Breast Cancer Patient Advocate, Navigator or Health Advocate
The concept of patient advocacy in its current form was developed in 1950’s as the treatment of cancer patients grew more and more technically complicated, as a means to make the voice of the patient more readily heard. In today’s world of constantly evolving medical techniques, treatments, and services, the average individual cannot be expected to be thoroughly acquainted with any and all this material. So it becomes the function of the breast cancer patient advocate to perform a variety of services to ease the burden of the patient, and their family, as they learn to deal with every aspect of the disease.
The primary concern of the breast cancer advocate is to support the cancer patient in all aspects of life with the disease, whether they be physical, emotional, or financial. An advocate can assist the patient in investigating treatment options available, and educating the patient on the efficacy of each of them, be it pharmacological or surgical. By educating the patient, the advocate can be of great assistance in helping them make an informed decision about their course of action, and the possible side effects and outcomes. Support may also involve recommending counseling services for the patient, and their family members, to help them cope from day to day. Breast cancer patient advocates may also be of assistance in helping the patient, and their caregivers, deal with any physical debilitation resulting from the disease, and its treatment.
Another aspect of breast patient advocacy is assistance in navigating the financial aspects of treating the disease. An advocate can act as a liaison between the patient and his or her insurance company, assuring that the patient receives any and all benefits to which they are entitled. When one is dealing with a serious disease, it is quite easy to lose track of other aspects of your life. An advocate can help to seek out sources of assistance which can ease the financial burden of the patient.
Education is also a major function of a cancer advocate. Both the patient, and their caregivers, are often in need of information about how the disease will affect their lives, both during its progression, and in its aftermath. Patients must be informed about how their condition will affect their mobility, the ability to care for themselves, and it if they will be left with any permanent impairment to their lifestyle. Caregivers need to be instructed in mechanisms, or techniques, they must use to cope with the patient’s daily care, such as injections, proper care of surgical dressings, etc.
The cancer patient, above everything else, needs to know that there is someone in their corner. Someone who will help them find their way through the confusing, and sometimes daunting, world of modern medicine. Someone who will have their best interests in mind as they face challenges presented every day in their struggle to find, secure, and finance the best treatment available.
What is Breast Cancer?
Breast cancer is one of the types of cancers referred to as hormonal regulated cancers. When breast cancer is mentioned, many people think of women as the only victims. Contrary to that view, men are also affected although the incidence is much lower. The cancer can develop from the lobule tissue of the breast, referred to as lobular carcinoma or it can grow from the milk duct tissue and this type is called ductal carcinoma.
Breast cancer symptoms vary according to the stage of the disease. Some are symptomless and are only noted during routine check-up. When there are symptoms they may include:
- Pain. This can be the first sign to draw attention to the breast. Initially it will be mild and may increase with time.
- Physical changes on the breast. A person may notice that the skin color or texture of the breast is changing. This can start from a particular point and may spread. The texture may have a characteristic enlargement of the pores which give it an orange skin-like appearance. One sided breast change in size is also a possible symptom.
- A lump or swelling may be noticeable on or just under the breast.
- On self-examination, a lump may be felt much deeper in the breast. The swelling is usually firm and cannot be moved freely. If pressed pain may be elicited.
- Nipple changes. This can be just skin changes on the nipple or structural changes. A nipple that was normally protruding outwards may start to retract or invert. Other changes include nipple discharge. The discharge can be a fluid of differing consistency or even blood-stained.
- Swollen armpit lymph nodes may be felt.
Causes of Breast Cancer
The exact cause of breast cancer is unknown. What is known is that for it to occur there are DNA changes that lead to abnormal cell multiplication and aging. Researchers have also established certain factors that seem to be more prevalent in people with breast cancer.
Risk factors can be those that an individual has some control or the ones where the potential victim has no control. Lifestyle choices that increase the risk include:
- Excessive and prolonged consumption of red meat.
- Excessive consumption of alcohol
- Use of breast implants.
Working in environments with exposure to high levels of substances thought or known to be carcinogenic. An example being plastic industries and some agricultural chemicals. Working in high radiation arears may also increase the risk.
The birth control pill is also a suspected risk factor.
There are those risk factors where a person has no control. These include:
Genetic predisposition. Some factors here include above average tall women and those with firm breasts. Women with this tendency, for unknown reasons, have a higher risk of developing breast cancer.
History of hormonal or radiotherapy treatment.
- Menarche or menopause onset. Early onset of periods and late menopause increase the risk.
How Breast Cancer is diagnosed.
After the initial clinical examination by a medical professional and breast cancer is suspected, specific investigations are done. The aim here is to confirm and identify the type of the cancer. Diagnostic measures involve:
- Mammography. This can be the traditional 2D tests or the newer type, breast tomosynthesis that give a more detailed 3D view of the breast tissue.
- Breast ultrasonography.
Invasive diagnostic techniques
- Biopsy removal for histological examination.
- Magnetic Resonance Imaging (MRI)
These investigations will help to confirm the diagnosis (or to rule it out), identify the type and classify the stage of the disease. The importance of knowing this is that it determines the best type of treatment to be followed.
1. Surgery is done with varying degrees of invasiveness. It may involve the removal of the lump, the lobe, the duct or the whole breast (mastectomy). It may also involve removal of associated lymph nodes to see whether the cancer has metastasized.
2. Radiotherapy. In most cases this follows surgery and the aim is to clear any malignant cells that may have missed the surgeon’s knife.
3. Chemotherapy. Cytotoxic drugs are used with the aim of killing the cancer cells either locally or those that have spread to other parts of the body.
4. Hormonal treatment. If the type of cancer is responsive to hormones then this type of treatment is appropriate. Some of the drugs used here are Tamoxifen and Aromatase inhibitors like Letrozole and anastrozole.
Breast cancer statistics
Breast cancer is a major cause of morbidity and mortality among women in the US. It has no regard for race. However, it is the leading killer cancer among women of Spanish origin. Among the Blacks, Whites and American Indians, it is the second commonest cancer to cause deaths after lung cancer.
The year 2011 statistics show that over 200 000 women were diagnosed with breast cancer. In the same year over 40000 women died of the disease.
When breast cancer is diagnosed early, the prognosis is better. If metastasis has occurred, the outlook is not as good.