Cancer Articles (Dr. S.N White)

I would like to have breast reconstruction after my surgery for breast cancer. Can this be done? You should ask your surgeon for a consultation with a plastic surgeon before the mastectomy if possible. Depending on the individual, breast reconstruction is available to women who have had either a single or a double mastectomy. The results and the difficulty of the operation will vary with each individual case. Many women having mastectomies may be candidates for breast reconstruction ifthey and their surgeons know the facts about current techniques. In many cases, if arrangements are made before the operation, the plastic surgeon can be in the operating room at the time of the mastectomy. Questions to Ask Your Plastic Surgeon Before Breast Reconstruction • What type of surgery do you recommend for me? Why? • What are the risks and benefits associated with it? • What is your experience with this operation? • Do you have any before and after pictures you can show...

Can a woman who has had breast cancer safely have a baby?  Most doctors discourage women from becoming pregnant for from 3 to 5 years following treatment for breast cancer, since recurrences most often happen during this period of time. Recent research has shown that pregnancy after breast cancer has no effect on survival rates. Statistics for women who have had breast cancer and become pregnant are at least as good as those of similar women who do not become pregnant. What is the outlook for women who discover breast cancer during pregnancy?  About 7 percent of women who develop breast cancer happen to be pregnant at the time of diagnosis. The outlook for a pregnant woman is just as favorable as that for a nonpregnant woman of the same age with a similar stage of disease provided that the cancer is diagnosed and treated promptly. When a suspicious lump is found, prompt biopsy is just as appropriate for a pregnant woman as for a nonpregnant woman. Biopsy can usuall...

What drugs are used in adjuvant chemotherapy?  The drugs most commonly used to treat breast cancer include melphalan, cyclophosphamide, methotrexate, 5-fluorouracil, Adriamycin, vincristine, tomaxifen, and prednisone. You may receive two ofthese drugs or as many as five in combination. Why is this adjuvant treatment given? In several research studies, patients who had one or more positive lymph nodes and received chemotherapy after breast cancer surgery, lived longer and had a longer time without disease than those patients with positive nodes who were treated with surgery alone. These studies are continuing, researching many different combinations of drugs. The selection of a specific drug or a combination of drugs is something that will be discussed by your doctor. Is radiation used in treating breast cancer? Yes. Radiation is often advised for lumpectomy or segmental mastectomy as well as when the lymph nodes under the armpit are involved or when the tumor is located i...

Are there some medical reasons why I should wear a prosthesis?  Yes, there are medical reasons why you should wear a form to replace the missing breast. The weight of the remaining breast, particularly for women with medium to large breasts, can cause shoulder, neck, and back pain. You may find that your posture will change, with the affected shoulder rising, if you do not have a prosthesis. The larger the remaining breast, the more vital the need, not only for appearance but also for weight. For your own well being, emotional comfort, and self confidence, you should plan to buy a prosthesis. In many cases, a well fitted prosthetic device means the difference between prompt, cheerful, total recovery and long term personal distress. You will need some device to make your clothing fit well. Can I wear the prosthesis all the time?  Yes. Many patients wear it all the time, around the clock. Some patients start by wearing it a few hours a day and gradually increasing the num...

Lymphedema sleeve It is a sleevelike apparatus into which you place your affected arm. It forces the fluids back into the lymph system and reduces the swelling. Although using it once or twice a day helps to control the swelling, it will not cure the problem. The doctor will tell you how long to leave your arm in the sleeve and the correct pressure setting. Usually the unit is used at a physical therapy department at a hospital, although some units are about the size of a train case and can be used at home. The doctor can write a prescription for one, and some insurance companies will cover its cost. Will all the pain, numbness, and tingling sensations eventually disappear?  Yes, they should. However, some women continue to have symptoms for many months after the operation has healed. Some patients say they have pain radiating from under the arm to the waist when they touch under the armpit. As with other operations, the symptoms are affected by the weather. If you have unus...

In the radical mastectomy (also known as the Halsted mastectomy) the doctor removes the breast tissue, the lymph nodes under the armpit, and the muscle under the breast. The modified radical, which most surgeons are now using, removes the breast tissue and the lymph nodes, but the muscle is left intact. The advantage of the modified radical is that it is cosmetically more attractive and does not handicap the motion of the arm. Studies indicate that the survival rate for the two operations is the same. Is the choice of what surgical procedure I will have up to me or up to the doctor? Of course your doctor is responsible for the surgery. But he cannot perform any operation unless you give your signed consent to have it done. You should have your doctor give you his complete explanation of what he recommends as his bestjudgment and ask him all the questions that concern you about the operation. Do not sign anything until you are certain you understand what you are signing. It is your r...

What size tumors are indicated by the "T" classifications? TO means there is no evidence of primary tumor. Tl refers to a tumor that is 2 centimeters or less in its greatest dimension. T2 refers to a tumor which is more than 2 centimeters but not more than 5 centimeters. T3 means that the tumor is more than 5 centimeters. A T4 designation indicates a tumor of any size with direct extension to the chest wall or skin. Is there more than one kind of breast cancer?  Cancer of the breast is not a single disease. There are at least fifteen distinct varieties. The doctor and the patient need to know which variety they are dealing with before making the decision as to how to proceed. Among the types of breast cancer are intraductal, inflammatory, medulluary, papillary, tubular, lobular and Paget's disease. What is inflammatory breast cancer?  This is a rare type of breast cancer which often spreads rapidly to other parts of the body. In inflammatory breast cancer, the b...

Will my scar be red and swollen? Probably you will see a slight redness and swelling along the incision or find a small amount of pink draining from the scar area. These symptoms are normal. If there is a lot of redness and swelling or pus around the area or if you have heavy bleeding, call the doctor right away. Your scar will be red for a while but will soon fade in color. What if when I ask for a separate procedure for the biopsy, the doctor says that I will be doubling my risk of undergoing general anesthesia twice?  Your doctor, if he uses this argument, has overlooked the fact that a general anesthetic is not usually needed for a biopsy. In most cases, a biopsy can be performed under local anesthesia, with the patient fully conscious or, if she prefers, semiconscious. Most biopsies are now performed on an outpatient basis. What happens next if the pathological report shows that the tumor is cancerous?  Eight out of ten times, the lump will prove to be benign, b...

Won't all this time delay mean that the cancer has more chance to spread? No. Studies have shown that a short delay between biopsy and treatment will not affect the spread of disease or reduce the chances for successful treatment. An interval of 2 days to a week between the two procedures is not a problem. Many medical professionals now agree that this time delay is perfectly acceptable and in most cases is a wise way to proceed. The advantages of getting all of the necessary information about the extent of the cancer far outweigh the advantages of performing a quick, disfiguring operation. I feel I need some time to think, but everybody keeps pushing me to have the biopsy and the operation done right away. What should I do?  It is important to have the time to think and to look at the alternatives. You may want to talk it over with your husband and children, your sisters, your mother, or your friends. You may want to get a second opinion. It is all right to take a few extra d...