About Cancer

Breast cancer is the number one disease that women in the United States fear the most, and for compelling reasons. It is the leading cause of death among women between 40 and 55 years of age and is the second overall cause of death among women (exceeded only by lung cancer). Unfortunately, it is also on the rise worldwide. According to the American Cancer Society, this year about 175,000 new cases of invasive breast cancer and about 43,300 deaths from breast cancer will occur among women in the USA.

Breast cancer is a rapid, uncontrolled growth of abnormal cells in one or both breasts. It is life-threatening because it quickly spreads to vital organs.

The years since World War II have seen a tremendous increase in the incidence of breast cancer, so efforts on identifying its causes often focus on changes in our society that have occurred since then, such as the increased use of pesticides, the advent of birth control pills, changes in diet, and different styles and materials in women's clothing. Researchers have identified lots of risk factors (such as age, diet, cigarette smoking, alcohol intake, and family history), but the specific causes of breast cancer remain elusive.

Cancers are divided into different groups, called stages, based on whether the cancer is invasive or non-invasive, the size of the tumor, how many lymph nodes are involved, and whether there is spread to other parts of the body. The stages identify tumor types that have a similar outlook and are treated in a similar way. There are five main stages of breast cancer. If breast cancer is detected in its early stages, the 5 year survival rate is greater than 95%.

Breast cancer is more easily treated and often curable if it is found early. Monthly breast self-examinations should begin at age 20. Recommended screening methods include breast self-examination and mammography. A mammogram is the most effective way to find breast cancer early, up to 2 years before the lump is even large enough to feel. Sometimes a doctor will discover a lump in a woman's breast during a routine examination or a patient might come to the doctor with questions about a lump she found. If clinical examination and mammography both reveal benign findings, biopsy may be unnecessary.

Treatment for breast cancer usually depends on the type of cancer and whether the cancer has spread outside of the breast to the rest of the body. Treatment options include surgery, radiation, chemotherapy, and endocrine/anti-hormone therapy. Treatment usually starts with anticancer drugs, or chemotherapy. The prognosis (chance of recovery) and treatment options depend on the stage of the cancer, the size of the tumor and whether it is in the breast only or has spread to lymph nodes or other places in the body. It's very important to diagnose inflammatory breast cancer quickly so that treatment can begin. After surgery, radiation treatment is used to try to kill any remaining cancer cells.

Possible surgical treatments are either a mastectomy (complete removal of the breast) or breast conserving therapy. Even if a mastectomy is needed (about 30-40% of patients need this), building a new breast, called reconstruction, offers a natural looking breast replacement. Breast-conserving surgery (which removes only some of your breast) often works just as well as a mastectomy (which removes all of your breast).

Mammograms can detect tumors in the earliest stages, however, a standard mammogram can miss 15-20% of cancerous tumors. Heightened awareness of breast cancer risk in the past decades has led to an increase in the number of women undergoing mammography for screening, leading to detection of cancers in earlier stages and a resultant improvement in survival rates.

Research suggests that routine exercise may help prevent breast cancer. No one knows the exact causes of breast cancer, but research has shown that women with certain risk factors are more likely than others to develop the disease. Researchers at Stanford University and the National Institutes of Health, for example, found that high concentrations of the IGF-1 hormone stimulate cancer cell growth.

Up to 10 percent of breast cancer patients eventually suffer a recurrence in the other breast. Simple mammograms often miss small tumors, the researchers from the American College of Radiology Imaging Network found, while MRIs rarely miss them.

The cause of breast cancer is unknown. Early detection of breast cancer is therefore vital as it increases the chances of successful treatment. The chance of a woman in her 40s developing breast cancer is about one in 70, whereas the risk of a woman in her 80s developing breast cancer is one in 25. When breast cancer is confined to the breast the five year survival rate is over 95%. For women aged 40-49, the evidence that screening mammography reduces mortality from breast cancer is weaker, and the absolute benefit of mammography is smaller, than it is for older women.

The good news is that breast cancer is a disease that can be treated and cured. More than 90 out of 100 women whose breast cancer is found early will be cured. Cancer found at a later stage, however, may be less likely to be cured. While there is still no cure for the disease, the experts and leading organizations such as the American Cancer Society, Susan G. Doctors and scientists are working on finding cures for all types of breast cancer. Finding and treating breast cancer early is the best way to increase your chances of survival and cure.

Colon cancer is the second leading cause of deaths resulting from cancer. Every year, approximately 48,000 people will die in the U.S. from colon cancer. Many of these deaths would be prevented with early detection and treatment through routine colon cancer screening.

Colon Cancer Progresses Through Stages

The stage of the colon cancer determines the appropriate treatment and determines the patient's relative 5-year survival rate which is the percentage of colon cancer patients who live at least 5 years after being diagnosed. Colon cancer progresses in stages as follows:

• Stage 0: The disease starts as a small non-cancerous growth, called a polyp, in the colon. Some of these polyps become precancerous, and over time, turn cancerous. Growth has not progressed beyond the inner layer (mucosa) of the colon.
• Stage 1: The cancer has started to work its way through the first layers of the colon - the mucosa and the submucosa.
• Stage 2: The cancer has advanced beyond the first two layers of the colon and is spreading deeper through the wall of the colon into the muscularis and the serosa but is not in the lymph nodes or distant organs.
• Stage 3: The cancer has spread to one or more of the nearby lymph nodes.
• Stage 4: The cancer has spread to other organs (typically the liver or the lungs).

In order to detect colon cancer early, everyone, even individuals who are not at high risk, that is, with no symptoms and with no family history of colon cancer, should be screened. Cancer specialists suggest that screening for such individuals start at age 50 and consist of tests that detect colon cancer in the body:

• Colonoscopy, at least every ten years,
• Sigmoidoscopy, at least every 5 years,
• Double-contrast Barium Enema, at least every 5 years, or
• Virtual Colonoscopy (computed tomographic colonography), at least every 5 years

These tests allow a doctor to actually see the growth or cancer inside the colon. The frequency at which these tests are repeated depends on what is found during the procedure.

Cancer specialists also recommend tests that look for blood in the stool, such as:

• Annual Guaiac-based Fecal Occult Blood Test (gFOBT)

Such tests detect the presence of blood from tumors in the stool. Generally these tests are not as effective at detecting colon cancer as those that detect cancer in the body.

Stage of Colon Cancer Determines Treatments and Relative 5-Year Survival Rates

If the disease is detected as a small polyp during a routine screening test, such as a colonoscopy, the polyp can usually be taken out during the colonoscopy without the need for the surgical removal of any of the colon.

When the polyp becomes a tumor and reaches Stage 1 or Stage 2, the tumor and a portion of the colon on both sides is surgical removed. The relative 5-year survival rate is over 90% for Stage 1 and 73% for Stage 2.

If the disease advances to a Stage 3, a colon resection is no longer sufficient and the patient also needs to undergo chemotherapy. The relative 5-year survival rate drops to 53%, depending on such factors as the number of lymph nodes that contain cancer.

By the time the colon cancer reaches Stage 4, treatment may require the use of chemotherapy and other drugs and surgery on multiple organs. If the size and number of tumors in other organs (such as the liver and lungs) are small enough, surgery may be the initial treatment, followed by chemotherapy. In some cases the size or number of tumors in the other organs takes away the option of surgery as the initial treatment. If chemotherapy and other drugs can reduce the number and size of these tumors, surgery may then become an option as the second form of treatment. If not, chemotherapy and other drugs (possibly through clinical trials) may temporarily stop or reduce the continued spread of the cancer. The relative 5-year survival rate drops to approximately 8%.

As the relative 5-year survival rates indicate, the time frame in which colon cancer is detected and treated makes a dramatic difference. If detected and treated early, the individual has an excellent chance of surviving the disease. As detection and treatment is delayed, the odds start turning against the individual so that by the time the colon cancer progresses to Stage 3, the percentage is almost even. And the odds drop precipitously when the colon cancer reaches Stage 4.

Failure to Screen for Colon Cancer May Constitute Medical Malpractice

Unfortunately, all too often doctors do not recommend routine colon cancer screening to their patients. By the time the cancer is discovered - often because the tumor has grown so large that it is causing blockage, because the patient has unexplained anemia that is getting progressively worse, or because the patient begins to notice other symptoms - the colon cancer has already advanced to a Stage 3 or even a Stage 4. The individual now faces a much different prognosis than if the cancer had been detected early through routine screening. In medical malpractice terms, the individual has suffered a "loss of chance" of a better recovery. That is to say, because the doctor did not advise the individual to undergo routine screening, the cancer is now much more advanced and the individual has a much reduced chance of surviving the cancer. The failure of a doctor to advise the individual about screening options for colon cancer may constitute medical malpractice.

Contact a Lawyer Today

You need to contact a lawyer immediately if you feel there was a delayed diagnosis of colon cancer due to a doctor's failure to recommend routine colon cancer screening. This article is for informational purposes only and is not intended to be legal (or medical) advice. You should not act, or refrain from acting, based upon any information at this web site without seeking professional legal counsel. A competent lawyer with experience in medical malpractice can assist you in determining whether you may have a claim for a delay in the diagnosis of colon cancer due to a failure on the part of the doctor to offer colon cancer screening. There is a time limit in cases like these so do not wait to call.