In recent years, breast cancer rates have increased among younger women. Read about what several doctors have to say about the trends and what patients face.
Dr. Cheng Yu-shu, an attending physician at the breast surgery department of the China Medical University Hospital in Taiwan and a breast cancer survivor, shared personal experiences on how breast cancer patients reassess their lives during treatment.
A Doctor’s Personal Experience With Cancer
Cheng said that one Sunday in June 2019, she discovered a lump in her breast.
After the diagnosis, her first reaction was to hide her condition because she subconsciously felt that as a breast surgeon, having breast cancer herself felt like a personal failure.
Her subsequent treatment did not go as smoothly as expected. During the fourth and fifth rounds of chemotherapy, she went into shock due to infection. She required emergency treatment and was admitted to the intensive care unit (ICU).
Cheng admitted that although she tried hard to conceal her illness, her colleagues still knew about it. With the help of a psychiatrist, she began to share her experiences in closed-group counseling and received numerous blessings and much encouragement.
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After that, she actively underwent chemotherapy and other treatments and experienced various side effects, ranging from poor immunity, mucosal damage, skin rashes, nail deformation, hair loss, fatigue, vomiting, diarrhea, and more. From this personal experience of both the treatment and its side effects, today, she can better understand how her patients feel.
Of all these side effects, the one that affected her most was the hair loss. As a doctor, she used to prescribe various chemotherapy drugs to patients, and she found it difficult to understand why some of them refused treatment out of concerns for hair loss. She had believed that since hair loss was not life-threatening, it was the least worrisome side effect.
But when she experienced similar side effects of chemotherapy firsthand, she then understood how others felt. Watching her hair fall away was like watching part of her body leave her, and she could do nothing about it. This feeling of helplessness made her panic.
During this period, Cheng had a serious conversation with her father about what made a person useful. They discussed how caring for others as a doctor was an admirable pursuit but that it didn’t define whether a person was useful or not. “If you can care for another person, then do that,” he said. “If you are too weak to care for even one other person, then take care of yourself and live a safe, healthy, and happy life.” These words from her father gave her great comfort.
During treatment, she continued to wonder: “Why me?” Today, she believes one of the reasons may have been to break down the part of herself she falsely believed to be perfect. Now, she believes accepting imperfection is key to starting a new life and that she must take better care of herself to prevent the cancer from coming back.
Importance of Breast Cancer Classification
Wei said the most common breast cancer is invasive (infiltrating) ductal carcinoma (IDC), accounting for 90 percent of all cases, and about 5 percent to 10 percent is lobular breast cancer.
Breast cancer is divided into stages four stages. Determining which stage one’s cancer is in requires complex clinical examinations and other auxiliary assessments.
Wei emphasized that cancer treatment is highly complex, so staging is essential. Doctors will prescribe different treatment plans based on various stages. For example, for stage 0 patients, surgery and a little medication may be good enough, whereas treatment is much more complicated for stage 4 patients.
After staging, doctors also need to analyze the characteristics of breast cancer. For example, if a patient is diagnosed with stage 1 breast cancer, it could be benign or malignant. In this case, doctors perform various in-depth examinations on breast cancer tissue sections to determine its characteristics. For example, two-thirds of breast cancer patients will exhibit estrogen and progesterone receptors.
Wei said that as a general rule, as long as a woman’s breast cancer is not yet stage 4, she will have a high survival rate.
No Rush to Have Breast Cancer Removed Immediately
It is a common belief that once cancer is detected, it should be removed immediately before any other treatment. However, there are also a few different situations where this may not be the best option. For example, for TNBC, or if the tumor is larger than 2 centimeters, clinical tests have proven that the survival rate can be greatly improved if chemotherapy is done first.
Moreover, if localized lobular breast cancer tumors are too large, removal at this stage would render the operation and postoperative reshaping more difficult. Therefore, targeted therapy to shrink the cancer prior to surgery is recommended. This can improve postoperative cosmetic effects and survival rates.
Breast Cancer Incidence and Prevention
In addition to skin cancer, breast cancer is the most common cancer among American women, and its mortality rate ranks second only to lung cancer. Statistics suggest that 13 percent of American women will develop breast cancer at some point in their lives, meaning one in eight women will become breast cancer patients.
1. Unmodifiable Factors
Five percent to 10 percent of breast cancer patients are born with genes that make them more vulnerable to its incidence, such as mutated BRCA1 and BRCA2. If these genes are present, the risk of breast cancer exceeds 60 percent.
Wei said that many breast cancer patients or people with a family history of breast cancer have begun to conduct extensive checks of their family genes. If they are found to bear such genes, the age at which they should be screened for cancer differs from that of the average person.
2. Modifiable Factors
According to Wei, the following lifestyle factors should be considered:
- Manage stress and keep a proactive, positive mindset.
- Eat a healthy, whole-food diet, avoiding toxins that lurk in processed food, tobacco, and alcohol. Also, be aware of endocrine-disrupting chemicals in personal care products.
- Exercise regularly and follow a consistent bedtime routine.
- Follow your doctor’s advice and undergo appropriate screenings.
Doctor Calls on More People to Participate in Clinical Trials
Winer said that breast cancer is more common among women in their 40s to 70s. Statistics show that from about 45 onward, the incidence rate begins to increase drastically.
Clinical trials are an essential way to evaluate new drugs, but the proportion of cancer patients participating in clinical trials in the United States is still small. This is especially true among Asian women, who participate less often in clinical trials.
Winer emphasized that side effects in clinical trials may differ across racial groups. Therefore, more Asian women must participate in clinical trials so we can have a better understanding of how they fare in treatment.
