Contemporary Issues in the Area of Addressing Breast Cancer - Research Paper Example

1 2 Breast Cancer The topic of the research is about contemporary issues and developments in the areaof addressing breast cancer. Despite the advancement and breakthroughs in medical technologies, drugs used to suppress and contain the spread of cancer cells, and the new discoveries that aimed to ultimately minimize and prevent the occurrence of breast cancer, statistics and current trends still manifest the preponderance of women contracting breast cancer. The researchers’ personal experiences on having known close relatives and associates’ families with some members who have had a history of breast cancer provided the impetus for intense interest to delve further into contemporary issues relating to breast cancer on a global scale. In this regard, the current research would touch on diverse issues that confound women’s contracting this illness such as: risk factors, recurrence rates, conservation surgery through Indian experience; pregnancy associated breast cancer; the impact of curable versus advanced cancer in West of Romania; bioengineering embryonic stem cell microenvironments for the study of breast cancer; and triple negative breast cancer cell lines; to name just a few. The research would initially start with an introduction of the topic to include the researchers’ rationale for interest in the subject and to present current statistics and relevant information on current trends and patterns on breast cancer. A historical background would be delved into, particularly how the specific area of interest emerged. Likewise, the researchers would proffer ways in which the current study would be beneficial to various professionals who are interested on the topic. The research problem is to determine the best possible way of addressing breast cancer through the review of related literature on the subject. The researchers would integrate and synthesize the relevant findings noted from at least 15 authoritative and academic studies which have been contemporarily published in peer-reviewed journals. The discussion portion would highlight innovative ways of looking into addressing issues that confound breast cancer with the aim of better understanding the dilemma, determining how others tried to attempt it, and finally how they progressed in their respective researches. The concluding portion highlights the findings and stipulates the researchers’ recommendations. As indicated, the most effective intervention or treatment does not depend on the new technological or medical breakthrough discovered but on early detection and appropriate treatment, depending on factors such as the patients’ preference, financial capacity, access to health care support, and doctor’s expertise and training given specific patients’ scenarios, at hand. Areas for future research would potentially delve into efforts designed, developed and implemented by international organizations, like the World Health Organization, to balance the lack of awareness, access to treatment, and sharing of innovative discoveries to countries most in need. Introduction Despite the advancement and breakthroughs in medical technologies, drugs used to suppress and contain the spread of cancer cells, and the new discoveries that aimed to ultimately minimize and prevent the occurrence of breast cancer, statistics and current trends still manifest the preponderance of women contracting breast cancer. In an overview of breast cancer, authors Manoharan & Pugalendhi (2010) have indicated that cancer is considered “the second largest non-communicable disease and can affect any part of the body.Worldwide, around 12.7 million new cancer cases and 7.6 million deaths were reported in 2008” (p. 2423; Ravichandran, Al-Hamdan, & Mohamed, 2011, Chavez, Garminella, & Lipkowitz, 2010-2011). In the statistics revealed from the study written by Manoharan & Pugalendhi (2010), the figures relating to persistently staggering trends on the number of women diagnosed to have contracted breast cancer is alarming. Accordingly, “globally more than 7,00,000 women are diagnosed with breast cancer every year. In USA, approximately 1,82,460 new cases of invasive and 67,770 new cases of non-invasive (in-situ) breast cancers were diagnosed in women. In India 70,000 new cases of breast cancer and 35,000 deaths due to this cancer are reported every year” (Manoharan & Pugalendhi, 2010, p. 2423). The researchers’ personal experiences on having known close relatives and associates’ families with some members who have had a history of breast cancer provided the impetus for intense interest to delve further into contemporary issues relating to breast cancer on a global scale. Due to the difficulties and challenges faced by women diagnosed with breast cancer, current researches have started to focus on delving into new avenues that aim to minimize the recurrence of this illness. In this regard, the current research would touch on diverse issues that confound women’s contracting this illness such as: risk factors, recurrence rates, conservation surgery through Indian experience; pregnancy associated breast cancer; the impact of curable versus advanced cancer in West of Romania; bioengineering embryonic stem cell microenvironments for the study of breast cancer; and triple negative breast cancer cell lines; behavior coping mechanisms, and knowledge, attitudes, and behavior towards cancer prevention practices, to name just a few. Problem Statement The research problem is to determine the best possible way of addressing breast cancer through the review of related literature on the subject. As the statistics revealed, there still remains increasing trends of new cases and deaths that arise from breast cancer and despite efforts to contain lower level stages of the disease, the recurrence rates are still significant (Burns, Jacobsen, Loftus, & Andrykowski, 2012; Field, et al., 2011). The current study hereby aims to divulge interesting details that increase the risk of contracting breast cancer to assist those at high risk demographic population to avoid these factors; and if the disease has been contracted, to at least minimize the recurrence rate. Likewise, innovative medical techniques and interventions that ventured into bioengineering embryonic stem cell procedures (Raof, Mooney, & Xie, 2011); menopausal hormone therapy (Chelowski & Anderson, 2012); adjuvant therapy (Gallo, De Luca, Lamura, & Normanno, 2012); or neoadjuvant chemotherapy (Sweeting, et al., 2011) are worthy to explore. The research objectives therefore are as follows: (1) To enhance awareness and understanding on risk factors, recurrence rates; as well as attitudes and behaviors that would mitigate the incidence of contracting this non- communicable illness; (2) To determine from the review of literature which is the most effective new technological or medical breakthrough would assist in minimizing the incidence of breast cancer; (3) To determine if the new or innovative technology could be applied on a global scale. Methods The researchers would integrate and synthesize the relevant findings noted from at least 15 authoritative and academic studies which have been contemporarily published in peer-reviewed journals. The articles that were reviewed came from various peer-reviewed journals including Journal of Family and Community Medicine, Journal of American College of Surgeons, the International Journal of Applied and Basic Medical Research, the International Journal of Radiation Oncology, Biology and Physiology, to name a few. Journals from other cultures include the Indian Journal of Cancer, the Middle East Journal of Family Medicine, and the Journal of Turkish-German Gynecology Association. Likewise, the Studia Universitatis journal published a study that delved into the impact of breast cancer (curable versus advanced) in a region in West Romania. By evaluating and analyzing the relevant findings in each discourse, the next section would highlight innovative ways of looking into addressing issues that confound breast cancer with the aim of better understanding the dilemma, determining how others tried to attempt it, and finally how they progressed in their respective researches. Discussion 1. General Information on Breast Cancer including Risk Factors, Recurrence Rates and Knowledge, Attitudes and Behavior in Self-Management and Preventive Practice Breast cancer has been as the most common cancer for women and the second leading cause of death among women (Manoharan & Pugalendhi, 2010; Shaika & Salama, 2009). The factors that increase preponderance for contracting this non-communicable illness are as follows: gender (women); age (older women); and “a high-fat diet, obesity, and environmental factors such as tobacco use, endocrine disruptors and shift work” (Manoharan & Pugalendhi, 2010, p. 2425). These factors were corroborated and validated in the study conducted by Shaika & Salama (2009) as the authors averred that: “there are three factors which strongly increase a woman’s risk of developing this disease: advancing age, family history of the disease, and a personal history of breast cancer. Several other factors can increase a woman’s risk of developing breast cancer, such as age at time of reproductive events, pregnancy and breastfeeding, hormone replacement therapy and race/ethnicity” (p. 9). In addition to being classified as non-communicable, breast cancer was likewise categorized as a chronic illness (Lok & Quek, 2011; Giorgios, 2012) that contains the following characteristics: “it is permanent, it involves residual disability, it is caused by nonreversible pathological alteration, and it requires special training/rehabilitation or a long period of supervision, observation, or care” (Lok & Quek, 2011, p. 85). As such, the types of interventions used have influenced the rates of recurrence. According to Field, et.al. (2011), relevant findings from their study indicated that “even among women at low risk, omitting definitive local therapy was associated with increased recurrence” (p. 757). Concurrently, recurrence rates were also found to be closely linked to behavioral factors (Burris, Jacobsen, Loftus, & Andrykowski, 2012). Most relevant in the findings of Burris, et.al. (2012) identified the behaviors that could significantly assist in reducing the recurrence rate, as follows: avoiding the use of tobacco, regular exercises of at least three times per week, eating a defined serving of fruits and vegetables of at least 5 servings per day, and maintaining current weight or losing weight, as needed (Burns, Jacobsen, Loftus, & Andrykowski, 2012). Finally, as emphasized by Ravichandran, Al-Hamdan, & Mohamed (2011), “early breast detection through mammogram, clinical breast examination, and breast self-examination is critical in reducing breast-cancer related morbidity and mortality” (p. 138). For curable and more advanced stages, there were identified ongoing medical researches that aim to increase the efficacy of recommended interventions in the hope of alleviating the side effects of more aggressive treatments, as required. 2. Most Effective Intervention for Breast Cancer Prevention As explicitly stated by Field, et al. (2011), the general guidelines given to women diagnosed for early-stage cancer included definitive local therapy in conjunction with two alternatives: “mastectomy or breast-conserving surgery (BCS) with radiation therapy” (p. 757). Raof, Mooney, & Xie (2011) enumerated the traditional treatments to prevent cancer cells to metastasize through “systemic therapy (e.g., chemotherapy, hormonal therapy, biological therapy) and local therapy (e.g., surgery, mastectomy, lumpectomy)” (p. 7663). In other more comprehensively technical studies, the interventions recommended depend on the number of positive lymph nodes that were detected (Yates, Kirby, Crichton, Gillet, Cane, & Fintionan, 2012). Accordingly, Yates, et.al. (2012) identified the supraclavicular fossa radiotherapy (SCF RT). The other therapeutic treatments that were noted from the review of literature are: (1) the use of zoledronic acid (Z which was reported to reduce locoregional and distant metastases in estrogen receptor (ER)-positive breast cancer patients (Gallo, De Luca, Lamura, & Normanno, 2012); (2) the use of triple negative breast cancer cell lines as tools to determine the best treatment for specifically identified triple negative breast cancer (Chavez, Garminella, & Lipkowitz, 2010-2011); and (3) the “engineering of unique tumor microenvironments in vitro which can manipulate the proliferation and migration of metastatic breast cancer cells may permit enhanced study of cancer metastasis. Consequently, this could provide greater insight into the decision-making processes regarding the growth, migration, and invasion of cancer cells and its subsequent prevention” (Raof, Mooney, & Xie, 2011, p. 7663), among others. As noted, breast cancer is more complex as it manifests diversity in prognosis which defines the needed interventions and treatment and the rate of recurrence and survival. 3. Universality of New or Innovative Breakthroughs The application of needed intervention differs according to nationality and to the patients’ preferences. In India, for instance, the study conducted by Narendra & Ray (2011) disclosed that the “most common surgical options for operable breast cancer are modified radical mastectomy (MRM) with or without reconstruction and breast conservation surgery (BCS). Choice of the procedure depends on various factors like surgeon’s training, patient’s desire, size of the tumor to breast ratio, the presence of contraindications for conservation and availability of radiotherapy facilities” (p. 415). In West Romania, on the other hand, findings revealed that there were apparent lack of systemic chemotherapy for women over 70 years contributing to significantly higher incidences of breast cancer rates (Giorgios, 2012). The study conducted by Shaika & Salama (2009) signified awareness and knowledge of women in Doha on the relevance of breast self-examination (BSE) but fear or lack of appropriate knowledge on how to do the BSE precludes them for making regular examination. Finally, Doger, Caliskan, & Mallmann (2011) illumined readers on the possibilities of pregnancy associated breast cancer, where findings revealed that “women experience a transient increase in breast cancer risk after pregnancy… If breast cancer is suspected in pregnant women, the diagnostic work-up should be similar to non-pregnant women as diagnostic delays are unacceptable costs” (p. 253). In this regard, the kind of treatment and prevention noted from various reviews of literature emphasize early detection through BSE, clinical breast examination and mammogram (Shaika & Salama, 2009; Ravichandran, Al-Hamdan, & Mohamed, 2011). The most effective treatment varies depending on the stage of illness, the capabilities of the patient to finance recommended treatments, access of health insurance, and the advances in technology that are available in the local setting. Concluding remarks The review of related literature has assisted in addressing the research objectives, to wit: (1 the study provided concise and relevant information that enhanced awareness and understanding on risk factors, recurrence rates; as well as attitudes and behaviors that would mitigate the incidence of contracting this non-communicable and chronic illness; (2) the study determined that the most effective intervention or treatment does not depend on the new technological or medical breakthrough discovered but on early detection and appropriate treatment, depending on factors such as the patients’ preference, financial capacity, access to health care support, and doctor’s expertise and training given specific patients’ scenarios, at hand; and (3) that the new or innovative technology could only be applied depending on the medical breakthroughs, resources, internal and external capabilities of the local setting. Given the limited time and amount of references for the current research, the researchers could look into working on future research topic on this area that delve into the specific programs that international organizations, like the World Health Organization, are implementing to balance the lack of awareness, access to treatment, and sharing of innovative discoveries to countries most in need; with the aim of reducing the rate of women contracting breast cancer and mitigating the recurrence rates for those who strived so hard to survive from this chronic illness. From the literatures reviewed, it was apparent that various organizations have acknowledged the significant threat posed by ever increasing risks of women contracting breast cancer and the evidence of rates of recurrence through monitoring the statistics on a global scale. As such, it is evident that these international organizations, through medical practitioners and researchers, have the accurate information, including access to research on advances in medical interventions and facilities to assist in seeking that incidences of breast cancer would ultimately be reduced and prevented. Works Cited Burns, J., Jacobsen, P., Loftus, L., & Andrykowski, M. (2012). Breast cancer recurrence risk reduction beliefs in breast cancer survivors: prevalence and relation to behavior. Psycho-Oncology, Vol. 21, 427-435. Chavez, K., Garminella, S., & Lipkowitz, S. (2010-2011). Triple negative breast cancer cell lives: One tool in the search for better treatment of triple negative breast cancer. Breast Disease, Vol. 32, 35-48. Chelowski, R., & Anderson, G. (2012). Changing Concepts: Menopausal Hormone Therapy and Breast Cancer. Advance Access Publication JNCI Reviews, Vol. 104, Issue 7, 517-527. Doger, E., Caliskan, E., & Mallmann, P. (2011). Pregnancy associated breast cancer and pregnancy after breast cancer treatment. Journal of Turkish-German Gynecology Association, Vol. 12, 247-255. Field, T., Bosco, J., Prout, M., Gold, H., Cutrona, S., Pawloski, P., et al. (2011). Age, Comorbidity, and Breast Cancer Severity: Impact on Receipt of Definitive Local Therapy and Rate of Recurrence among Older Women with Early-Stage Breast Cancer. Journal of American College of Surgeons, Vol. 213, Issue 6, 757-765. Gallo, M., De Luca, A., Lamura, L., & Normanno, N. (2012). Zoledronic acid blocks the interaction between mesenchymal stem cells and breast cancer cells: implications for adjuvant therapy of breast cancer. Annals of Oncology, Vol. 23, 597-604. Giorgios, Z. (2012). Study on the Impact of Breast Cancer, Curable vs Advanced Cases in Region 5 West of Romania, 2005 - 2009. Studia Universitatis, Vol. 22, Issue1, 57-65. Lok, S., & Quek, K. (2011). Cancer-behavior-coping in women with breast cancer: Effect of a cancer self-management program. International Journal of Applied and Basic Medical Research, Vol. 1, Issue 2, 84-88. Manoharan, S., & Pugalendhi, P. (2010). Breast Cancer: An Overview. Journal of Cell and Tissue Research, Vol. 10, Issue 3, 2423-2432. Narendra, H., & Ray, S. (2011). Breast conservation surgery: Indian experience. Indian Journal of Cancer, Vol. 48, Issue 4, 415-422. Raof, N., Mooney, B., & Xie, Y. (2011). Bioengineering Embryonic Stem Cell Micro-environments for the Study of Breast Cancer. International Journal of Molecular Sciences, Vol. 12, 7662-7691. Ravichandran, K., Al-Hamdan, N., & Mohamed, G. (2011). Knowledge, attitude, and behavior among Saudis toward cancer preventive practice. Journal of Family and Community Medicine, Vol. 18, Issue 3, 135-142. Shaika, S., & Salama, R. (2009). Knowledge and Attitude Towards Breast Cancer and Breast Self Examination among Women Attending Primary Health Care Centers in Doha, 2009. Middle East Journal of Family Medicine, Vol. 9, Issue 6, 8-21. Sweeting, R., Klauber-Demore, N., Meyer, M., Deal, A., Burrows, E., Drobish, A., et al. (2011). Young Women with Locally Advanced Breast Cancer who Achieve Breast Conservation after Neoadjuvant Chemotherapy Have a Low Local Recurrence Rate. American Surgeon, Vol. 7, 850-855. Yates, L., Kirby, A., Crichton, S., Gillet, C., Cane, P., & Fintionan, I. (2012). Risk Factors for Regional Nodal Relapse in Breast Cancer Patients with One to Three Positive Axillary Nodes. International Radiation Oncology Biol. Phys., Vol. 82, Issue 5, 2093-2103. Read More