Women and their loved ones may feel frightened, angry, or depressed- These are normal reactions that people have when faced with a serious health problem. Others in the same situation have found that they cope with their emotions better if they can talk openly about their illness and their feelings with those who love them.
Concerns about what the future holds as well as worries about tests, treatments, a hospital stay, and medical bills-are common. Talking with doctors, nurses, or other members of the health care team may help to calm fears and ease confusion. A woman can take an active part in decisions about her medical care by asking questions about breast cancer and her treatment choices- Patients, family members, and friends often find it helpful to write down questions to ask the doctor as they think of them. Taking notes during visits to the doctor helps them remember what was said.
Patients should ask the doctor to explain anything that is not clear. Patients have many important questions, and the doctor is the best person to answer them. Most women ask about the extent of their cancer, how it can be treated, and how successful the treatment is likely to be.
These are some other questions to ask the doctor:
Sometimes women who have had breast cancer are worried, especially after surgery, that the changes to their bodies will affect not only how they look but how other people feel about them. They may worry about holding a job, caring for their families, or starting new relationships. Concerns about sex can be upsetting, too.
Sharing these feelings with loved ones can help everyone feel more at ease, opening the way for others to show their concern and offer their support. Many patients feel that it helps to talk with others who are facing problems like theirs. Women can meet other breast cancer patients through self help and support groups such as those described in the next section.
The doctor is the best person to give advice about treatment, working, or limiting daily activities. If it is hard to talk with the doctor about feelings or other very personal matters, it may be helpful to speak with a nurse, social worker, counselor, or member of the clergy.
Living with any serious illness can be difficult and challenging. The public library is a good source of books and articles on living with cancer. Cancer patients and their families can also find helpful suggestions in the NCI booklet Taking Time.
Doctors often talk about "surviving" cancer, or they may use the term "remission" rather than "cure" Even though many breast cancer patients recover completely, doctors use these terms because cancer can recur. It is normal for patients to be concerned about their futures. Sometimes patients use statistics they have heard to try to figure out their own chances of being cured. It is important to remember, however, that statistics are averages. They are based on the experiences of large numbers of patients, and no two cancer patients are alike. Only the doctor who takes care of the patient knows enough about her case to discuss her chance of recovery (prognosis).
Causes and Prevention Breast cancer is the second leading cause of cancer deaths among women in the United States (lung cancer is the first). About 1 woman in 10 will develop breast cancer at some time in her life. (Breast cancer also affects about 900 men each year.)
Doctors can seldom explain why one woman gets breast cancer and another doesn't. It is clear, however, that breast cancer is not caused by bumping, bruising, or touching the breast. And it is not contagious; no one can "catch" breast cancer from another person.
Although scientists do not know exactly why breast cancer develops, they know some things increase a woman's chances of getting the disease:
* Age About 75 percent of all breast cancers are found in women over the age of 50. The disease is uncommon in women under the age of 35 and quite rare under the age of 20.
*Family history. The risk of getting breast cancer doubles for a woman whose mother or sister has had the disease. If the mother's cancer began before meno pause, her daughter's risk is somewhat higher.
* Personal history. Having cancer in one breast means that the risk of getting cancer in the other breast is about four to five times higher than the average. About 15 percent of women treated for cancer in one breast are likely to get cancer in the other breast later on.
Other risk factors include having the first menstrual period at an early age, having a late menopause, having the first child after the age of 30, and never having children.
Recent research suggests that a person's diet may affect the chances of getting some types of cancer. Breast cancer appears more likely to occur in women whose diet is high in fat. Many scientists believe that avoiding a high-fat diet, eating well-balanced meals, and maintaining ideal weight can lower a woman's risk of cancer. (Diet guidelines are in NCI 's Diet, Nutrition, and Cancer Prevention: The Good News.) The ordinary lumpiness that many women have in their breasts (also called benign breast condition) does not increase the risk of breast cancer.