The gift of breast cancer survival

In USA, November is a thanksgiving month. Families gather from far and wide to celebrate freedom, liberty, happiness, prosperity and individual achievements. Personally, I am thankful for the gifts of love and life which are the essence of Providence—the gift of breast cancer survival. Come to think about it, we are all survivours of various circumstances for are we not at the moment all alive? The challenging question is: What are you doing with your survival? Are you using it to make your sphere of influence, be it home, village, workplace, community, nation or the world a better place in some personal way? Or are you desperately interested in your own advancement and reputation at the expense of your “neighbour”? My survival compels me to share lessons I have learned with the hope that someone out there will be empowered, for we all know that ‘Knowledge is Power’. So let us see what is currently known about this disease using the adage: “What you know does not kill you.” What is Breast Cancer? Breast cancer is an uncontrolled growth of breast cells. To better understand breast cancer, it helps to understand how any cancer can develop. Cancer occurs as a result of mutations, or abnormal changes, in the genes responsible for regulating the growth of cells and keeping them healthy. The genes are in each cell’s nucleus, which acts as the “control room” of each cell. Normally, the cells in our bodies replace themselves through an orderly process of cell growth: healthy new cells take over as old ones die out. But over time, mutations can “turn on” certain genes and “turn off” others in a cell. That changed cell gains the ability to keep dividing without control or order, producing more cells just like it and forming a tumor. A tumor can be benign (not dangerous to health) or malignant (has the potential to be dangerous). Benign tumors are not considered cancerous: their cells are close to normal in appearance, they grow slowly, and they do not invade nearby tissues or spread to other parts of the body. Malignant tumors are cancerous. Left unchecked, malignant cells eventually can spread beyond the original tumor to other parts of the body. The term “breast cancer” refers to a malignant tumor that has developed from cells in the breast. Usually breast cancer either begins in the cells of the lobules, which are the milk-producing glands, or the ducts, the passages that drain milk from the lobules to the nipple. Less commonly, breast cancer can begin in the stromal tissues, which include the fatty and fibrous connective tissues of the breast. Over time, cancer cells can invade nearby healthy breast tissue and make their way into the underarm lymph nodes, small organs that filter out foreign substances in the body. If cancer cells get into the lymph nodes, they then have a pathway into other parts of the body. The breast cancer’s stage refers to how far the cancer cells have spread beyond the original tumor Breast cancer is always caused by a genetic abnormality (a “mistake” in the genetic material). However, only 5-10 percent of cancers are due to an abnormality inherited from your mother or father. About 90 percent of breast cancers are due to genetic abnormalities that happen as a result of the aging process and the “wear and tear” of life in general. While there are steps every person can take to help the body stay as healthy as possible (such as eating a balanced diet, not smoking, limiting alcohol, and exercising regularly), breast cancer is never anyone’s fault. Feeling guilty, or telling yourself that breast cancer happened because of something you or anyone else did, is not productive. Risk Factors People tend to have very different ways of viewing risk. For you, a 1-in-8 lifetime risk may seem like a high likelihood of getting breast cancer. Or you may turn this around and reason that there is a 7-in-8, or 87.5 percent, chance you will never get breast cancer, even if you live to age 80. How you view risk often depends on your individual situation — for example, whether you or many women you know have had breast cancer, or you have reason to believe you are at higher-than-normal risk for the disease — and your usual way of looking at the world. Even though studies have found that women have a 12.7 percent lifetime risk of developing breast cancer, your individual risk may be higher or lower than that. Individual risk is affected by many different factors, such as family history, reproductive history, lifestyle, environment, and others. The term “risk” is used to refer to a number or percentage that describes how likely a certain event is to occur. When we talk about factors that can increase or decrease the risk of developing breast cancer, either for the first time or as a recurrence, we often talk about two different types of risk: absolute risk and relative risk. Absolute risk is used to describe an individual’s likelihood of developing breast cancer Relative risk is a number or percentage that compares one group’s risk of developing breast cancer to another’sAnything that increases your chance of developing breast cancer is called a risk factor. Anything that reduces your risk of developing breast cancer is called a protective factor. A tremendous amount of promising research is under way to determine the cause of breast cancer and to establish effective ways to prevent it. Still, doctors cannot always explain why one woman develops breast cancer and another doesn’t. Everyone seems to know someone with breast cancer, and we wonder whether we, too, will be affected during our lifetime. All of us want to do everything we can to reduce the risk of ever getting the disease. Right now, though, we just do not know enough about what causes breast cancer and we have not yet figured out how to keep it from happening — so we cannot say that we can “prevent” it. However, researchers are working to learn how “external” and “internal” environments may work separately and together to affect health and possibly the risk of developing breast cancer. “Internal environment” means the things inside our bodies that influence our health, such as genetics (the genes you got from your mother and father), hormones, illnesses, and feelings and thoughts. “External environment” refers to the things outside of our bodies that influence our health, such as air, water, food, danger, poverty, music, noise, people, and stress. Also, the external environment enters our internal environment every day — think of the food you eat, water you drink, air you breathe (including whether you smoke or not), and medicines you take. More subtlety, there is the way you “breathe in” or absorb your environment, such as your home or workplace, and the way you take in energy from the people you spend time with. Some of these factors, such as your genetic makeup and the medicines that you take, have a very direct effect on your breast health. The impact of other, indirect factors, such as air quality, exercise, meditation, and spending time with friends, is less well understood. You can control some risk factors. For example, if you are overweight, you can seek to lose excess pounds, which may reduce your risk of breast cancer. You can also make informed choices about the medicines you take. But other factors are beyond your control. For instance, you cannot change your gender. Women are much more likely than men to have breast cancer. This is mostly because women have more estrogen and progesterone in their bodies. These hormones stimulate breast cell growth—both normal and abnormal. Also, you cannot stop growing older. Aging is the biggest risk factor for breast cancer (besides being a woman). Risk reduction means making choices to avoid or minimize any possible risk factors that you can. It also means increasing the protective factors in your life so your chances of developing breast cancer are lower. Although you can control many risk factors, remember that doing so does not guarantee zero risk. It is also important to keep in mind that many women who have a particular risk factor for breast cancer never develop it. Knowledge is power. Instead of living under the shadow of myths, stigma and misunderstandings, know your own realistic level of risk. Then you can talk to your doctor about ways to lessen controllable risk factors and boost your protective factors. Healthy Wishes until next time when we discuss Breast Cancer Risk Factors. The author is a Survivor/Breast Health Advocate nfo@breastcancerafrica.org www.breastcancerafrica.org