September 26, 2018
Breast Cancer Awareness
by Dr. Gregory Marino, Hematologist/Oncologist JCHC
October is breast cancer awareness month, and this new tradition has contributed greatly to the communities’ greater understanding of this disease, has lead to better screening participation and techniques, and has seen improvements in treatment and outcomes.
Not A Single Disease
While we have seen improvements in detection and therapy for this disease, it should be understood that breast cancer is not a single disease. There are at least fifteen distinct subtypes of breast cancer, excluding such rare cancers such as sarcomas or lymphomas arising from the breast. It appears that doctors like to find and classify as many different diseases as they can, but in the case of breast cancer determining the subtype may have a major impact on prognosis and therapeutic options.
Can Run In Families
For decades physicians have observed the tendency for some breast cancers to run in families, especially when these malignancies appear at any early age or in men. Yes, men can get breast cancer too, accounting for about one percent of all cases. When breast cancer seems to run in a family, occurs at a young age, especially under the age of fifty, or appears in a male, referral to a genetics counselor should be considered and genetics testing might be appropriate. This could reveal the significant risk of developing other cancers, such as in the other breast or of the ovary, and might show an increase risk of cancer in offspring or siblings.
The care of the patient with breast cancer should be comprehensive and multidisciplinary as this approach not only improves survival for the patient it may also save the lives of their loved ones.
October may also be a good time to think about cancer prevention, and to consider what could be done to prevent some cancers. Not all cancers can be prevented, or at least as far as we know in 2018, but several can. One of the biggest killers is preventable in 80 – 90 percent of cases, and that killer is lung cancer, and the cause is smoking. Tobacco also causes or promotes many of the cancers of the aero-digestive tract, and of the urinary tract. There is a higher rate lymphomas in smokers. Obesity causes a higher rate of cancer, and it is thought that the higher levels of insulin found in obesity may be the culprit. Excessive sun exposure, especially at a young age, is behind most cases of skin cancer. Hepatitis B vaccination can prevent primary liver cancer, and vaccination against HPV can prevent cervical cancer and mouth and throat cancer.
Attention to diet and fitness, using sun screen, avoiding tobacco in any form, and being sure that vaccinations are up to date may help us to live longer and better.