A cell is a kingdom. And like any kingdom, it can be overthrown.

Breast cancer can be referred to as an overambitious lump of cells in the breast tissue. Before the 1970s, breast cancer was a stigmatized disease, the subject thought of as taboo. Today, however, it is an entire brand so to say; with a Breast Cancer Awareness month (October) dedicated to it and a pink ribbon as its symbol. The once empty room is now crowded with hearts full of hope and spirits full of energy. It’s an unsurprising fact, however, that many people do not know that  anyone with breast tissue can get breast cancer; men and women, young and old alike. Many more do not know that there are different types of breast cancer, and the difference betweeen one type and another.

TYPES OF BREAST CANCER

Breast cancers can be named depending on the specific breast cells affected, e.g. ductal carcinoma to refer to cancer that initially develops in the milk ducts.

Breast cancers can also be invasive and in situ breast  depending  on whether the cancer has spread to other tissues or not . Triple-negative breast cancer is a common type of invasive breast cancer that is difficult  to treat.              

Breast cancers are called hormone receptor-positive or hormone receptor-negative based on whether or not they have receptors for hormones (e.g. estogen and progestrerone) that fuel the cancer growth. Hormone-receptor positive breast cancer has targeted treatments for it.     

HER2 is a growth-enhancing protein expressed on the outside of all breast cells. Breast cancer in which the cells have exaggerated levels of HER2 is called HER2-positive breast cancer. Although it tends to grow rapidly and spread faster than other types of  breast cancers, HER2-positive breast cancer is much more responsive to treatment.

CAUSES OF BREAST CANCER

Before the 1980s, different scientists had come up with various possible causes of all types of cancer, among them Heredity, Environment, Viruses and Chance. These discoveries were like the blind men and the elephant; where each man had a theory but they were only describing a part of the whole. It was until the 1980s that the role of genes in cancer completed the puzzle- One could inherit altered genes that cause cancer, viruses and carcinogens in the environment could mutate or cause circumstances that mutate growth-regulating genes, and growth-controlling genes could mutate on their own by chance to cause cancerous growths.  

RISK FACTORS FOR BREAST CANCER

1. Having breasts; women are at higher risk for developing breast cancer than men.
2. Family history of breast cancer or ovarian cancer.
3. Reproductive history, e.g. prolonged and uninterrupted exposure to estrogen that occurs when menarche, the onset of menses, occurs at a very young age, or when pregnancy occurs later in life.
4. Previous treatment therapies that employed use of radiation.

5. Personal history of the disease.
6. Being overweight and lack of exercise.
7. Smoking, drinking and eating unhealthy food.
8. Exposure to some chemicals in cosmetics and work places.

DETECTION OF BREAST CANCER

1. Abnormal changes in the size and shape of breasts.

2. Inverted nipples and abnormal discharge from the breasts.

3. Feeling a rock-hard lump(s) especially in the axillary (below the armpits).
4. Mammograms, which are X-ray pictures of the breast. They help in the early-detection of breast cancer.
5. Biopsy. This is a confirmatory laboratory test done by pathologists to acertain it’s cancer.

MOST COMMON TREATMENT THERAPIES OF BREAST CANCER

1. Radical masectomy. This approach roots from Halsted, a brave experimentalist of a surgeon, who fantasized with the idea that if cancer was a lump of bad cells, then we could cut them off thus curing it. Radical mastectomy therefore entails removing more to cure more.
2. Chemotherapy. When there are high chances that the cancer will recur, chemotherapy drugs are administered, mainly intravenously, to destroy any lurking cancerous cells. In this method, cells are killed by using a chemical that is in some way poisonous to them. Someone once said that Chemotherapy is like choosing to jump off a building when someone is holding a gun to your head. You jump from a desire to live, even if that life will be a painful one for the rest of its duration. Although chemotherapy has adverse effects such as loss of hair and nails, it is potentially life-saving. Common chemotherapy drugs include Cyclophosphamide (mustard gas) and Adriamycin.

By blocking Topoisomerase II enzyme, Adriamycin inhibits the rapid proliferation of cells. Adriamycin is so corrosive that, it is rumoured, if spilled, can cause the linoleum of clinic floors to melt away. For several days after the administration of Adriamycin, the patient’s body fluids become  toxic to other people and to their own tissues. The urine, for instance, becomes so toxic that patients are advised to flush twice.

3. Anesthetic creams. These are applied over the chemotherapy ports in order to make the insertion of large needles into the patient’s chest bearable.

Other classes of drugs taken by breast cancer patients include Steroids, Antinausea medications, antidepressants, sedatives, anxiolytics, anti-inflammatories, antibiotics and antifungals.

PREVENTION

Seek medical attention at the first sign of cancer. “Everything about being sick is written in our bodies first, and then later (sometimes) written in books.” – Anne Boyer.

If the world were a football pitch, cancer patients would be those who are given the red card while the rest of the  players keep playing the game of life without feeling accountable for what happens to them.

The rest of the players includes governments-who don’t adequately fund research in cancer and offer little support to patients who can’t afford the life-altering medications they need, pharmaceutical industries- which have kept the cost of chemotherapy drugs higher than many people’s annual salary, and manufacturing/processing industries- which keep emitting toxins and producing products that make us prone to cancer. 

Our priorities have become so mixed that pink ribbons adorn some of the objects that kill us. “Breast cancer cannot be understood as just the abnormal division of cells,” writes Anne Boyer. “It is, rather, a socially-constructed nebula; and the women who have it suffer from the world.”

In our times, cancer has transitioned from being a disease of cells, to being a disease of genes.

“The secret to battling cancer is to find means of preventing genetic mutations from occuring in susceptible cells,or to find better means of eliminating the mutated cells without compromising normal growth.” Dr Siddhartha Murkherjee tells us in his book The Emperor of all Maladies.

This might just be the toughest medical challenge being passed down generations of medics. However, with advancements in cancer research and development of treatment systems like CRISPR, which basically works by editing (cutting and repairing) any targeted DNA locus, the door is slowly opening and we are getting a glimpse of the light at the end of the tunnel.

The structure of knowledge that allows us to make such a molecule, one that acts like a DNA scissor, makes everything else seem like child’s play- the kindergarten of technological evolution.

As we climb through academic ranks, it should be part of our deepest interest to contribute in fighting this disease which seems to have refused to fall into step in the march towards medical progress.

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