(This is a report about Breast Cancer and how it effected her written in 1999 by Brandon, Donna's grandson. Donna's fight against Breast Cancer started in May of 1996. She fought a tough battle for over five years and is an inspiration to all who knew her. She decided to stop her cancer treatment in November of 2000 after constantly feeling ill. Her decision reflected her attitude at that point, that quality of life was more important than quantity. On February 21st, 2001 she signed up for Hospice Care. Our family dedicated themselves to taking care of mom those last two weeks, spending the nights to help out with her care. It was a time of sadness as well as family unity. Donna died on March 9th, 2001, with her family at her bedside.)


BREAST CANCER

By: Brandon Harper, Grade 7, February 4, 1999

Brandon with his Grandma and Grandpa in June 2000
STATEMENT OF PURPOSE
I decided to do my research project on Breast Cancer because my grandma has Breast Cancer. I wanted to learn more about the disease so that I can better understand what she is going through.


RESEARCH

    What is Cancer?
    Cancer is a group of diseases that occur when cells become abnormal and divide without control or order. Every organ in the body is made up of various kinds of cells. Cells normally divide in an orderly way to produce more cells only when they are needed. This process helps to keep the body healthy. If cells divide when new cells are not needed, they form too much tissue. The mass or lump of extra tissue, which is called a tumor, can be benign or malignant.

    Benign tumors are not cancer. They can usually be removed, and in most cases, they donít come back. Most important, the cells in benign tumors do not invade other tissues and do not spread to other parts of the body. Benign breast tumors are not life threatening.

    Malignant tumors are cancer. The cancer cells grow and divide out of control. They can invade and damage nearby tissues and organs. Also, cancer cells can break away from a malignant tumor and enter the bloodstream. That is how breast cancer spreads and forms secondary tumors in other parts of the body. The spread of cancer is called metastasis.

    What is Breast Cancer?
    Breast cancer is a disease in which cancer cells are found in the tissues of the breast.

    Breast Cancer Facts in the United States

    • Breast Cancer is the most common form of cancer in women in the United States. Both its cause and its cure remain undiscovered. About two million breast cancer survivors are alive in America today.
    • In 1998, 180,000 new cases of female breast cancer will be diagnosed, and 43,500 women will die from the disease.
    • Breast cancer is the second leading cause of cancer death for all women, and the leading cause of cancer death in all women between the ages of 40 and 55.
    • Men develop breast cancer, too, although its incidence is low. In 1998, 1,600 male cases are projected to be diagnosed, and 400 men will die from the disease.
    • One out of nine women in the United States will develop breast cancer in her lifetime.
    • A breast cancer will be newly diagnosed every three minutes.
    • Every 12 minutes a woman will die from breast cancer.

    Types of Breast Cancer:
    There are several types of breast cancer. The most common one begins in the lining of the ducts and is called Ductal Carcinoma. Another type, called Lobular Carcinoma, arises in the lobules. When breast cancer spreads outside the breast, cancer cells are often found in the lymph nodes under the arm (axillary lymph nodes). If the cancer has reached these nodes, it may mean that cancer cells have spread to other parts of the bodyóother lymph nodes and other organs, such as the bones, liver, or lungs. Cancer that spreads is the same disease and has the same name as the original (primary) cancer. When breast cancer spreads, it is called Metastatic Breast Cancer, even though the secondary tumor is another organ. Doctors call this "distant" disease.

    What is the Cause of Breast Cancer? We do not yet know what causes breast cancer. There is a great deal of research under way to learn more. The American Cancer Society is funding millions of dollars in breast cancer research, supporting efforts to investigate any potential cause of the disease. Nobody knows for certain why some women get breast cancer and others do not. For every disease, there are certain risk factors that increase the likelihood of the disease. While the cause of breast cancer is not yet known, we do know that there are a number of specific factors that put women at risk for the disease.

    Risk Factors for Breast Cancer:

    Risks:
    Every woman is at risk for breast cancer simply because sheís female. Over 70 percent of cases occur in women who have no identifiable risk factor. To date, the knowledge about risk factors has not translated into practical ways to prevent cancer. The best opportunity for reducing the death rate is through early detection.

    Major risks:

    • Age: Women age 50 and over account for 77% of new diagnoses of breast cancer
    • Family History: Women whose mother or sister has had breast cancer
    • Personal History: Women who have already had cancer in one breast

    Other risks:

    • Women with precancerous breast disease
    • Women who have never had any children
    • Women who had their first child after the age of 30
    • Women who got their first period at age 12 or younger
    • Women who have experienced menopause after 55

    What is the Cause of Breast Cancer?
    We do not yet know what causes breast cancer. There is a great deal of research under way to learn more. The American Cancer Society is funding millions of dollars in breast cancer research, supporting efforts to investigate any potential cause of the disease. Nobody knows for certain why some women get breast cancer and others do not. For every disease, there are certain risk factors that increase the likelihood of the disease. While the cause of breast cancer is not yet known, we do know that there are a number of specific factors that put women at risk for the disease.

    Early Detection:
    Most breast cancers, more than 70 percent, are found by women themselves, either during monthly self-examination or by accident when showering or looking in the mirror. If detected early, breast cancer can often be treated effectively with surgery that preserves the breast, followed by radiation therapy. Systemic chemotherapy and/or hormonal therapy sometimes accompany this local therapy. Five-year survival after treatment for early-stage breast cancer is over 97 percent. Early detection improves the chances that breast cancer can be located, diagnosed, and treated successfully.

    Women should ask their doctor about:

    • Mammograms (x-rays of the breast)
    • Clinical breast exams (breast exams by a doctor or nurse)
    • Breast self-examination

    Staging of Breast Cancer:
    Once cancer has been found, more tests will be done to find out if the cancer has spread from the breast to other parts of the body. This is called staging. To plan treatment, a doctor needs to know the stage of the disease.

    The following stages are used for breast cancer:


    • Stage 0: Also called in situ or noninvasive cancer. Very little breast cancer or preinvasive cancer. This type of cancer has not spread within or outside of the breast.
    • Stage 1: Cancer cells have not spread beyond the breast. Tumor is smaller than 1 inch.
    • Stage 2: Cancer has spread to underarm lymph nodes. Tumor in the breast is 1 to 2 inches across.
    • Stage 3: Called locally advanced cancer. Cancer is extensive in the underarm lymph nodes, or has spread to other lymph node areas or to other tissues near the breast. Tumor in the breast is large (more than 2 inches across)
    • Stage 4: Called metastatic cancer. Cancer has spread from the breast to other parts of the body, such as the bones, lungs, liver or brain.

    Recurrent Cancer:
    Recurrent cancer means the disease has come back in spite of the initial treatment. Even when a tumor in the breast seems to have been completely removed or destroyed, the disease sometimes returns because undetected cancer cells remained in the area after treatment or because the disease had already spread before treatment. Most recurrences appear within the first 2 or 3 years after treatment, but breast cancer can recur many years later. Cancer that returns only in the area of the surgery is called a local recurrence. If the disease returns in another part of the body, it is called metastatic breast cancer (or distant disease).

    Risk Factors For Recurrence:
    Some women are at higher risk for the spread and return of breast cancer. The risk factors for recurrence are complex. They are not absolute forecasts of what the future will be.

    The Risk Factors are:

    • Tumor size: The larger your tumor, the higher your risk.
    • Lymph nodes: The more lymph nodes in your armpit that have cancer, the higher your risk.
    • Cell studies: New tests can measure the growth rate and aggressiveness of the tumor Cells. The cancer cells that show the most rapid growth are linked to higher risk for the return of cancer.

    How Breast Cancer is Treated:
    There are treatments for all patients with breast cancer. Treatments, and the range of options available to the patient, are highly dependent on the type and size of her tumor and how far the breast cancer has progressed at the time of diagnosis. Surgery and radiation therapies are local treatments used to remove, destroy, or control the cancer cells in a specific area. Chemotherapy and hormonal therapy are systemic treatments. Systemic treatments are used to destroy or control cancer cells anywhere in the body.

    The Four Types Of Treatment Used Are:

    • Surgery: Taking out the cancer in an operation.
    • Radiation Therapy: Using high-energy x-rays to damage cancer cells and stop them from growing.
    • Chemotherapy: The use of drugs designed to travel throughout your body and slow the growth of cancer cells or kill them. The drugs are injected into the bloodstream through an intravenous (IV) needle that is inserted into a vein.
    • Hormonal Therapy: Taken daily in pill form, it is used to keep cancer cells from getting the hormones they need to grow.

    Emotional Healing:
    It is normal to have trouble coping with a diagnosis of breast cancer. Some women feel fear, anger, denial, frustration, and loss of control, confusion, and grief. Others feel lonely, isolated, and depressed. Women also have to deal with issues about their self-image, future priorities, sexuality, and possible death. Each woman has to deal with these issues and her diagnosis of cancer in her own way and on her own time schedule. Many women find that it helps to talk about their feelings with their loved ones or close friends. When you reach out, you are giving loved ones and friends the chance to show their support during this difficult time.

    Living With Cancer:
    The diagnosis of breast cancer can change a womanís life and the lives of those close to her. These changes can be hard to handle. It is common for the woman and her family and friends to have many different and sometimes confusing emotions. Concerns and fears about breast cancer are likely to stay with you. A new ache or pain, a medical test, or the anniversary of your diagnosis may unexpectedly get you down or worried. These feelings are part of being a cancer survivor. But the emotions will be fewer and farther between as you return to your regular activities.

    My Grandma and Her Breast Cancer (Interview)
    I interviewed my Grandma on January 31, 1999 about her breast cancer. She was first diagnosed with breast cancer in May 1996. ~Brandon

    Q: How did you find out you had breast cancer?
    A: "My primary care physician found the lump in my breast during my normal check-up".

    Q: How did you decide your treatment option?
    A: The doctor laid out all the choices. California law lets the patient decide what their treatment will be. "Because the lump was small, I went for the lumpectomy".

    Q: What happened because of your choice?
    A: "I had to have chemotherapy and radiation".

    Q: What was your chemotherapy like and how did you receive it?
    A: "I was terrified at first, but it wasnít as bad as I expected". Her first round of chemo left her sick, sleepy and really dragged her out. She lost all of her hair in a short amount of time. With her second phase of chemo, (more about that later) she was left wondering why they didnít give her the drug "Taxol" the first time. It made a big difference in the way she felt after the treatments. My grandma received her chemo through an IV.

    Q: How long does one chemo treatment take, and how many have you had?
    A: It takes about 4 hours for each cycle. Each cycle is given 3 weeks apart, on average. The first time she received three cycles of chemo, then 8 weeks of radiation, and then three more cycles of chemo.

    Q: How long does radiation treatment last?
    A: Each radiation treatment lasts only 15 minutes, but you have this treatment 5 days a week for 8 weeks in a row. "Radiation leaves you very tired!"

    Q: Why did you stop getting chemotherapy?
    A: "My treatments stopped in December of 1996 because they didnít find any more signs of cancer. I thought I was cured, I later found out what remission was".

    Q: Did you have to go back to the doctor?
    A: "Yes, I went every 3 months for checkups, exams and to see the radiologist. Everything looked great for a long time".

    Q: What happened next?
    Phase 2 Ė The Cancerís Back: Chemotherapy started again. She began a new drug, which is called Taxol. Taxol was used for 2nd time cancer for my grandma, but it is now used for first time cancer patients. The side effects she feels are numbness to toes and hands, nerve ends and sore joints.

    It became harder and harder for the doctor to find a vein that would allow the IV for treatment, so she went into the hospital and they inserted a tube into her chest. This is how she has chemo now. This tube will stay in until she doesnít need chemo anymore.

    Since my grandma already knew that loosing all her hair was a side effect of chemo, she had her head shaved right away. She said that with the first phase of chemo, she tried to hang on to it as long as possible, even though her scalp hurt as it fell out. An interesting fact with this new drug is that her hair is actually growing back during her treatments. She is very proud of the fact that she is also growing her eyelashes back!

    Aredia is given 2 days after chemo to help strengthen the bones. The same night or the following day is when the side effects kick in. Those side effects are aching, painful knees and weakness to the legs.

    My grandma is on her 13th cycle of chemo treatment for this phase. After every 3-4 cycles of chemo treatment, she has a catscan and a bone scan to tell if the cancer is changing. There has been no change in her cancer. It has not become smaller nor has it grown bigger. She is in the process of trying to go to "The City of Hope" to see if there is something else they can do for her. At this point she is up for anything. My grandma says that "treading water is better than dying". She says she will continue treatment until she dies or the cancer dies.

    Q: What keeps you going? What helps you get through the day?
    A: "Faith, family, love and prayers from everyone around me! Your grandfather, or as I like to refer to him, my side kick, has been with me every step of the way. For that I am very grateful! It is also extremely important to like the doctor you are working with. With the doctor I have now, Dr. Lym, hope is always there!"

    Where To Get Help:
    • American Cancer Society (ACS) 1-800-227-2345
    • California Breast Cancer Organizations (CABCO) 1-619-239-9283
    • National Alliance of Breast Cancer (NABCO) 1-800-719-9154
    • National Cancer Instituteís Hotline 1-800-4-CANCER
    • National Coalition for Cancer Survivorship 1-301-650-8868
    • National Womenís Health Network 1-202-347-1140
    • Susan G. Komen Breast Cancer Foundation 1-800-462-9273
    • Womenís Information Network (WIN) 1-619-488-6300
    • Y-ME National Breast Cancer Hotline 1-800-221-2141

    Words To Know / Medical Terms:

    • Benign: A growth that is not cancer
    • Biopsy: Removal of a sample of tissue to see if cancer is present
    • Cancer: A term for more than 100 diseases in which abnormal cells divide without control
    • Chemotherapy: Treatment with drugs to kill or slow the growth of cancer
    • Duct: A small channel in the breast through which milk passes from the lobules to the nipple
    • Hormonal Therapy: Treatment of cancer by removing, blocking or adding hormones
    • Hormones: Chemicals produced by glands in the body
    • Invasive Cancer: Cancer that has spread to nearby tissue, lymph nodes in the armpit, or other parts of the body
    • In situ cancer: Very early of noninvasive growths that are confined to the ducts in the breast
    • Lobe: A part of the breast; each breast contains 6 to 9 lobes
    • Lumpectomy: Surgical removal of breast cancer and a small amount of normal tissue surrounding the cancer
    • Lymph Nodes: Small, bean-shaped structures located along the channels of the lymphatic system. Lymph nodes in the armpit are usually removed to determine the stage of breast cancer.
    • Malignant: Cancer
    • Mammogram: An x-ray of the breast
    • Mastectomy: Removing the breast by surgery
    • Metastasis: The spread of cancer from one part of the body to another
    • Oncologist: A doctor who specializes in treating cancer
    • Pathologist: A doctor who identifies diseases by studying cells and tissues under a microscope
    • Prognosis: The probable outcome or course of a disease; the chance of recovery
    • Radiation Therapy: Treatment with high-energy rays to kill cancer cells
    • Recurrence: Reappearance of cancer at the same site (local recurrence), near the original site (regional recurrence), or in other areas of the body (distant recurrence).
    • Remission: Disappearance of the signs and symptoms of cancer. A remission can be temporary or permanent.
    • Risk Factors: Something that increases a personís chance of developing a disease
    • Staging: Classifying breast cancer according to its size and spread
    • Tumor: An abnormal mass of tissue. Tumors may be either benign (not cancer) or malignant (cancer)


OBSERVATION AND RESULTS
Almost everything that I have in my project is new to me. The reason I didnít know about the subject was because I never knew how serious breast cancer could be until my grandma got it.

The highlights of my learning experience had to be a couple of things on page 4. For example, I had no idea that a woman with breast cancer dies every twelve minutes, or even that men can get breast cancer. Out of all I learned, I think those were the two facts that really got my attention.


CONCLUSION
I have learned so much about Breast Cancer that now I can have a good, smart conversation with my grandma about it. Also, if someone else in my family ever gets breast cancer I could help them because of my knowledge.

Breast Cancer is the most common form of cancer in women, and the second leading cause of cancer death. The fact that one out of nine women in the United States will develop breast cancer in her lifetime is a very serious problem.

Although both its cause and its cure remain undiscovered, millions of dollars are being spent on breast cancer research. Doctors and researchers are trying to learn more about what causes this disease and how to prevent it. They are also looking for better ways to diagnose and treat it. Because of this research, our knowledge about breast cancer keeps increasing. Researchers are always looking for better ways to detect and treat breast cancer, so the chances of recovery keep improving.


ACKNOWLEDGMENTS
I would like to thank my mom because she spent a lot of time helping me find the information to do my project. Also, a special thanks to my grandma because she gave me not only her time, but also the inspiration for me to learn more about the disease of breast cancer. My grandma also helped me understand that having a positive attitude helps when dealing with a bad situation.