Breast Cancer

Having Breast Cancer

The American Cancer Society estimates that over 178,000 women will be diagnosed with breast cancer this year in the United States alone. And over 40,000 women in the United States will die from the disease.* Each woman afflicted with breast cancer has an unique story. Marcy E. Rosenbaum and Gun M. Roos collected some of these stories and noted some common patterns in women's experiences. They described their findings in a compelling essay titled, "Women's Experiences of Breast Cancer,"** published in the book Breast Cancer: Society Shapes an Epidemic.

Surgery for Breast Cancer

Surgical removal of breast tissue is the most common treatment for breast cancer. Prior to the 20th century, surgery on the breast was rare. In the 1890s, a surgeon named William Halstead created a procedure called the radical mastectomy, which he declared was a cure for the disease. In a radical mastecotomy, the surgeon removes the entire breast, the lymph nodes, and the chest muscles that stretch over the breast. Radical mastectomies soon became the most prevalent breast cancer treatment in the United States. While radical mastectomy did significantly increase the survival rate of patients afflicted with breast cancer over those who did not have the procedure, it failed to cure all patients. Unfortunately, the surgery also caused a number of side effects in many patients, including weakness in the arm, respiratory problems, and chronic pain. In the 1960s and 1970s, health advocates and patients began to question whether it was necessary to remove the chest muscles in mastectomy, since most of the problematic side effects of the procedure were linked to muscle loss and studies showed that breast cancer cells rarely migrated to the chest muscles. Consequently, surgeons developed a procedure dubbed the modified radical mastectomy, in which the breast tissue and lymph nodes are removed, but chest muscles are left intact. Subsequent studies showed a drastic reduction in side effects and virtually no reduction in survival rates. In the ensuing decades, prevailing opinions on breast cancer surgery shifted from a belief that it was more effective to remove all tissue and muscle in the breast area to a belief that it is better for the patient if only areas containing cancer cells are removed. Today, radical mastectomies are uncommon and most patients undergo either lumpectomies (removal of only the cancerous lump of breast tissue), modified radical mastectomies, or two other procedures known as total mastectomies, and partial mastectomies. In The Waiting Room, Wanda undergoes a modified radical mastectomy. To see diagrams of the areas removed in these different types of surgery and learn more about them, visit the University of Virginia Health System Website.

Alternative and Complementary Treatments

There are a people around the world who offer forms of breast cancer treatment outside of the typical surgery, chemotherapy, hormone therapy, and radiation offered by conventional doctors and medical institutions. Some of these treatments are presented as substitutes for conventional treatments. Others are offered as complements, usually in an attempt to create a more holistic approach to healing. Some of these treatements are offered by licensed medical practitioners. Others are offered by naturopaths, shamens, or other alternative healers. Some of these treatments have been proven beneficial in medical studies. Others have not been formally studied, but patients testify that they are beneficial. Still others have been scientifically discredited as hoaxes. To see how pervasive alternative and contemporary treatments are, do simple internet search for "breast cancer treatment."

Agencies affiliated with the U.S. government typically only advocate treatments that have undergone extensive clinical trials. Visit the National Cancer Institute's Treatment Option Overview to learn about new treatments that are currently undergoing testing.

For information on discredited alternative cures (including laetrile, which is mentioned in The Waiting Room) read James S. Olson's "Patient Heal Thyself: Quacks and Cures in the Age of Narcissism," chapter four of his book, Bathsheba's Breast: Women, Cancer, & History.**

*Cancer Statistics taken from American Cancer Society. Most Requested Graphs and Figures 2007. Accessed 9/27/07. <http://www.cancer.org/docroot/MED/content/MED_1_1_Most-Requested_Graphs_and_Figures_2007.asp>

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