Sunday, September 30, 2012

Improved medicine, awareness and activism have decreased breast cancer's impact

Though much of the activism surrounding breast cancer may be a relatively recent phenomenon, people have struggled with the disease for thousands of years.

In fact, according to the American Cancer Society, the oldest known written record of any cancer ? found in a 4,000-year-old Egyptian surgery textbook ? describes eight instances of tumors affecting women?s breasts. Called the Edwin Smith Papyrus, the document describes how to remove tumors using a procedure similar to cauterization with a device known as a ?fire-drill.?

It ends on a grim note, saying ?there is no treatment? for the disease.

Yet even though it has been a known condition since ancient times, breast cancer remained uncommon until the 19th century.

It?s not because people were any healthier before that; on the contrary, most people simply died too young to develop cancer. But the 1800s saw advances in sanitation and medicine that resulted in dramatic increases in lifespan.

Today, breast cancer is the most common cancer afflicting women, with about 1 in 8 women being affected during their lifetime, according to the American Cancer Society. Though on the decline, breast cancer death rates in women are higher than the rates for any other type of cancer, except lung cancer.

And although breast cancer most commonly appears in women, the disease can strike men as well ? in 2011, more than 2,000 men were diagnosed with breast cancer.

Thomas Marsland is a medical oncologist, currently practicing in Orange Park. He has practiced for about 30 years around the North Florida region and described the advancements he?s witnessed in the treatment of breast cancer as ?amazing.?

?When I first started in practice back in the early ?80s, we had maybe half a dozen drugs that we used to treat breast cancer,? said Marsland. ?And for a woman with advanced breast cancer, if she lived a couple of years, she was doing well.?

That?s no longer the case, he said.

Marsland said that between advances in the drugs used to treat breast cancer over the past few decades and the increased knowledge physicians have about the disease, cure rates have improved by as much as 60 percent, particularly when the disease is treated aggressively at an early stage.

?I think there?s been a great deal of progress,? said Marsland. ?We still have some work to do, women are still dying with breast cancer. Even though there?s been significant improvement, we have a ways to go.?

Marsland also said that research has improved the tolerability of many chemotherapy medications and that doctors have learned a lot about controlling unpleasant side effects.

He expressed optimism about future treatments for the disease, particularly those based around an individual molecular analysis of each patient?s cancer. Marsland noted that one thing doctors have learned over the past several decades is that not all breast cancer is created equal.

?What we?re moving into is an era of molecular and biological definitions of cancers,? he said. ?And they?ve now identified as many as 70 to 100 genes seen in breast cancer.?

He also described advancements in surgical treatments and noted that the field has moved past the days of radical mastectomies, wherein the entire affected breast would be removed. There are still cases that require mastectomy, but Marsland said cure rates with less invasive procedures have improved to be on par with mastectomies.

Marsland, who has volunteered with the American Cancer Society for a number of years, also gives credit to the increased activism and awareness efforts surrounding breast cancer over the past few years. He stressed the importance of early detection in fighting breast cancer and praised the work of awareness groups, such as the ACS and Susan G. Komen For the Cure, in spreading the message that breast cancer no longer has to be a death sentence.

Chandini Portteus, the vice president of research, evaluation and scientific programs for the Komen foundation, expressed similar optimism over how far physicians and the scientific community have come in the treatment of breast cancer.

?In the early 1900s we knew that people had breast cancer, but I don?t think people understood it could spread throughout the body,? said Portteus. ?We now know that when cancer spreads, that?s what really kills people.?

Susan G. Komen For the Cure was founded in 1982, by the sister of the late Susan G. Komen, after she succumbed to breast cancer. Today, the group invests more than $300 million, mostly in bringing research ?from the lab, to the clinic,? as Portteus put it.

She also pointed to the increase in activism and awareness surrounding the disease over the last few decades as a big achievement for those affected.

According to Portteus, with early detection, the five-year survival rate for breast cancer can now be as high as 98 to 99 percent.

But she stresses that early detection remains the key.

?I think we?ve found that teaching women what?s normal for them is a very important thing, said Portteus. ?If you know what normal is and something doesn?t feel normal, see a doctor.?

Source: http://jacksonville.com/news/health-and-fitness/2012-09-30/story/improved-medicine-awareness-and-activism-have-decreased

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