Breast cancer survival rates up
BY MATTHEW SCHWERHA For Sun-Times Media
Shadows from the past: The journey through breast cancer carries on for years after diagnosis and treatment — taking a toll on the mind, body and wallet. | FILE PHOTO
After treatment: what to watch for
Women who have been treated for breast cancer sometimes develop the following:
Breast cancer survivors face the possibility of developing lymphedema, or swelling of the arm from buildup of fluid, for the rest of their lives. Any treatment that involves removing or giving radiation to the axillary lymph nodes carries the risk of lymphedema.
2. Uterine cancer.
Women who are taking tamoxifen or toremifene are at increased risk for uterine cancer and should have annual pelvic exams. This risk is highest in women who have gone through menopause.
3. Diminished bone health.
Women who are taking an aromatase inhibitor or are pre-menopausal and taking tamoxifen or toremifene, especially need to monitor their bone health. A bone density test may be in order.
If symptoms, exams, or tests suggest a recurrence, imaging tests such as an X-ray, CT scan, PET scan, MRI scan, bone scan, and/or a biopsy may be done. Your doctor may also measure levels of blood tumor markers.
The American Cancer Society
When diagnosed with breast cancer, the news that a reconstructive surgery also acts as a pseudo-tummy tuck is about the best thing someone can hear.
“I had two kids, and to be honest, my stomach could go,” said Jennifer McDermott, 45, of Evanston, who underwent a TRAM (transverse rectus abdominis muscle) Flap to reconstruct her breasts. “It’s almost like a tummy tuck. It’s a similar thing.
“A lot of women do silicon or saline breast implants. Breast implants have a shelf life and have to be replaced every 20 years. When I’m 60 and I’m 80, I don’t think I want to have surgery.”
Like McDermott, more and more women are surviving breast cancer and looking to live a long and happy life. According to the American Cancer Society, breast cancer death rates decreased 2.2 percent per year from 1990 to 2007, after having increased 0.4 percent per year from 1975 to 1990. The decline in breast cancer deaths has been attributed to improvements in breast cancer treatment and early detection.
Such was the case for McDermott.
“I was 42 and went and got a mammogram that revealed a lump,” McDermott said. “I had cancer in three different areas of my breasts.”
Upon receiving a diagnosis, breast cancer patients need to make many difficult choices regarding their treatment.
“I had a mastectomy and decided to not take my other breast off,” McDermott said. “Everybody always worries it’s going to go on the other side. The doctors biopsied me and said nothing was there.”
Sometimes the scariest part of the process takes place after the cancerous cells have been removed.
Mary Maryland, patient nurse navigator for the American Cancer Society at Loyola University Bernadine Cancer Center, sees the trepidation.
“To some degree, after whatever intervention has happened, there is a ‘now what?’ feeling,” Maryland said.
The journey of breast cancer carries on for years after diagnosis and treatment — taking a toll on the mind, body and wallet.
“I did chemo after my surgery and I was on that for 15 months,” said 4-year breast cancer survivor Jennifer Lowlight, 38, of Mundelein. “There were three different regimens: six months of intravenous chemo and nine months of a clinical trial of a pill I could take from home. I also did radiation and because of the type of cancer, I have been on tamoxifen and continue to take that everyday.”
But the same things that helped Lowlight overcome her cancer are now providing a roadblock to the life she had imagined, which included children.
“I was just married 6 weeks prior to my diagnosis and wanted a family someday,” Lowlight said. “Because of the tamoxifen, it is really bad if I were to get pregnant. I would have to go off of it.”
The stress of cancer can be elevated to whole other level if a patient does not have insurance or the best coverage. According to a 2009 synthesis of published evidence on the National Center for Biotechnology Information’s website, the estimated lifetime per-patient cost of breast cancer in the United States ranges from $20,000 to $100,000. Continuing care accounted for the largest share of lifetime cost due to the relatively long survival of breast cancer patients. Susan G. Komen For the Cure reports in its “Facts for Life” that a generic form of tamoxifen costs about $100 per month.
“I had good insurance and am really lucky with my insurance situation,” said McDermott, citing that she pays $7 a month for her tamoxifen.
Lowlight points to her insurance as being a bit of a lifesaver.
“I did have insurance, which was a blessing,” Lowlight said. “I had been laid off 12 weeks prior to my diagnosis. I decided to get Cobra. I don’t know what I would have done had I not had insurance.”
According to Dr. Patricia Robinson, assistant professor in the hematology and oncology division in the department of medicine at Loyola University, after diagnosis, treatment and recovery, the process comes full circle.
“Don’t let one’s diagnosis define who they are, but take it as one step in their cancer journey,” Robinson said. “When you transition from treatment to cancer survivor it loops back to prevention. Employ strategies to reduce the risk of getting any type of cancer, like colonoscopies, pap smears and dermatology.”