyetrowitz, & Belin, 2011, p. 743). This shows that adjuvant therapy is responsible for fatigue that breast cancer patients experience during therapy and even years after the therapy. Moreover, sexual dysfunction due to loss of libido is a long-term effect of breast cancer. After undergoing therapy, some patients usually lose their sexual ability. Concerning cognitive and adaptive functions, patients with breast cancer portray normal cognitive abilities and adaptive functions. Hence, breast cancer and treatment have no significant impact on the cognitive and adaptive capacities of patients.
Conclusion
Breast cancer is a tumor that is dominant among women. Chemotherapy, radiotherapy, and surgery are common treatment options for breast cancer. Additionally, rehabilitation options for breast cancer are pain-relieving, reduction of fatigue, exercise, and psychotherapy. Analysis of functional assessment and residual functional capacity indicates that breast cancer affects motor, sensory, cognitive, emotional/behavioral, and adaptive functions of patients.
References
Bower, J., Ganz, P., Desmond, K., Rowland, J., Meyetrowitz, B., & Belin, T. (2011).
Fatigue in breast cancer survivors: Occurrence, correlates, and impact on quality of life. Journal of Oncology, 18(4), 743-753.
Lin, Y., & Pan, P. (2012). The use of rehabilitation among patients with breast cancer: A retrospective longitudinal cohort study. Health Services Research, 12(282), 1-7.
Melisko, M., Goldman, M., & Rugo, H. (2010). Amelioration of sexual adverse affects in early breast cancer patient. Journal of Cancer Survival, 4(3), 247-255.
Perry, S., Kowalski, T., & Chang, C. (2007). Quality of life assessment in women with breast cancer: Benefits, acceptability, and utilization. Health and Quality of Life Outcomes, 5(24), 1-14.
Silver, J. (2007). Rehabilitation in women with breast cancer. Physical Medicine and Rehabilitation Clinics of North America, 18(3), 521-537.
One of the most critical factors of breast cancer development is heredity since it causes a genetically inherent disease. If the patients closest relatives have been diagnosed with breast cancer, a tumors likelihood is high even at a young age (Coleman & Tsongalis, 2016). Since one of the patients close relatives had this disease, this diagnosis is indeed possible for her as well. Another significant factor in developing cancer is various diseases of the mammary glands, for example, cystic breasts. In the presence of such conditions, the formation of atypical cells is possible in the mammary gland (Tkaczuk et al., 2016). This can lead to their overgrowth and increase the risk of more severe diseases.
The hormonal factor also has a critical influence on health. In the described case, this aspect is the most significant since it includes various details of the patients life. These include the first pregnancy after 30 years, not breastfeeding, and many years of taking hormonal contraceptives. This leads to the fact that the patients hormonal background can be disrupted (Tkaczuk et al., 2016). Therefore, with age, it becomes more difficult for the body to deal with abnormal processes.
If there is an initial stage of cancer, there can be no metastasis in the patients organs. However, early active metastasis is characteristic of aggressive forms of cancer. There are multiple ways to determine them, and it is necessary to use some of them in any case to avoid future health problems. Histological analysis of tissue can determine the aggressiveness of the cancer type at an early stage. Breast cancer metastases detected by CT or scintigraphy indicate secondary foci in the lungs, liver, bones, and brain. It must be remembered that in breast cancer, metastases are capable of long-term existence in a latent state, even five to ten years after removal of the primary tumor.
References
Coleman, W. B., & Tsongalis, G. H. (2016). The molecular basis of human cancer. Humana Press.
Tkaczuk, K., et al. (2016). Handbook of breast cancer and related breast disease. Springer Publishing Company.
Patients seek medical treatment with the primary goal of keeping complications to a minimum. Furthermore, every patient wishes to live a more fulfilling life before being diagnosed with a medical condition. When it comes to breast cancer, this is not always the case since treating patients with chemotherapy has side effects that result in psychological problems. Therefore, it is necessary to devise a strategy that ensures the patient is not adversely affected by the treatment and that their mental condition has improved despite side effects. Lesiuks research shows that practicing mindfulness improves the mental health of patients undergoing treatment and lessens the adverse effects of medication on the brain. She focuses on a small sample to conduct a pilot study on the impact of mindfulness-based music therapy (MBMT) on breast cancer patients concerning the chemotherapy treatment they are receiving. To provide an accurate assessment of Lesiuks article, I will examine its presentation of information and the soundness of the methodology and research strategy she used to arrive at her arguments. The assessment will determine the validity of applying Lesiuks study recommendations to nursing practice, focusing on adjuvant chemotherapy treatment.
The primary objective of this study is to conduct a critical evaluation of Lesiuks article. It is titled The effect of mindfulness-based music therapy on attention and mood in women receiving adjuvant chemotherapy for breast cancer: a pilot study. The paper seeks to comprehend its implications for nursing practice and the outcomes that can be anticipated to be accomplished. This paper will discuss the effects that music focusing on the patients mindfulness will have on the patients ability to recall chemotherapy sessions while minimizing the negative effects associated with chemotherapy sessions. These effects are expected to have a positive impact to patients with breast cancer who are being cared for by nurses.
Evaluation of Lesiuks presentation reveals an articulate and persuasive argument concerning the efficacy of music therapy for breast cancer patients undergoing adjuvant treatment. She zeroes in on 15 women whose breast cancer has been diagnosed between stages 1-3 and who are currently undergoing chemotherapy (278). She is forthright about her research, methods, and results (279). The information is presented in an orderly fashion that is easy to comprehend with no ambiguity. She discusses the significance of the study to the nursing field and how nurses can use the findings to help their patients cope with stress (281). Lesiuk stays on track with the studys purpose and includes essential, pertinent details that enrich the discussion. Researchers in the same field as Lesiuk are the only ones who can help improve the presentation of ideas as they are presented here.
A critical evaluation of the researchs methodology reveals a variety of crucial approaches for conducting credible research. The longitudinal method enables the researcher to identify population-level changes and track the development of the subject in real-time. Lesiuk opted for a research design that integrated longitudinal, quantitative, and descriptive methods (277). Due to the use of this research strategy, the outcomes of the preliminary study and pilot project were highly successful in meeting their respective objectives (278). In addition, the researcher collected all of the information she sought, which has a significant bearing on the significance of her findings, indicating that music therapy will benefit women with breast cancer. She used repeated measures analysis of variance to analyze her data accurately (279). Due to the designs high level of precision, it is possible to ensure that the data is always authentic and verifiable. It significantly reduces the margin for error, laying the groundwork for enhanced performance and more equitable outcomes. Consequently, she has taken the necessary measures to ensure that her methodology is sufficiently detailed, enabling the reader to easily replicate her actions and identify problem areas requiring further study.
My evaluation of the argument presented by Lesiuk in her study reveals that she is a thorough researcher who wants to leave nothing to chance. I, therefore, concur with her findings since the study has a great deal of credibility as it draws on the work of other scholars and uses their research to support its arguments (280). In addition, she ensures credibility in her research by being mindful of her sample (277), which ensures that she gets the correct data from them. She maintains professionalism and ensures her participants know her research (278). As a result of studies examining the aftereffects of MBMT participation, medical professionals now have a wealth of new information that can be used to provide patients with the best possible care. Since they can significantly improve patient health and help restore patients faith in chemotherapy treatment, which has been shown to impact patients lives negatively, the research findings are likely to be implemented.
In conclusion, Lesiuk found that patients who practiced mindfulness during adjuvant chemotherapy for breast cancer reported feeling better emotionally and experiencing fewer adverse side effects from their medication. She provides a transparent account of her studys methods and findings. Her information is well-structured as she elaborates on the significance of MBMT for nurses and how they can apply the findings to aid patients in dealing with the adverse effects of stress. The studys results are likely to be implemented since they can enhance patient health and renew patients faith in chemotherapy treatment. Therefore, I am pleased to have selected this learning resource to evaluate as I am more enlightened regarding MBMT. The resource has contributed significantly to my desire to learn more about MBMT; the other therapy areas are significant. As a result, I concur with Lesiuk that the unique contribution of music to mindfulness practice in the form of MBMT significantly improves attention and mood states for women receiving adjuvant chemotherapy for breast cancer.
Cancer results from the cellular disorder that involves a poorly characterized sequence of molecular events that comprise unrestrained cell propagation, morphological and cellular alteration. It may also result from deregulation of apoptosis, angiogenesis, increased invasive cell activity as well as succeeding confined and remote metastases. It has now been approved that tumor microenvironment that increase and modifies in line with the growth load is central in the cancer development process (Menard et al, 2000, p.256). Indeed cancer growth is a series of processes that is driven by alterations of genes that bring about the progressive conversion of usual body cells into extremely malignant imitation. The altered cell explosive phenotype of malignancy involves distinguished progression of molecular events that in most cases lead to the growth of metastasis (Menard et al., 2000, p.256).
According to Gajria and Chandarlapaty (2011), about 5 to 10 percent cases of breast cancer are hereditary, the abnormal genes causing cancer is passed on the child from the parent (p.270). Genes are the unit particles of a cell but they are contained in chromosomes and are made up of deoxyribonucleic acid (DNA). DNA is the part of the gene that contains coded instructions that built up proteins. Proteins are the building blocks of the body structure of a cell and controls the functions of a cell that make up the whole body of an organism. Abnormalities in the gene structure may result in the coding error or instructional error leading to defective growth in cells or its function (Gajria & Chandarlapaty, 2011, p.269).
Breast Cancer gene 1 (BRCA1) and Breast Cancer gene 2 (BRCA2)
Most of the breast cancer cases are related to the BRCA1 and BRCA2 abnormal genes. All people posses the two genes in their breast cells and the major functions are to repair damages in the breast cells and to maintain the normal growth of these cells. Any abnormality in the gene structure will cause a malfunction and uncontrolled growth of the breast cells (Gajria & Chandarlapaty, 2011, p.269). The abnormalities in the genetic coded structure may be caused by mutations that might be inherited or may be caused by other environmental causative agents. However, mutations in the BRCA genes do not necessarily mean that one will be diagnosed with breast cancer. Nevertheless, cases of Breast cancer that result from the BRCA abnormalities accounts for only 10%. In most cases the gene mutations that result in breast cancer are inheritable (Gajria & Chandarlapaty, 2011, p.269).
Several researches have confirmed that other gene mutations called single nucleotide polymorphisms (SNPS) also occur in the peace of chromosomes that contain the BRCA genes. When combined together with the BRCA abnormality, there are high chances that an individual will develop breast cancer particularly those women that do not possess the inheritable BRCA abnormality (Jones & Buzdar, 2009, p.1181). Majority of women that are diagnosed with breast cancer in one way or the other have a family history of other forms of cancer such as the ovarian cancer. But this is not true to all the breast cancer victims.
How Herceptin Works
Herceptin is part of the monoclonal groups of drugs that are used in the treatment of cancer. Monoclonal antibodies distinguish specific proteins and locks onto the surface of cancerous cells. This helps the body immune system to destroy the recognized cancer cells. Monoclonal therapies are known as targeted treatments since their designation are to target specific cancer cells (Spector & Blackwell, 2009, p.5840).
Monoclonal antibodies treatment is relatively a modern type of targeted cancer therapy. Antibodies are element of the larger body immune system. In most cases the body manufacture antibodies in response to any foreign materials entering the body (antigen). The antibody works by attaching to the surface of the antigen and destroying the foreign body or preparing the antigen for further action by other elements of the immune system (Spector & Blackwell, 2009, p.5842). Scientists are capable of analyzing the antigen that can specifically attach to the surfaces of particular cancer cells. Using the antibody antigen key and lock technology scientists has created a particular antibody that attaches itself to the surfaces of the antigenic cancer cells outgrowths. Moreover the technology has allowed the treatment of targeted cancer cells without further destruction or toxicating other healthy cells. Monoclonal therapy is only applied to the cancer cells whose antigens and their receptive antibodies have been identified (Spector & Blackwell, 2009, p.5842).
Herceptin works by aiming at the antigen HER-2 receptors on the surfaces of cancer cells. Basically, HER-2 genes produce a particular receptor protein on the breasts cell surfaces stimulating growth and multiplication. The cancerous breast cells produces too much of the HER-2 protein triggering an abnormal rapid cell division and multiplication (Garrett & Arteaga, 2011, p.795). Herceptin is an artificial antibody that binds to with the extra HER-2 receptors preventing over-multiplication of cells hence reducing the rate of tumor growth and decreasing the cancer progression. Herceptin may also stimulate the immune system to naturally work destroy the tumor cells or slow the growth of tumor cells.
Cancer cells have a tendency of growing uncontrollably. On the surface of these cells herceptin blocks the chemical signal that act as a stimulant to the uncontrolled growth. Various cancer cells are capable of over expressing many copies of a certain gene known as the HER-2 which is responsible for manufacturing HER-2 receptor protein (Garrett & Arteaga, 2011, p.795). The HER -2 are responsible for the growth and multiplication of the cells. However the HER-2 receptors can be over stimulated resulting into haphazard growth and multiplication leading to breast cancer. HER-2 breast cancer positive are the cancer cells that over express the HER-2 genes in their surfaces (Garrett & Arteaga, 2011, p.795).
Herceptin attaches itself to the HER-2 receptors on the breast cancer cells surfaces and stops growth stimulation. Hence herceptin slows down the growth of breast cancer. The drug is an example of immune therapy that targets a particular antibody. Apart from blocking the HER-2 receptors from over expressing itself herceptin can also inform the body immune system to kill cancer cells that it attaches to (Jones & Buzdar, 2009, p.1181). In addition, herceptin can be combined with chemotherapy can synergistically and effectively destroy the tumor cells.
HER-2 is 20-25% is over expressed invasive breast cancer cells that are linked with aggressive tumor phenotype as well as the reduced survival rate (Addeo & Caraglia, 2011, p.140). The status of HER-2 in a tumor is essential in determining the response to the targeted antibody Herceptin. Hence the expression levels of the HER-2 in the tumor cells must be accurately assessed so as to determine the breast cancer patients who can particularly benefit from the HER-2-targeted treatment. Herceptin combine with other therapies such as chemotherapy and hormonal therapy augments the response rate, slows down the tumor growth and increases the chances of survival (Jones & Buzdar, 2009, p.1181). However, majority of cancer patients that originally react to herceptin commence to progress once more a year after the treatment.
The side effects of Herceptin
Individuals react differently to the treatment of cancer more in the use of drugs especially herceptin. While some people may experience minor and few side effects others may experience severe effects of the drug. Herceptin side effects are grouped into two. They include the effects that are experienced in the early stages in the drug infusion and the effects that may occur later after the drug has been used. Early infusion-related effects normally occur within four hours after the diagnosis (Menard et al, 2000, p.257). The side effects are imminent with the first few doses but disappear with subsequent doses. The late side effects normally occur after some days or may extent to some weeks after the therapy.
Early fusion-related side-effects
These include Flu-like symptoms that are characterized with headaches, high temperature or fever. These types of side effects normally come about as a result of immediate body reaction to the drugs. Another immediate body reaction to the drug is allergy though uncommon. The signs for allergy may include wheezing, breathlessness, body rashes and itching. Allergic reactions occur due to the activation of immune system surrounding these cells (Addeo & Caraglia, 2011, p.143). The reaction of the immune system to the surrounding cells may trigger their overproduction or inducing them to produce more antigens to react with the antibody entering the body.
The late side effects
These may include diarrhea which may be mild or severe. Others are headaches, nausea which is very common with many monoclonal drugs. In most cases these normally occur as a result of the interferences with body systems such as the digestive and circulatory systems. These systems normally produce a lot of antibodies and therefore any addition of the antibodies may kill the normal proteins in the system. In the circulatory system is where all the antibodies are produced hence the system must be greatly interfered with by the introduction of the drug. These side effects together with the early infusion- side-effects can be reduced by using the necessary prescribed drugs (Garrett & Arteaga, 2011, p.793).
The greatest and most lethal side effect of the herceptin is associated with the heart failure. The drug may cause heart problem to some people. It is not always recommended for people with heart problem history or with high blood pressure. Herceptin destroys the heart linings thereby causing the slow malfunctioning of the heart. Cells aligning the major tissues of the heart are prone to the herceptin antibodies thus causing their destruction (Garrett & Arteaga, 2011, p.795). Before herceptin diagnosis the victims are recommended for checks to determine the patients chances of developing heart problems. The other side effect is the destruction of fetuses in pregnant women. In some cases the drug may cause the death of the fetus. It is recommended that women who are likely to become pregnant use the appropriate birth control measures while undergoing herceptin treatment (Menard et al, 2000, p.257). Similarly, mothers nursing their babies should also avoid the drug or completely stop nursing.
Conclusion
Herceptin is monoclonal antibody therapy that kills or destroys tumor cells using the natural body immune system. Though cancerous cells may grow beyond the normal level, they similar to the body cells hence are capable of escaping the normal destruction by the natural body immune mechanisms. However there exist some remarkable differences between normal and cancer cells. In case of breast cancer, there are numerous copies of cancer causing gene known as the HER-2. This implies that HER-2 results in the over expression of receptor protein on the surface of the cells responsible for the growth and cell multiplication. Over production of the proteins may result in the increased growth or multiplication of the cells leading to a tumor. Herceptin is made in such a way that it targets the cells that over express HER-2 genes. Herceptin, though not very effective in the treatment of breast cancer, when combined with other therapies it becomes more effective.
References
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