Online health and medical information » Cancer

BREAST CANCER: WHEN SURGERY IS NEEDED

admin — Fri, 15 Apr 2011 10:28:18 +0000

Once, women with breast cancer were routinely advised to have a radical mastectomy (removal of the breast and lymph nodes under the arm). But 18 years ago, Dr. Bernard Fisher of the University of Pittsburgh began a pioneering study in many hospitals simultaneously. The research compared two treatments for early cancer. One was radical mastectomy. The other combined radiation with lumpectomy (cutting out small cancers). The results, published in 1985, showed the treatments were equally effective against early-stage cancer. Women now had a choice.

In 1982, Wilma Gauthier, a secretary in San Diego, chose lumpectomy. Her doctors were against it. “They told me that if I didn’t have a mastectomy, I would orphan my children,” she recalls. “I did feel scared that I had made a mistake. My husband supported me. It has been 12 years, and I am cancer-free.”

Still, only 20 percent of women who have early-stage cancer – and so are good candidates for lumpectomy – have that treatment. Surgeons may still be recommending mastectomy.

The issue was raised again this year after it was revealed that a Canadian doctor had committed fraud when he participated in Dr. Fisher’s studies. In a complicated way, he had entered patients into the research who did not meet the qualifying guidelines.

Dr. Fisher did another analysis of the results, leaving out the Canadian data. Fortunately, the outcome remained the same: Lumpectomy with radiation is just as effective as radical mastectomy for early-stage cancer.

But Fisher waited months before revealing the fraud and announcing the new analysis. Cancer scientists and women’s health advocates were infuriated. “It was a terrible thing,” says Dr. Jeffrey S. Abrams, a breast cancer specialist at the NCI.

*11/266/5*

BREATHLESSNESS – INTRODUCTION

admin — Mon, 18 May 2009 06:54:08 +0000

Feeling short of breath basically means that you are not getting enough oxygen into your blood. This could be because there is something wrong with the lung tissue itself—cancer in the lung, clots on the lung, pneumonia, radiation reaction, lung damage caused by bleomycin, or fluid building up in the lung because your heart is not working efficiently. Breathless-ness can also be due to the lung being squashed by fluid building up outside it in what we call the pleural cavity (the membrane-lined space between the lung and the chest wall). Partial blockage of some of the bronchial tubes can also make you feel short of breath. The blockage could be caused by cancer pressing on them or spasm (as happens with asthma). Breathlessness can also be a symptom of anaemia. When you are anaemic, your blood does not carry as much oxygen as normal, so you automatically breathe faster to try to get more oxygen into the blood. And, of course, nervous tension can result in a feeling of breathlessness, or aggravate breathlessness of any other cause.

*207/40/1*

BEFORE THE OPERATION ON BREAST CANCER: ABOUT SMOKING, OBESITY, ETC

admin — Thu, 23 Apr 2009 05:30:39 +0000

Smoking

If you are a heavy smoker and have not been able to cut down or stop altogether, you will be advised not to smoke in the hours before your operation. It is, of course, much better to stop smoking some months before surgery. The carbon monoxide contained in cigarette smoke poisons the blood by replacing some of the oxygen which is carried in it and which is vital to processes such as wound healing.

Obesity

Obesity adds to the risk of anesthesia, and for this reason people who are very overweight should try to lose weight before entering hospital. Some surgeons are reluctant to carry out nonemergency operations on heavy smokers or obese patients as they consider the risks to be too great. However, starting a long, strict diet before your operation is inadvisable. The consultant will have assessed your weight when seeing you at your outpatients’ appointment, and will probably have given you some guidance at that time.

Waiting

It may seem that you have been admitted to hospital unnecessarily early, and you may find you have to wait on the ward with little to do. Apart from having to be seen by all the medical staff mentioned above, who are responsible for many other patients as well, time will also have been allowed for the assessment of any medical problems you may have, and for the results of any blood tests to be received.

Sometimes operations have to be cancelled at the last moment if an emergency has arisen and an earlier operation has taken longer than expected. Your operation may have to be postponed, perhaps for a few hours or until the following day, but as the stress a cancelled operation of this sort would cause is well understood, it is extremely unlikely that you would be sent home.

You will probably be given only an approximate time for your operation, being told if it is scheduled for the morning or afternoon. Surgery being done before yours may take longer than expected if complications arise.

Leaving the ward for your operation

Before being taken from the ward to the anesthetic room or operating theatre, you will be given a hospital operating gown to wear and will be asked to put on your anti-embolism stockings. A plastic-covered bracelet bearing your name and an identifying hospital number will be attached to one or both of your wrists. You will then be taken from the ward on a hospital trolley.

*32/39/5*