Overview and Treatment in Women

Introduction

Breast cancer is abnormal growth of cells in the breast which is usually expressed in the form of tumour or felt as a lump. The presence of breast cancer is rare in men with 350 cases reported each year in the UK compared to 55,000 cases reported among women in the country within a year (cancerresearchuk.org, 2018). In this assignment, overview regarding the health issue and treatment for breast cancer in women is to be discussed.

Overview regarding breast cancer

In the UK, each year nearly 11,500 women along with 80 men die due to breast cancer which is 1000 deaths per month. Breast cancer is regarded as the fourth common reason for death among women who are under 50 years in the UK (breastcancernow.org, 2019a). The statistics indicate that breast cancer is a concerning disease that mostly affects women and is fatal to a concerning level in the UK. Thus, further exploration regarding the topic is chosen to understand its influence and prevalence. The stigmas regarding the impact of the interventions in all the types of breast cancer are similarly present for women (Sparano et al. 2018). Therefore, the topic is to be explored to understand the challenges or issues regarding breast cancer to be controlled for better physical and mental well-being of women with breast cancer.

During treatment of breast cancer, women lose hair as a result of reaction to steroids or rays used in chemotherapy or experience mastectomy as surgical intervention. It leads them to be body-shamed in the society, in turn, making them develop depression and low self-esteem (Yang & Kim, 2019). This is evident as body-shaming leads them to feel low regarding their value in the society as well as traumatic surgery and prolonged intervention for the condition leads them to feel anxiety and stress regarding them health often making them depressed. In contrast, the study by Masoumi et al. (2018), mentions that body shaming in the society of breast cancer patients make them isolated from others which contributes them to develop depression. This is because the women are unable to share their emotions or inform their perception freely with others.

The treatment of breast cancer for younger women is seen to cause them early menopause in some cases. It leads the women to experience issues of infertility which contributes to make them depressed (Bień et al. 2017). This is because infertility makes the women feel incomplete to have a family making to feel grieved for prolonged time. However, the study by Renehan et al. (2020) mentions that breast cancer intervention leads women to develop health issue of gaining weight out of decreased oestrogen level with the impact of steroids and chemotherapy. It is evident as lower oestrogen leads the lipoprotein lipase in the body to store fat cells in the body leading to contribute weight gain.

Health issues regarding breast cancer

The health issue of detection at later stage of breast cancer is perceived among minority ethnic communities in the UK as it is regarded as a taboo which hinders its proper detection and early treatment (Lukong, 2017). In Black Asian communities in the UK, talking about breast is considered a personal as well as feminine concept and it is shameful to discuss regarding it in public. Moreover, the families of the communities feel that breast cancer is a shameful condition for the women and information regarding it to be kept contained within the family (Naseem, 2018). This leads to delayed care for the women in the communities as they often go for late diagnosis making health professionals are unable to detect and treat such individuals at the proper time. However, in white communities, it is seen that the people are found to be free discussing regarding breast cancer. This makes them take early intervention to control the disease which creates lower health issue of late detection regarding the disease (Brown et al. 2018). This is evident as late-stage detection rate among the Black African is 25% and the Black Caribbean is 22%. However, white individuals show rate of 13% late-detection informing they have better awareness regarding breast cancer and goes for early intervention compared to the minority communities (bbc.com, 2016).

In the UK, it is found that there are widely considered wrong concept regarding breast cancer along with lack of breast cancer awareness among the most deprived communities compared to least deprived communities. As a result, increased deaths due to breast cancer are reported among female living in the most deprived areas compared to least deprived areas (cancerresearchuk.org, 2019). This is because lack of awareness and effectively timely intervention leads the women in the most deprived areas unable to avail required care for their survival compared to the least deprived ones making the suffer increased fatal incidences. The study by Nemchek (2018) mentions that men are often diagnosed at a later stage in breast cancer compared to women. This is because of the gender disparity where breast cancer is regarded solely to disease for the women as they are with prominent breast whereas in men there is no presence of breast. It has created increased chances of mortality among the men compared to women as a result of breast cancer.

Intervention for breast cancer

The timely detection of breast cancer at the early stage is regarded as one of the intervention to manage the negative health issues regarding the disease. This is because it would help the health professionals to implement proper solution to overcome and manage the disease (Gbenga, Christopher & Yetunde, 2017). The BRCA1 and 2 gene testing are referred to the blood test which is performed for identifying changes or mutation in DNA. This is because mutation in these genes is seen to cause uncontrolled growth of cells in the breast and other parts of the body (Nilsson et al. 2018). The study by Tung & Garber (2018) informs that BRCA genes are named as tumour suppressor genes in the body which helps in repair of DNA damage which stimulated the formation of uncontrolled growth in the body. However, the mutation in the genes leads them to be ineffective in repairing broken DNA making them unable to prevent formation of breast cancer. This is evident as loss of proper functioning of BRCA 1 and 2 disables the homologous recombinant pathway. It forces the cells in the body to depend on lower fidelity and error-prone pathway to repair DNA like non-homologous joining of ends. During this condition, genetic instability and mutation are introduced leading to uncontrolled growth of cells (Tuffaha et al. 2018).

According to NHS England, presence of BRCA 1 or 2 mutation leads to raise 12% risk of developing breast cancer, whereas, mutation in BRCA1 raises the risk by 60% and BRCA2 raises the risk by 55% for women till the age of 70 years (NHS England, 2015). Thus, the test for BRCA1 and 2 are executed to detect if they are mutated to determine the extent of risk of presence of breast cancer among women. The BRCA1 and 2 gene testing in the UK cost nearly £1400 and need 3-4 weeks for revealing the report (NHS, 2018). The person with positive BRCA1 or 2 genes is considered to be at risk of developing breast cancer and appropriate treatment is initiated to ensure their good health. According to NICE guidelines, the genetic testing of BRCA1 or 2 is to be done for all eligible individuals by making them aware regarding the reason and way of performing the test. Moreover, immediate relatives of the patients are to be informed regarding the results of the test and the time to be required for its execution (NICE, 2019).

The NHS, UK informs that genetic testing for breast cancer is effective in lowering morbidity and early detection of the disease. It is true from the reports which mention that out of 26.65 million women who took BRCA1 and 2 tests in the population, it led to prevention of 64,500 breast cancer and 12,300 mortality incidences due to breast cancer (NHS, 2018). Moreover, this test led to prevent 523 deaths in each million women in the UK due to breast cancer as well as acted to ensure addition of 7.5 to 9.3 extra days of life for each woman (NHS, 2018). Thus, the figures indicate that execution of BRCA1 and 2 tests for all women in time is going to act in lowering mortality rate for breast cancer. In addition, it would act to reduce extra financial burden on the NHS for management of breast cancer for women in the UK.

Strength and Limitation of treatment for breast cancer

The BRCA1 and 2 test have the strength to inform individuals regarding the risk of development of breast cancer which in turn helps them to make informed in taking early intervention for the disease (Nilsson et al. 2017). The other strength of the test is that it creates opportunity to educate family members and patients regarding the potential risk of ovarian cancer in them along with other cancers (Singer et al. 2019). Thus, the test is worthy to be performed in creating awareness regarding the risk of cancer in the family and patient. The limitation of performing BRCA test is that it may be regarded as worrisome endurance test by some individuals, mainly in those families that have history of BRCA related mutation (Zhen et al. 2018). The other limitation regarding the test is that proper results may not be revealed making the individuals unable to detect risk regarding cancer (Singer et al. 2019).

Conclusion

The above discussion informs the breast cancer is prominent among women compared to men and they face depression, social isolation, delay diagnosis and others as health issues. If I could click my fingers and solve this health issue regarding women the use of BRCA1 and 2 gene test would be effective as it would help to detect the extent of risk of breast cancer present in them and ensure taking proper actions for them.

References

Bień, A., Rzońca, E., Iwanowicz-Palus, G., Lecyk, U., & Bojar, I. (2017). The quality of life and satisfaction with life of women who are childless by choice. Ann Agric Environ Med, 24(2), 250-253.

Brown, N., Smith, J., Brasher, A., Omrani, A., & Wakefield-Scurr, J. (2018). Breast cancer education for schoolgirls: an exploratory study. European Journal of Cancer Prevention, 27(5), 443-448.

Gbenga, D. E., Christopher, N., & Yetunde, D. C. (2017). Performance comparison of machine learning techniques for breast cancer detection. Nova, 6(1), 1-8.

Masoumi, S. Z., Zanganeh, F., Kazemi, F., Matinnia, N., Mohagheghi, H., & Mohammadi, Y. (2018). Evaluation of body image after mastectomy due to breast cancer in women referred to Imam Khomeini clinic in Hamadan. National Journal of Physiology, Pharmacy and Pharmacology, 8(7), 953-956.

Naseem, S. (2018). “Breaking breast cancer news” with ethnic minority: a UK experience. Journal of multidisciplinary healthcare, 11, 317.

Nemchek, L., 2018. Male Breast Cancer: Examining gender disparity in diagnosis and treatment. Clinical journal of oncology nursing, 22(5).20-35.

Nilsson, M. P., Törngren, T., Henriksson, K., Kristoffersson, U., Kvist, A., Silfverberg, B., ... & Loman, N. (2018). BRCAsearch: written pre-test information and BRCA1/2 germline mutation testing in unselected patients with newly diagnosed breast cancer. Breast cancer research and treatment, 168(1), 117-126.

Nilsson, M. P., Winter, C., Kristoffersson, U., Rehn, M., Larsson, C., Saal, L. H., & Loman, N. (2017). Efficacy versus effectiveness of clinical genetic testing criteria for BRCA1 and BRCA2 hereditary mutations in incident breast cancer. Familial cancer, 16(2), 187-193.

Renehan, A. G., Pegington, M., Harvie, M. N., Sperrin, M., Astley, S. M., Brentnall, A. R., ... & Evans, D. G. (2020). Young adulthood body mass index, adult weight gain and breast cancer risk: the PROCAS Study (United Kingdom). British Journal of Cancer, 1-10.

Singer, C. F., Tan, Y. Y., Muhr, D., Rappaport, C., Gschwantler‐Kaulich, D., Grimm, C., ... & Tea, M. K. M. (2019). Association between family history, mutation locations, and prevalence of BRCA1 or 2 mutations in ovarian cancer patients. Cancer medicine, 8(4), 1875-1881.

Singer, C. F., Balmaña, J., Bürki, N., Delaloge, S., Filieri, M. E., Gerdes, A. M., ... & Krajc, M. (2019). Genetic counselling and testing of susceptibility genes for therapeutic decision-making in breast cancer—an European consensus statement and expert recommendations. European Journal of Cancer, 106, 54-60.

Sparano, J. A., Gray, R. J., Makower, D. F., Pritchard, K. I., Albain, K. S., Hayes, D. F., ... & Lively, T. (2018). Adjuvant chemotherapy guided by a 21-gene expression assay in breast cancer. New England Journal of Medicine, 379(2), 111-121.

Tuffaha, H. W., Mitchell, A., Ward, R. L., Connelly, L., Butler, J. R., Norris, S., & Scuffham, P. A. (2018). Cost-effectiveness analysis of germ-line BRCA testing in women with breast cancer and cascade testing in family members of mutation carriers. Genetics in Medicine, 20(9), 985-994.

Tung, N. M., & Garber, J. E. (2018). BRCA 1/2 testing: therapeutic implications for breast cancer management. British journal of cancer, 119(2), 141.

Yang, E. J., & Kim, Y. J. (2019). Psychological Systematic Consideration of Breast Cancer Radiotherapy. Journal of the Korean Society of Radiology, 13(4), 629-635.

Zhen, J. T., Syed, J., Nguyen, K. A., Leapman, M. S., Agarwal, N., Brierley, K., ... & Shuch, B. (2018). Genetic testing for hereditary prostate cancer: Current status and limitations. Cancer, 124(15), 3105-3117.

Looking for further insights on Case Study on Left Arm Pain in Edward Lewis? Click here.