Breast and Uterine Cancer

The Politics of Medicine


There are over 211,000 new cases of breast cancer that occurs each year in the United States. Over 40,000 women die of this disease each year as well if it is not caught early enough. Unfortunately, the risk of surviving breast cancer today is the same as it was over 50 years ago. Why have we not advanced enough in breast cancer treatment and other types of cancer in the past 50 plus years? The politics of medicine in the health care industry itself has a faint reality to what needs to be accomplished in the direction of advanced treatment of cancer on a whole. The only two main options for breast cancer treatment is a mastectomy which is the removal of the entire breast and a lumpectomy in which part of the breast is removed. With a lumpectomy, there is a 40% chance of the breast cancer returning even with radiation treatment. Many women who opt for a lumpectomy receive radiation treatment. They must remember though there is that 40% chance the breast cancer can return with a lumpectomy along with the radiation treatment .The radiation itself can cause the cancer to return. I don’t understand why this treatment option is even offered because more than half of the breast is deformed and the danger of radiation can be significant if given in high doses. However, each breast cancer patient has a right to their own preference of treatment upon their doctor’s diagnosis of treatment.

Over half of all women diagnosed with breast cancer opt for a mastectomy over a lumpectomy. Why? Well, there are many reasons. However, this is a personal decision each breast cancer patient must make for themselves along with their doctor according to the advancement, outcome of their disease as each treatment is different for each breast cancer patient. In other words, it’s all a matter of personal choice when given a choice between a mastectomy and a lumpectomy upon the doctor’s diagnosis of treatment. A mammogram is recommended each year for women 40 years of age and over. If there is breast cancer in the family it should be done earlier as recommended by a family physician.

Breast Cancer Treatment

In addition to radiation for breast cancer treatment, there is also chemotherapy and medication prescribed to each breast cancer patient according to the advancement of their disease. Some women may have one or two of these treatments or all three combined together depending on the advancement of this disease. For medication, there is tamoxifen which is routinely prescribed for most breast cancer patients after surgery. Doctors view this drug as a extremely peculiar drug. Why? It blocks estrogen, but in other organs of the body. It acts like an estrogen which is linked to uterine cancer. About 3% of breast cancer patients who have used tamoxifen for breast cancer treatment have developed uterine cancer as a result of this drug. This is hotly debated among doctors. However, doctors have now slowly moved away from this drug. They now only prescribe tamoxifen for extreme, advanced cases of breast cancer. There is also what is called, aromatase inhibitors, introduced in the early 1990’s for breast cancer treatment. Aromatase inhibitors involves three separate drugs, Arimidex, Aromasin and Femara. Aromatase inhibitors is classified as the enzyme found in the adrenal glands which is fat and muscle that converts testosterone as well as androste-estrogen in pre-menopausal women. While the side effects of aromatase inhibitors seem far less invasive than tamoxifen, there is still a dim reality towards the effectiveness of these drugs. Although, the aromatase inhibitors are far more effective than tamoxifen in breast cancer treatment, there is still the faint reality of its effectiveness that silently lingers with most doctors in the back of their mind, overall. One of the main side effects of these drugs is bone pain. Women taking these drugs should have their bone density closely monitored by their doctor.

Uterine Cancer

Uterine cancer includes both the cervical cancer and endometrial cancer of the uterus. There are two main cancers of the cervix, the first one is located in the lower part of the uterus. This is called the Squamous cell carcinoma which makes up 85-90% of these cancers. The second one is called the Adencarcinoma which makes up 10-15% of these cancers. The symptoms of uterine cancer can include watery vaginal discharge and painless bleeding. Over time though, the bleeding becomes heavier and most frequent, therefore, the pain becomes more noticeable. We must remember, most cervical cancers increase slowly and may not give any visible symptoms in the early stages. About 49,000 women in the United States will be diagnosed with uterine cancer each year. The good news is the five year survival rate is 71 percent. And if this disease is caught early enough, the survival rate is increased at 91 percent. The single most risk factor is infection, thus known as the papiloma,(HPV) virus. However, other factors include sexual partners before the age of 18, having many sexual partners and cigarette smoking.