Over the years, science and medicine has come a long way towards improving healthcare. There was a time when we knew little about ailments like breast cancer, but today, we know that early intervention helps reduce risk significantly. And this intervention begins with you!

Before we get into the technicalities, let us know what breast cancer really is. Simply put, breast cancer is a form of cancer that is found in the breast when the cells grow out of control. These mutated cells cause a tumour, which leads to various health complications.

 Though the disease occurs mainly in women, a few men can fall prey to breast cancer as well. According to the World Health Organization, an estimate of 110 000 cases of breast cancer are recorded every year in both developed and developing countries.

To understand breast cancer better, we need to know a bit about the breast. Broadly put, breasts are made up of three main parts: Connective tissues, Ducts, and Lobules. The lobules are the glands that produce milk. The tube that carries milk to the nipples are called ducts and the connective tissue surrounds and holds everything together. While most forms of breast cancer begin in either the ducts or lobules, there’s always a chance that it forms in another part of the breast.

Through blood vessels and lymph vessels, breast cancer can also spread outside the breast. It is said to have metastasized when cancer spreads to other parts of the body. It is important to know that all breast lumps are not cancerous. In most cases, they are benign and not life-threatening. Non-cancerous tumours grow abnormally but do not spread outside of the breast. But some forms of benign lumps can increase a women’s risk of getting breast cancer. So, it is important to visit a healthcare professional as soon as you notice any changes or lumps.

The Different Forms of Breast Cancer

The most common kinds of breast cancer are: 

• Invasive Ductal Carcinoma: They grow outside the ducts in other parts of the breast tissue. They can metastasize or spread to other parts of the body. 
• Invasive Lobular carcinoma: The cancer cells spread from the lobules to the tissues close by and can also spread to other parts of the body.

Some rare forms of breast cancers include Phyllodes tumours and Angiosarcoma

Cancer detection begins with a diagnostic procedure called a biopsy. Once the biopsy is done, the cancer cells are tested for proteins called Estrogen receptors, Progesterone receptors, and HER2. The tumour cells are tested closely in the lab to know which grade it is which helps decide treatment options.

Types of breast cancer surgery

Once your doctor looks at the biopsy reports, they decide on surgical intervention basis several factors. These include:

• The cancer size
• The location of the cancer lump in your breast
• The size of the breast
• The grade of your cancer

Moving to the surgical table:

Basis the factors mentioned above, your doctor may present you with surgical options which may be from one of the below –

• Lumpectomy: A Lumpectomy is also known as a breast conversing surgery because only a portion of the breast is removed. In this surgery, the surgeon removes the tumour along with other abnormal tissues while leaving behind the healthy tissues. Along with the surgery, your doctor may also suggest radiation therapy to kill any remaining abnormal cells.

While a Lumpectomy is pretty straightforward, there are chances that cancer in your breast is at a complicated stage. At such times, your doctor may suggest you undergo a Mastectomy. A Mastectomy usually involves the removal of the whole breast.

There are various kinds of Mastectomy surgeries. These include –

1. Simple or total mastectomy: The entire breast is removed, the surgeon does not perform axillary lymph node dissection, which is, the removal of lymph nodes in the underarm area. No muscles are removed beneath the breast.
2. Modified radical mastectomy: The entire breast is removed and the surgeon performs axillary dissection and no muscles are removed from beneath the breast. 
3. Radical Mastectomy: The entire breast is removed along with levels 1, 2, and 3 of the underarm lymph nodes and the surgeon also removes the chest wall muscles under the breast. Radical mastectomy is recommended only when cancer has spread to the chest and muscles under the breast.
4. Partial mastectomy: Only the cancerous part of the breast is removed along with normal tissues around it. More tissues are removed in partial mastectomy compared to lumpectomy.
5. Nipple-sparing mastectomy: All of the breast tissue is removed but the nipple is left alone. 

• Lymph node removal and analysis

Cancer can be found in cells of Axillary lymph nodes in some cancer cases. Hence it is important to find out whether the lymph nodes near the breast contain cancer. This helps in treatment and prognosis. The procedure includes –

1. Sentinel lymph node biopsy: The sentinel nodes are the first few lymph nodes into which a tumour drains. Sentinel node biopsy is a surgical procedure to determine whether cancer has spread beyond a primary tumour.
2. Axillary lymph node dissection: Axillary lymph node dissection is a surgical procedure that removes nodes in levels 1 and 2 for women with invasive breast cancer.  

• Reconstructive surgery

After Mastectomy, doctors might suggest a reconstruction of the breast. This is a surgery to recreate the breast using the tissue taken from another part of the body or synthetic implants. It is usually performed by a plastic surgeon.

Can Side Effects Occur Post Surgery?

Like any other major surgery, breast cancer surgery may present symptoms post the operation. These side effects include –

• Fatigue: Fatigue or Cancer tiredness is the most common side effects of cancer treatment. Though the emotional impact of the diagnosis may continue for a few weeks or months, it is paramount to be physically active.

• Shoulder stiffness: Gentle arm and shoulder exercise can prevent this, ask your doctor when you can start exercising. 

• Numbness and tingling: Bruising or injury to nerves can be caused due to surgery which can lead to numbness and tingling in the armpit, upper arm, or chest area.

• Seroma: This is most common after a mastectomy. The fluid collects in or around the surgical scar and causes a balloon-like swelling.

• Change in nipple, breast, or arm sensation: It is temporary but might be permanent in few patients. 

• Lymphedema: After the lymph nodes surgery, fluid building up in the tissue of the arm and the breast may cause swelling.

Some of the late side effects of the surgery are:

• Loss of fertility
• Weight gain
• Early-onset of menopause
• Anxiety
• Problems of intimacy and sexual behaviour
• Pain in muscles and joints
• Problems in bone health
• Hot flashes

So, should you be worried about Breast Cancer Surgery?

While there are, a few risks involved, our understanding of Breast Cancer has grown significantly over the years. So, if your doctor advises you to undergo surgery, do consider it. Indeed, certain side effects, either short term or long term, may present. But in most cases, it far outweighs the risk that breast cancer presents. Even if you aren’t suffering from Breast Cancer yet, you must do a self-check from time to time so that you can stay ahead of the ailment!

Cancer – just the word is enough to scare the best of us. But in reality, Cancer isn’t a singular, blanket term. There are many different types of cancers that can be formed in the body. Usually, once cancer forms, they spread to other parts of the body, which makes it fatal. Generally speaking, these are the clinical terms used for cancer –

• Cancer that starts in the skin or the tissues which line other organs is Carcinoma.
• The cancer of connective tissues such as muscles, bones, and blood vessels is Sarcoma.
• The cancer of bone marrow is Leukemia.
• The cancer of the immune system is Lymphoma and Myeloma.

Cancer cells grow out of control and become invasive, unlike normal cells. Cancer cells are less specialized than normal cells. Normal cells mature into distant cells, unlike cancer cells. They can influence normal cells, molecules, and blood vessels that feed and surround the tumor.

So, what is Cervical Cancer?

Unlike most other cancers, Cervical cancer spreads slowly, giving enough time for specialists to diagnose and treat it before it gets complicated. But Cervical cancer shouldn’t be taken lightly as it can metastasize, which is, spread to other parts of the body. These often include cancer spreading to the Liver, Bladder, Lungs, Vagina, and Rectum.

In the majority of cases, cervical cancer is caused by various strains of human papillomavirus (HPV), a sexually transmitted infection that is preventable through vaccines. When exposed to HPV, the body itself fights against the virus. But in some cases, the virus survives for years contributing to the development of cancer. Hence it is important to go for regular screen testing or to get an HPV vaccine.

The HPV vaccine protects women against these infections. The purpose of the vaccine is to produce antibodies that help fight against the HPV, thus preventing it from infecting cells.

The vaccine does not treat the existing HPV infection or prevent other sexually transmitted diseases.

In the year 2018, an estimated 570, 000 women were diagnosed with cervical cancer and about 311 000 women died from cancer. It is the fourth most common type of cancer. But that being said, if Cervical cancer is detected early and managed effectively, it is one of the most successful and treatable types of cancer. 

What are the symptoms you need to look out for?

A woman might experience no signs or symptoms at all in the early stage of cancer . Depending on the tissue and organ in which the disease has spread, the symptoms might differ. As a result of which women should have regular cervical smear tests or pap tests.

The most common signs or symptoms of cervical cancer are: 

• Increased watery or bloody vaginal discharge will have a foul odor. 
• Bleeding after menopause. 
• Bleeding in between periods. 
• Pelvic or back pain is unexplainable.
• Bleeding after intercourse.
• Pain while having intercourse. 
• Longer and heavier menstrual bleeding. 

The cause of these symptoms may also occur due to some other medical condition or infection but it is important to visit the doctor if you spot any of the symptoms.

How is Cervical Cancer Treated?

While the final call for treatment lies in the hands of your doctor, there are some factors that they will consider which include the stage of cancer, age as well as overall health.

Cervical cancer treatments include Surgery, Chemotherapy, Radiotherapy, or the combination of these according to cancer. 

The early-stage treatment: 

When cancer has not spread from the cervix, surgery is the common treatment method. If the doctor feels the cancer cells are still inside the body then they might suggest radiation therapy. 

Radiation therapy also decreases the chances of reoccurrence.

Advanced cancer treatment:

Advanced cancer is also referred to as invasive cancer because it has invaded other parts of the body. Surgery is usually not an option after cancer has spread beyond the cervix. 

In the advanced stages, doctors often suggest palliative therapy to relieve symptoms and improve quality of life. 

Chemotherapy

Chemotherapy is an aggressive drug treatment that targets the cancer cells that divide and grow rapidly. In simpler terms, chemotherapy is the use of medication to treat the disease.

What are the side effects after treatment?

Post-treatment, women may experience certain symptoms. These vary from treatment to treatment. While your doctor will tell you about these in detail, on a general note, these are some of the side effects you may face.

The side effects after Chemotherapy –

• Diarrhea 
• Nausea 
• Mood swings 
• Early menopause 
• Hair loss 
• Fatigue 
• Infertility 

The side effects from Radiation Therapy 

Radiation therapy involves the high energy of beam that is used to destroy the cancer cells. Radiation therapy is targeted to the pelvic area. It also has certain side effects which may occur after the course of treatment is over such as: 

• Upset stomach 
• Bladder Irritation 
• Interrupted menstrual cycle 
• Narrowing of the vagina 

It is important to remember that the success rate of the treatment in the early stage is more compared to the ones detected after it has injected the other tissues or organs. So, you must take steps to prevent it as much as possible.

Here are ways to prevent Cervical Cancer:

• Have regular Pap tests with screenings: A pap test can help you find any precancerous cells to treat and monitor them to prevent cervical cancer.
• Safe Sex: Take measures to prevent sexually transmitted infections like using condoms every time you have sex and limiting sexual partners one has. 
• HPV vaccine: Talk to your doctor about the HPV vaccine and whether it is appropriate for you. 
• Say no to smoking: If you are a regular smoker then talk to your doctor about the methods to quit smoking. Smoking is linked to various cancers.

Regular tests and visiting the doctor when you observe any change are important. Practicing all the preventive measures can reduce the risk of getting cervical cancer. Cervical cancer found in the early stages is highly treatable and is associated with long survival and good quality of life.