Medical Questions & Answers » breast cancer

Treatment of Cancer

medicalquestions — Fri, 25 Apr 2008 06:00:55 +0000

Question: My mother is on methotrexate for treatment of cancer. It is having terrible side effects. Is it worth continuing?
This is an extremely difficult and delicate question of ethics, medical technology and common sense. The treatment of a cancer can include surgery, irradiation and drugs. The type of treatment will vary depending on the type and site of the cancer. Methotrexate is a drug that kills cancer cells. Unfortunately it, and other cancer drugs, can have severe side effects, as they damage some normal cells while destroying the cancer. The usual problems are loss ot hair and vomiting associated with constant nausea and a sense of being unwell.
Ethically, all doctors ate required to do everything possible to prolong human life, and cure disease. If statistics indicate that methotrexate, or any other drug, is likely to be the best treatment, a doctor is ethically obliged to prescribe it. Medical technology may also indicate that certain treatments are sometimes successful, and that a combination of several treatments may give a slightly higher chance of success, but with a dramatic increase in side effects.
This is where common sense is required. If a patient is likely to be cured in 50% or even 25% of cases with the use of a course of Treatment that may be most unpleasant, most doctors and patients would proceed. If the success rate was only 1%, most doctors would consult with the patient and relatives and not proceed, leaving the remainder of the patient’s life as calm, peaceful and free of side effects as possible.
The problem arises between these extremes. Should the patient be given a slight chance of survival after a few months ot drug-induced agony, or should nature be allowed to take its course? There is no simple answer. Frank discussions between the patient, doctor and relatives is the only way for a consensus to be reached in solving the dilemma.

Spread of Cancer

medicalquestions — Fri, 25 Apr 2008 06:00:51 +0000

Question: Where does cancer spread to when you have a secondary cancer? I have had cancer in the breast, and I have been told that surgery has been successful and I have no secondaries, but I would like to watch out for any problems.
The liver, lymph nodes, and bones are the most common areas involved in the spread of cancer, but cancel can spread almost anywhere in the body from its original site. The type of cancer will also determine where it may spread, as some types of cancer cells appear to spread more easily to one part of the body than another.
The lymph nodes are responsible for dealing with waste products and infection, and there are direct channels from them to every part of the body. Cancer cells can spread very easily along these channels, and so with most cancers, the nearest group of lymph nodes is often surgically removed, irradiated or treated with cancer-killing drugs.
The liver is responsible for processing the blood to remove abnormal and dying cells, waste products and toxins. This too can therefore be easily affected by cancer cells. Bone marrow is responsible for producing many of the infection- and cancer-fighting cells in the body, and may itself be infilttated by cancer cells that destroy its correct function.
Secondary cancer is certainly harder to treat than primary, but it is not an inevitable death sentence because modern anti-cancer drugs, the new radiation techniques available and delicate surgery can still remove and control many of these growths.

Breast removal for cancer

medicalquestions — Wed, 23 Apr 2008 06:00:13 +0000

Question: I have had a mastectomy (breast removal) for cancer, and found that I avoided many complications of restricted arm movement and swelling ol my arm by keeping the arm above my head on a pillow, and moving it as much as possible, starting immediately after the operation.
Arm movement restrictions and lymphoedema (swelling) of the arm are common complications of breast surgery when the glands in the armpit are removed to prevent the further spread of breast cancer.
Lymph is the waste products of the cells, and lymph returns from every cell through a complex network of fine tubes, rather like thin veins. These lymph ducts pass through the lymph glands that concentrate in the armpit, groin, neck and along the inside of your backbone. Tne glands act to remove any germs that may be attempting to penetrate deeper into the body. Eventually the lymph, having being cleaned by the glands, drains into a major vein near the heart.
The complication of lymphoedema (lymph accumulation) alter breast cancer surgery varies dramatically from one patient to another, with only partial relationship to the severity of the surgery. Those who suffer severely may have an arm that is rock hard and three times its normal size. Elevation and pressure bandages are the normal treatments, but a plastic sleeve that envelopes the arm and is rhythmically inflated by a machine is the most successful treatment.
Patients requiring further help with this problem should contact the Lymphoedema Association in their state.

Large breast

medicalquestions — Tue, 22 Apr 2008 06:00:17 +0000

Question: I am 22 years old and my breasts are too large. They are quite saggy and I get rashes under them, and they cause me great discomfort. I would like to know who I can see about getting my breasts uplifted and decreased in size, the effects of the operation and how much it would cost.
Women with very large breasts can find them to be both uncomfortable and embarrassing. They develop fungal and heat rashes under the breast, and tired shoulder and back muscles from supporting them. They get in the way when Performing some tasks, and make the woman look fatter than she is. Many women gain enormous benefit by having a breast reduction operation per-formed, and the sooner such a procedure is undertaken, the better. There are a lot of plastic surgeons who perform this procedure, and you should discuss with your general practitioner who s/he recommends in your area.
There are a number of different ways of reducing the breast size, but in the most common operation, a slice of tissue and fat is removed from the underside of the breast, so that the resulting scar is in the fold under the breast, and barely noticeable. If nothing further was done, the nipple would be left pointing at the floor instead of straight ahead, so a further vertical cut must be made, to allow the nipple to be moved further up the smaller breast. The resultant vertical scar is below the nipple on an area of the breast that is rarely exposed to public view.
After the operation, you will feel much more comfortable, you will still be able to breast feed, and no one except your most intimate friends will ever know.
The costs involved in the operation will be partially refunded by Medicare (for the doctor’s fees) and your private health fund (for the hospital charges and part of the doctor’s fee). If you have no private insurance, you may have to pay $3000 to $4000. You should discuss this further at the initial consultation with the plastic surgeon, which will put you under no obligation to proceed further unless you wish to.

Treatment of breast cancer

medicalquestions — Mon, 21 Apr 2008 06:00:35 +0000

Question: My mother has just been diagnosed as suffering from breast cancer. Please tell me, how is breast cancer treated, and is it successful?
Once a breast lump is detected, a diagnosis can often be made before operation by methods such as x-rays of the breast (mammography) and needle biopsy. This is important as it allows the surgeon to discuss the diagnosis and method of treatment with the patient.
Radical mastectomy (removal of the breast and underlying muscles), and its accompanying disfigurement, is an operation of the past. It has been replaced by simple mastectomy in which only the breast is removed, leaving a cosmetically acceptable scar and scope for reconstruction of the breast by plastic surgery at a later date. Often the lymph glands under the arm will be removed at the same time, because this is the area that cancel spreads to first. Alternatively, or combined with this, a course of radiotherapy or chemotherapy (drugs) may be recommended.
In some women, equally good results in controlling the cancer can be obtained by removal of the lump alone, coupled with radiotherapy to the breast and excision of the under-arm glands. A gradually increasing proportion of women are being treated this way. Lumpectomy is only suitable for early cancers: more advanced cancers still require mastectomy. Thus delay in presentation can have a dramatic cosmetic effect as well as a prognostic one, and a return to a normal lifestyle may be only a couple of weeks away with the simpler procedure.
Two-thirds of all breast cancers may be cured. With early presentation an diagnosis, this can rise to 90%+.

Small breast problem

medicalquestions — Mon, 21 Apr 2008 06:00:21 +0000

Question: I am 17 years old with very small breasts. The other night on the TV news there was a female model who used to be a man. This person had breasts of normal size. Why is it that an ex-male can have larger breasts than a naturally born woman?
Men who wish to change their sex do so by taking large doses of female hormones (oestrogen). Men possess breast tissue, but usually in a residual form. If this is stimulated by female hormones, the breast tissue will start enlarging in the same way as that of a teenage girl. Some teenage boys develop small breasts for a few months due to a temporary imbalance in their hormone levels.
When you start your periods and start developing breasts, it is because your ovaries start producing female hormones. Some women have breast tissue that is larger in quantity, and/or more sensitive to these hormones than other women, and they develop large breasts. The reverse can also occur. The tendency to large or small breasts is hereditary, so that if your mother and grandmother had small breasts, your chance of doing the same is quite high.
Large breasts can also be caused by obesity. From my male doctor perspective, I feel that women with very large breasts are at a much greater disadvantage than those with small breasts, in both appearance and personal comfort. It would be possible to increase your breast size by taking large doses of female hormone, but the side effects on the other parts of your body that respond to this hormone (the womb, ovaries and vagina) would be significant, and you would be strongly advised not to take this course.
A moderate increase in breast size can often be achieved by taking the oral contraceptive pill. During and after a ptegnancy, your breast size increases significantly, and some of this increase may persist after feeding ceases. Small-breasted women can breast feed just as easily as those with large breasts.
In the long run, if you feel that your small breasts are a significant cosmetic problem, it is possible to have plastic surgery to increase their size. This is a far better option than taking hormones that may have harmful complications. Any such surgery should be delayed until you are in your early twenties, as some breast growth is possible in your late teens.

Regular breast checking

medicalquestions — Mon, 21 Apr 2008 06:00:07 +0000

Question: How should i check my breasts regularly. Just how do I check for breast lumps?
All women should be taught how to check their breasts for lumps by a doctor, and should perform this easy procedure every month after their period has finished.
The first step is inspecting the breasts in a mirror, with your arms at your sides and then raised above your head. Get to know the shape and size of your breasts, and note any changes that occur. Then lie down, and with one hand behind your head, examine the opposite breast with the free hand. This should be done by resting your hand flat on the chest below the breast, and then creeping the fingers up over the breast by one finger breadth at a time. You should do this twice, once over the inside half of the breast, and then over the outside half. Check under the nipple with your finger tips and finally check your arm pit for lumps. Repeat the procedure on the other breast.
It only takes two minutes a month for this simple but effective form of health care. Any lumps that are found should be shown to a doctor.