Read an Excerpt
Breast Cancer Clear & Simple
All Your Questions Answered
By American Cancer Society
American Cancer Society / Health PromotionsCopyright © 2008 American Cancer Society
All rights reserved.
Finding Out You Have Breast Cancer
The doctor told me I have breast cancer. What do I do now?
You may be in shock. You may feel angry, worried, overwhelmed, hopeless, or scared. In fact, you may not know what to do. That's okay. It's normal to be upset and confused. No one wants to hear that she has breast cancer.
You may feel like your cancer must be treated right now, even if you aren't sure how. But learning more about your breast cancer first can help.
Reading this book might be helpful to you. Take a few days or weeks to talk to your doctor and learn about your treatment choices. That way, you can make sure you're making the best decisions for you and your health.
What will happen to me?
Will I be okay?
Each person's cancer is different.
Most women with breast cancer are treated and live. In fact, two million women in the United States have had breast cancer and are alive today.
You may already know family members and friends who have had breast cancer, were treated, and went on with their lives. These women are proof that there is life after breast cancer treatment for most people.
Experts are working on better ways to find and treat breast cancer all the time.
Will I lose my breast?
Most women do not lose a breast.
Doctors can often remove the breast cancer without removing the whole breast. They take out the cancerous lump and some of the breast tissue around the cancer. This is called a lumpectomy (lump-EK-tuh-me).
What if I do need my breast removed?
Some women do need their whole breast removed to get all the cancer
Removing one breast is called a mastectomy (ma-TEK-tuh-me). Removing both breasts is called a double mastectomy.
It is very upsetting to lose one or both of your breasts. You will need support and information to help you cope with your loss. Read more about mastectomy and coping after a mastectomy on pages 42–43.
Will I be in pain?
Having cancer does not mean you have to be in pain.
If you do have pain from cancer or cancer treatment, there are many ways you can feel better. You do not have to suffer through any pain you feel. Medicines and some ways of relaxing can help. Here are some suggestions:
Talk to your doctors about any pain you feel. The more doctors know about your pain, the better job they can do to relieve it. Don't be afraid to talk about your pain.
Ask for help with your pain. Getting relief from your pain can help you deal with your cancer. Being free of pain will help you stay strong so you can get through your cancer treatment.
Don't feel you have to choose between getting treated for cancer and getting treated for pain. Doctors can take away your pain while also treating your cancer.
My friend had breast cancer. Will the same things happen to me?
Each woman with breast cancer is different.
What happens to one woman with breast cancer will not happen to all women with breast cancer. Here are a few reasons why:
Breast cancer affects people in different ways. Not everyone with one type of cancer has the same experience.
There are different kinds of breast cancer. They affect the body in varied ways.
Doctors don't treat every breast cancer the same way. They think about your breast cancer and your health. Then they make a special treatment plan for your cancer. Your doctors will make a treatment plan just for you.
My loved one had another kind of cancer. Should I expect the same things to happen to me?
Not all cancers are the same.
You've probably known someone who has had cancer. Just because something happened to that person does not mean it will happen to you. There are several reasons for this:
Some types of cancer, like breast cancer, can be treated more easily than other types.
Some types of cancer and cancer treatments make people sicker than others.
Some types of cancer are found when they are small and easier to treat. Others are found later, after they have been growing for a while, and are harder to treat.
People often have other illnesses that affect how they respond to the cancer treatment.
What is breast cancer?
All living things, from plants to people, are made up of tiny cells. The healthy cells in your body grow, form new cells, and die when they're supposed to.
But cancer cells are not normal and do not follow the patterns they should. They don't die like other cells. They keep growing, making new cells, and spreading in the body. In breast cancer, these cells grow out of control and form a lump called a tumor (TOO-mer).
Here are more facts about breast cancer:
When doctors find breast cancer before it grows into a large tumor or spreads, they can treat it more easily.
There are different types of breast cancer. Not every breast cancer grows the same way, and doctors don't treat every breast cancer the same way.
Breast cancer mostly grows in women, but men also can get breast cancer.
For information about different types of breast cancer, call the American Cancer Society — Toll-free: (800) ACS-2345.
Am I to blame for my breast cancer?
No. It's not your fault you have breast cancer.
Many women want to know why they got breast cancer. Some women think they caused their cancer. They may think they got breast cancer as a punishment for something they did or didn't do. Or they may think if they had done something differently, they wouldn't have breast cancer. You did not cause your breast cancer.
We don't know what makes most breast cancer start to grow. We do know that some things in a woman's life affect her chances of getting breast cancer. This is called her "breast cancer risk." But even if they increase a woman's chances of getting breast cancer, no one has proved that they cause breast cancer.
For more information about breast cancer risk, see pages 139–144.
If I don't feel sick, do I really have cancer?
Cancer doesn't always make you feel sick.
Some women say they can't believe they have cancer because they feel fine. It can be hard to accept that you have breast cancer when you don't feel any different. Other women may not feel quite right for a while before doctors find their breast cancer.
Cancer can grow for a long time before it spreads and causes problems or pain. That's why getting checked regularly for cancer is so important. The earlier cancer is found and treated, the better a person's chances for a long life after treatment.
How serious is my cancer?
How do doctors know how serious my cancer is?
They study the lump in your breast.
Doctors study your breast tissue sample (taken out during your biopsy) and write a pathology (path-AWL-uh-gee) report. It explains the type of breast cancer you have and how big the tumor is. It also states whether your tumor is likely to grow quickly or slowly.
Doctors use the report as a guide to help them plan how to treat your cancer. The pathology report uses a system of numbers and letters to show how serious your cancer is and to decide your "cancer stage." For more information about cancer staging, see pages 146–149.
The doctor says my breast cancer has spread. What does that mean?
It's possible for cancer to move to another part of the body.
Sometimes cancer cells break away from a tumor and spread to other parts of the body. They can settle in other places in the body and form new tumors. This spreading is called metastasis (meh-TAS-tuh-sis).
Even when cancer has spread to a new place in the body, it is still named after the part of the body where it started. If breast cancer spreads to the lungs, for example, it is still called breast cancer. Breast cancer is most likely to spread to the lungs, bones, liver, or brain.
What does "cancer grade" mean?
"Cancer grade" shows how likely it is that your cancer will grow and spread quickly.
When doctors talk about "cancer grade," it is one way of talking about how serious your cancer is.
To figure out the grade of your cancer, doctors look at your cancer cells under a microscope. They give your cancer a grade from 1 to 3. Cancer grades are described as
grade 1, or low grade;
grade 2, or intermediate grade; and
grade 3, or high grade.
Grade 1 cancer cells look the most like healthy, normal cells. They are less likely to grow and spread quickly. Cancer cells that are grade 3 look the most different from normal cells. They are more serious and could grow more quickly.
What does "cancer stage" mean?
"Cancer stage" means how much cancer is present and if it has spread.
Doctors use the term "cancer stage" to describe
the extent of your cancer;
if your cancer has grown; and
if your cancer has spread to other parts of your body.
Doctors use a system of letters and numbers to describe how much your cancer has spread. They use this information to decide your cancer stage. The cancer stage helps your doctor make treatment plans and also figure out what is likely to happen with your cancer.
See pages 146–149 for more information about cancer staging.
How big is the tumor?
The drawings below will give you an idea of how big the lump in your breast is. They show breast tumors that range in size from one centimeter to five centimeters.
Does my doctor know how well I will respond to treatment?
Your doctor may be able to predict how you will respond to treatment.
Your doctors study what has happened to other women who had the same cancer stage and grade you have. They find the latest information on how many women with breast cancer like yours have had the same treatment. Then they see how well treatment worked for these women. With this information, they can help predict how you might do with treatment.
What does the doctor mean by "prognosis"] (prog-NO-sis)?
The doctor is talking about what will probably happen with your cancer.
Prognosis is a prediction of how well you will do during the course of your cancer treatment and afterwards. It relates to your chances of recovering from cancer and living after cancer treatment.
But you are not a number on a chart. You are a person. You have your own way of facing cancer. Your body reacts to cancer and treatment in its own way. Just because something happened to other women with breast cancer like yours does not mean it will happen to you. And cancer treatment is getting better all the time, so numbers and charts don't always show the many resources that are helping women today.
Why doesn't the doctor use the word "cure"?
Because it's hard to know if every cancer cell is gone forever.
Most doctors use the word "remission" instead of "cure." They will say, "Your cancer is in remission." This means that tests done after you have completed cancer treatment don't show any cancer. It is a wonderful moment for many women.
However, a few cancer cells might still be hidden somewhere in the body and start growing later. That's why doctors don't like to use the word "cure." They cannot guarantee that the cancer is completely gone.
Many women recover completely from breast cancer and have no sign of any cancer being present. Other women are able to keep their cancer under control and live long lives.
Do I need a second opinion?
Consider getting a second opinion. It can be helpful to hear what another doctor says about your breast cancer.
You may want to talk to another doctor about your diagnosis and the treatment plan your first doctor suggested. This is called getting a second opinion.
Talking to another doctor about your cancer helps you make sure the first doctor had the best plan. You also can make sure you understand your treatment choices.
How do I get a second opinion?
Start by getting recommendations from others.
You may want to ask the doctor who gave you the cancer diagnosis for names of other doctors you could see. You also can ask for help getting in to see these other doctors. Some women choose to get a third opinion.
After talking with different doctors, think about what you have learned. Talk it over with friends and family members. Then choose the best treatment for you. Once you make that decision, it's time to start your breast cancer treatment.
If you have health insurance, it may pay for you to see a doctor for a second opinion. Talk to your insurance company before you go to another doctor.
Won't the first doctor be mad if I want to talk to someone else?
Doctors understand why you want a second opinion.
Wanting a second opinion doesn't mean you think the first doctor gave you poor treatment or advice, or that you don't trust the doctor. It means you want to know more and get the best treatment.
Many doctors will encourage you to talk to another doctor about your biopsy, your cancer, and what is likely to happen. They know that your health and life are at stake. They also know you should feel as comfortable as you can with the diagnosis and treatment plan.
If your doctor gets mad or refuses to suggest another doctor, then you need to think about whether he or she is the right doctor for you.
Questions to ask the doctor who told you about your cancer
1. What is the grade of my breast cancer?
2. What could this cancer grade mean for my health and my life?
3. What is the stage of my breast cancer?
4. How does my cancer stage affect which cancer treatments I should have?
5. How does my cancer stage affect my prognosis?
6. Could you explain the different parts of my pathology report to me?
7. I'd like a second opinion. How do I get one?
8. Can you recommend a doctor to give me a second opinion?
9. How do I get my biopsy samples to that doctor?
10. What other tests do you think I will need?CHAPTER 2
Treating Your Breast Cancer
Who will help with my cancer treatment?
Can I choose my doctor?
You may be able to choose who will be in charge of your cancer treatment.
Talk to your doctor about finding an oncologist (on-CALL-uh-jist). This is a doctor who treats people with cancer. You will want to find an oncologist who has treated a lot of women with breast cancer.
Most hospitals have more than one doctor who treats breast cancer. These doctors may be experts in cancer, surgery, or radiation treatment. Your oncologist will most likely oversee all your treatment.
What should I think about when choosing a doctor?
Think about what you want most from a doctor.
You will be with your cancer doctor (oncologist) for quite some time. He or she will give you your treatment. And you will continue to see your oncologist for regular checkups years after treatment. It is really important to find a doctor you trust.
Here are some questions that may help you choose your doctor:
Does the doctor explain things in a way you can understand?
Does the doctor listen to your concerns and questions?
Does the doctor treat you with respect?
Do you and the doctor share a common approach to your health and breast cancer treatment?
Can you reach the doctor when you need to ask questions or get other information?
Has the doctor treated a lot of women with breast cancer like yours?
Most doctors only work at certain hospitals. Your decision about which doctor to see may be closely tied to the hospital where he or she works. See the next question for more information on hospitals.
Where will I go for treatment?
It's most likely that you will get treatment at the hospital or clinic where your oncologist works.
Most doctors only work at certain hospitals. A good doctor usually works at a good hospital. Find out if the hospital where your doctor works treats a lot of women with breast cancer. Ask if the hospital is well known for its good treatment of women with breast cancer.
You can ask your oncologist and family doctor these questions. They will help you feel comfortable about the hospital where you will get care.
Who else will care for me?
There will be many people caring for you during your cancer treatment.
You will see doctors, nurses, and other medical staff trained to help women with breast cancer. This flow chart shows the people who may be part of your treatment team. See pages 150–154 for descriptions of the medical team members.
Questions to ask a doctor who may treat you
1. What is the exact type of breast cancer I have?
2. Have you treated this type of breast cancer before? If yes, how many times?
3. When is your office open?
4. Who would take care of me if you were on vacation or if I needed help when the office was closed?
5. Can I bring someone with me to take notes?
6. Where would I be treated (which hospital)?
7. Does this hospital treat a lot of women with breast cancer?
8. Do they use the best, most current breast cancer treatments?
9. Are you willing to talk to my family members about their concerns?
10. Do you have information about breast cancer I can take with me?
11. Where can I find more information about breast cancer?
How to talk to your doctor
It is not always easy to talk with your doctor. You may feel worried, think your questions are silly, or just feel too tired to talk. Also, your doctor may be in a rush. You may get the feeling that he or she doesn't have time or want to answer your questions. All these issues can make it hard to talk to your doctor.
Here are some tips to help you feel more comfortable talking to your doctor and asking questions:
Make a list of questions to ask your doctor.
Understand that there are no "stupid" or "silly" questions.
Let the doctor know right away that you have questions.
Take notes of what your doctor says.
Have someone come with you to help ask questions and take notes.
Why ask questions?
Your doctor knows a lot about cancer. Talk to him or her and find out about your breast cancer treatment. Questions are important for these reasons:
You need to understand what is going on.
You should know why the doctor thinks you should have a certain treatment.
Excerpted from Breast Cancer Clear & Simple by American Cancer Society. Copyright © 2008 American Cancer Society. Excerpted by permission of American Cancer Society / Health Promotions.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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