Month: January 2023

What is breast cancer?

Breast cancer originates in your breast tissue. It occurs when breast cells mutate (change) and grow out of control, creating a mass of tissue (tumor). Like other cancers, breast cancer can invade and grow into the tissue surrounding your breast. It can also travel to other parts of your body and form new tumors. When this happens, it’s called metastasis. (1)

Symptoms (2)

Signs and symptoms of breast cancer may include:

• A breast lump or thickening that feels different from the surrounding tissue
• Change in the size, shape, or appearance of a breast
• Changes to the skin over the breast, such as dimpling
• A newly inverted nipple
• Peeling, scaling, crusting, or flaking of the pigmented area of skin surrounding the nipple (areola) or breast skin
• Redness or pitting of the skin over your breast, like the skin of an orange

When to see a doctor

If you find a lump or other change in your breast — even if a recent mammogram was normal — make an appointment with your doctor for prompt evaluation.

Causes(3)

After puberty, a female’s breasts are made up of fat, connective tissue, and thousands of lobules. These are tiny glands that can produce milk. Tiny tubes, or ducts, carry the milk toward the nipple.

Breast cancer develops as a result of genetic mutations or damage to DNA. These can be associated with exposure to estrogen, inherited genetic defects, or genes that can cause cancer, such as the BRCA1 and BRCA2 genes.

When a person is healthy, their immune system attacks any abnormal DNA or growths. When a person has cancer, this does not happen.

As a result, cells within breast tissue begin to multiply uncontrollably, and they do not die as usual. This excessive cell growth forms a tumor that deprives surrounding cells of nutrients and energy.

Breast cancer usually starts in the inner lining of the milk ducts or the lobules that supply them with milk. From there, it can spread to other parts of the body.

Factors that are associated with an increased risk of breast cancer include:(4)

• Being female. Women are much more likely than men to develop breast cancer.
• Increasing age. Your risk of breast cancer increases as you age.
• A personal history of breast conditions. If you've had a breast biopsy that found lobular carcinoma in situ (LCIS) or atypical hyperplasia of the breast, you have an increased risk of breast cancer.
• A personal history of breast cancer. If you've had breast cancer in one breast, you have an increased risk of developing cancer in the other breast.
• A family history of breast cancer. If your mother, sister, or daughter was diagnosed with breast cancer, particularly at a young age, your risk of breast cancer is increased. Still, the majority of people diagnosed with breast cancer have no family history of the disease.
• Inherited genes that increase cancer risk. Certain gene mutations that increase the risk of breast cancer can be passed from parents to children. The most well-known gene mutations are referred to as BRCA1 and BRCA2. These genes can greatly increase your risk of breast cancer and other cancers, but they don't make cancer inevitable.
• Radiation exposure. If you received radiation treatments to your chest as a child or young adult, your risk of breast cancer is increased.
• Obesity. Being obese increases your risk of breast cancer.
• Beginning your period at a younger age. Beginning your period before age 12 increases your risk of breast cancer.
• Beginning menopause at an older age. If you began menopause at an older age, you're more likely to develop breast cancer.
• Having your first child at an older age. Women who give birth to their first child after age 30 may have an increased risk of breast cancer.
• Having never been pregnant. Women who have never been pregnant have a greater risk of breast cancer than women who have had one or more pregnancies.
• Postmenopausal hormone therapy. Women who take hormone therapy medications that combine estrogen and progesterone to treat the signs and symptoms of menopause have an increased risk of breast cancer. The risk of breast cancer decreases when women stop taking these medications.

Drinking alcohol. Drinking alcohol increases the risk of breast cancer.

Breast Cancer Stages(5)

The stages are the number zero and the Roman numerals I, II, III, or IV (often followed by A, B, or C). In general, the higher the number, the more advanced cancer. But there’s more to it than that.

Stage 0.  Cancer has been diagnosed early. It started in the breast ducts or milk glands and has stayed there. You’re likely to hear or see the words in situ, meaning “in the original place.” Get more details about stage 0 breast cancer types and treatment options.

Stage I. starting at this level, breast cancer is called invasive, meaning it has broken free to attack healthy tissue.

Stage 1A means cancer has spread into the fatty breast tissue. The tumor itself is no larger than a shelled peanut, or there may be no tumor.

Stage IB means some cancer cells, but just tiny amounts, have been found in a few lymph nodes.

Stage II. Cancer has grown, spread, or both.

IIA means the tumor in the breast is still small if there's one at all. There may be no cancer in the lymph nodes, or it may have spread to as many as three.

A stage IIB breast tumor is bigger -- it may be the size of a walnut or as big as a lime. It may or may not be in any lymph nodes.

Stage III. Cancer has not spread to bones or organs, but it’s considered advanced, and it’s harder to fight.

IIIA means cancer has been found in up to nine of the lymph nodes that form a chain from your underarm to your collarbone. Or it has spread to or enlarged the lymph nodes deep in your breast. In some cases, there is a large tumor in the breast, but other times there’s no tumor.

IIIB means the tumor has grown into the chest wall or skin around your breast, even if it hasn’t spread to the lymph nodes.

IIIC means cancer has been found in 10 or more lymph nodes or has spread above or below your collarbone. It’s also IIIC if fewer lymph nodes outside the breast are affected but those inside it are enlarged or cancerous.

Stage IV. Breast cancer cells have spread far away from the breast and lymph nodes right around it. The most common sites are the bones, lungs, liver, and brain. This stage is described as “metastatic,” meaning it has spread beyond the region of the body where it was first found.

What can I do to reduce my risk of breast cancer?

Research shows that lifestyle changes can decrease the risk of breast cancer, even in women at high risk. To lower your risk:(6)

• Limit alcohol.
• Maintain a healthy weight.
• Be physically active.
• Breast-feed. Breastfeeding might play a role in breast cancer prevention. The longer you breastfeed, the greater the protective effect.
• Limit postmenopausal hormone therapy. Combination hormone therapy may increase the risk of breast cancer. Talk with your doctor about the risks and benefits of hormone therapy. You might be able to manage your symptoms with nonhormonal therapies and medications. If you decide that the benefits of short-term hormone therapy outweigh the risks, use the lowest dose that works for you and continue to have your doctor monitor the length of time you're taking hormones.
• Take your daily supplements like Vitamin D, Calcium, and probiotics

Makkah Pharmacy recommends:

How Is Breast Cancer Diagnosed?(7)

Doctors often use additional tests to find or diagnose breast cancer. They may refer women to a breast specialist or a surgeon. This does not mean that she has cancer or that she needs surgery. These doctors are experts in diagnosing breast problems.

• Breast ultrasound. A machine that uses sound waves to make pictures, called sonograms, of areas inside the breast.
• Diagnostic mammogram. If you have a problem in your breast, such as lumps, or if an area of the breast looks abnormal on a screening mammogram, doctors may have you get a diagnostic mammogram. This is a more detailed X-ray of the breast.
• Breast magnetic resonance imaging (MRI). A kind of body scan that uses a magnet linked to a computer. The MRI scan will make detailed pictures of areas inside the breast.
• Biopsy. This is a test that removes tissue or fluid from the breast to be looked at under a microscope and do more testing. There are different kinds of biopsies (for example, fine-needle aspiration, core biopsy, or open biopsy).

Breast self-exam (8)

1) In the Shower 

With the pads/flats of your 3 middle fingers, check the entire breast and armpit area pressing down with light, medium, and firm pressure. Check both breasts each month feeling for any lump, thickening, hardened knot, or any other breast changes.

2) In Front of a Mirror 

Visually inspect your breasts with your arms at your sides. Next, raise your arms high overhead.

Look for any changes in the contour, any swelling, or dimpling of the skin, or changes in the nipples. Next, rest your palms on your hips and press firmly to flex your chest muscles. Left and right breasts will not exactly match—few women’s breasts do, so look for any dimpling, puckering, or changes, particularly on one side.

3) Lying Down

When lying down, the breast tissue spreads out evenly along the chest wall. Place a pillow under your right shoulder and your right arm behind your head. Using your left hand, move the pads of your fingers around your right breast gently covering the entire breast area and armpit.

Use light, medium, and firm pressure. Squeeze the nipple; check for discharge and lumps. Repeat these steps for your left breast.

Finding Breast Cancer during Pregnancy(9)

Breast cancer during pregnancy isn't common. But if you find a lump or notice any changes in your breasts that concern you, tell your doctor or nurse right away. There are a variety of tests a pregnant woman can have if breast cancer is suspected. And there are options for treating breast cancer if you are pregnant.

If you are pregnant and breast cancer is found, it may be called gestational breast cancer or pregnancy-associated breast cancer (PABC).

Breast cancers can be harder to find when you’re pregnant

Changes in hormone levels during pregnancy cause the breasts to change. The breasts may become larger, lumpy, and/or tender. This can make it harder for you or your doctor to notice a lump caused by cancer until it gets quite large.

Another reason it may be hard to find breast cancers early during pregnancy is that many women put off breast cancer screening with mammograms until after the pregnancy. Even when women do get mammograms, pregnancy and breastfeeding can make breast tissue denser, which can make it harder to see early cancer on a mammogram.

Because of these challenges, when a pregnant woman develops breast cancer, it’s often diagnosed at a later stage than it usually is in women who are not pregnant. For example, it’s more likely to have already spread to lymph nodes.

Treatment(10)

Your doctor determines your breast cancer treatment options based on your type of breast cancer, its stage and grade, size, and whether the cancer cells are sensitive to hormones. Your doctor also considers your overall health and your own preferences.

Breast cancer surgery

• Removing the breast cancer (lumpectomy). During a lumpectomy, which may be referred to as breast-conserving surgery or wide local excision, the surgeon removes the tumor and a small margin of surrounding healthy tissue.

A lumpectomy may be recommended for removing smaller tumors. Some people with larger tumors may undergo chemotherapy before surgery to shrink a tumor and make it possible to remove it completely with a lumpectomy procedure.

• Removing the entire breast (mastectomy). A mastectomy is an operation to remove all of your breast tissue. Most mastectomy procedures remove all of the breast tissue — the lobules, ducts, fatty tissue, and some skin, including the nipple and areola (total or simple mastectomy).

Newer surgical techniques may be an option in selected cases to improve the appearance of the breast. Skin-sparing mastectomy and nipple-sparing mastectomy are increasingly common operations for breast cancer.

• Removing a limited number of lymph nodes (sentinel node biopsy). To determine whether cancer has spread to your lymph nodes, your surgeon will discuss with you the role of removing the lymph nodes that are the first to receive the lymph drainage from your tumor.

If no cancer is found in those lymph nodes, the chance of finding cancer in any of the remaining lymph nodes is small and no other nodes need to be removed.

• • Removing several lymph nodes (axillary lymph node dissection). If cancer is found in the sentinel lymph nodes, your surgeon will discuss with you the role of removing additional lymph nodes in your armpit.
  • Removing both breasts. Some women with cancer in one breast may choose to have their other (healthy) breast removed (contralateral prophylactic mastectomy) if they have a very increased risk of cancer in the other breast because of a genetic predisposition or strong family history.

• Radiation therapy
• Chemotherapy
• Hormone therapy
• Immunotherapy

Most women with breast cancer in one breast will never develop cancer in the other breast. Discuss your breast cancer risk with your doctor, along with the benefits and risks of this procedure.

References

1. DeSantis CE, Ma J, Goding Sauer A, Newman LA, Jemal A. Breast cancer statistics, 2017, racial disparity in mortality by state. CA Cancer J Clin [Internet]. 2017 Nov [cited 2022 Sep 21];67(6):439–48. Available from: https://my.clevelandclinic.org/health/diseases/3986-breast-cancer
2. Breast cancer - Symptoms and causes - Mayo Clinic [Internet]. [cited 2022 Sep 21]. Available from: https://www.mayoclinic.org/diseases-conditions/breast-cancer/symptoms-causes/syc-20352470
3. Breast cancer: Symptoms, causes, stages, types, and more [Internet]. [cited 2022 Sep 21]. Available from: https://www.medicalnewstoday.com/articles/37136#causes
4. Breast cancer - Symptoms and causes - Mayo Clinic [Internet]. [cited 2022 Sep 21]. Available from: https://www.mayoclinic.org/diseases-conditions/breast-cancer/symptoms-causes/syc-20352470
5. What Are the Stages of Breast Cancer? [Internet]. [cited 2022 Sep 21]. Available from: https://www.webmd.com/breast-cancer/stages-grades-breast-cancer
6. Breast cancer prevention: How to reduce your risk - Mayo Clinic [Internet]. [cited 2022 Sep 21]. Available from: https://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/breast-cancer-prevention/art-20044676
7. How Is Breast Cancer Diagnosed? | CDC [Internet]. [cited 2022 Sep 21]. Available from: https://www.cdc.gov/cancer/breast/basic_info/diagnosis.htm
8. Breast Self-Exam - National Breast Cancer Foundation [Internet]. [cited 2022 Sep 21]. Available from: https://www.nationalbreastcancer.org/breast-self-exam
9. Finding Breast Cancer During Pregnancy [Internet]. [cited 2022 Sep 21]. Available from: https://www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/finding-breast-cancer-during-pregnancy.html
10. Breast cancer - Diagnosis and treatment - Mayo Clinic [Internet]. [cited 2022 Sep 21]. Available from: https://www.mayoclinic.org/diseases-conditions/breast-cancer/diagnosis-treatment/drc-20352475

Prostate cancer is a common type of cancer in males, but it is highly treatable in the early stages. It begins in the prostate gland, which sits between the penis and the bladder.

The prostate is a small walnut-shaped gland in males that produces the seminal fluid that nourishes and transports sperm.

Many prostate cancers grow slowly and are confined to the prostate gland, where they may not cause serious harm. However, while some types of prostate cancer grow slowly and may need minimal or even no treatment, other types are aggressive and can spread quickly. (1)

Prostate cancer that's detected early — when it's still confined to the prostate gland — has the best chance of successful treatment.

Signs and symptoms

There are often no symptoms during the early stages of prostate cancer, but screening can detect changes that may indicate cancer. Screening involves a test that measures levels of PSA in the blood. High levels suggest that cancer may be present.

Males who do experience symptoms may notice:(2)

• Difficulty starting urination.
• Weak or interrupted flow of urine.
• Urinating often, especially at night.
• Trouble emptying the bladder.
• Pain or burning during urination.
• Blood in the urine or semen.
• Pain in the back, hips, or pelvis that doesn’t go away.
• Painful ejaculation.

What Is Screening for Prostate Cancer? (3)

Cancer screening means looking for cancer before it causes symptoms. The goal of screening for prostate cancer is to find cancers that may be at high risk for spreading if not treated, and to find them early before they spread.

If you are thinking about being screened, learn about the possible benefits and harms of screening, diagnosis, and treatment, and talk to your doctor about your risk factors.

There is no standard test to screen for prostate cancer. Two tests that are commonly used to screen for prostate cancer are described below.

Prostate Specific Antigen (PSA) Test(3)

A blood test called a prostate-specific antigen (PSA) test measures the level of PSA in the blood. PSA is a substance made by the prostate. The levels of PSA in the blood can be higher in men who have prostate cancer. The PSA level may also be elevated in other prostate conditions.

As a rule, the higher the PSA level in the blood, the more likely a prostate problem is present. But many factors, such as age and race, can affect PSA levels. Some prostate glands make more PSA than others.

PSA levels also can be affected by:

• Certain medical procedures.
• Certain medications.
• An enlarged prostate.
• A prostate infection.

Because many factors can affect PSA levels, your doctor is the best person to interpret your PSA test results. If the PSA test is abnormal, your doctor may recommend a biopsy to find out if you have prostate cancer.

Prostate Specific Antigen (PSA) Test(3)

Digital rectal examination (DRE) is when a health care provider inserts a gloved, lubricated finger into a man’s rectum to feel the prostate for anything abnormal, such as cancer. The U.S. Preventive Services Task Force does not recommend DRE as a screening test because of a lack of evidence on the benefits.

Causes

Researchers are unsure of the exact cause of prostate cancer. It develops when specific changes occur, usually in glandular cells. When prostate gland cells appear abnormal, a doctor may refer to these changes as prostatic intraepithelial neoplasia (PIN). Nearly 50% of all males over the age of 50 years have a PIN.(4)

At first, the changes will be slow, and the cells will not be cancerous. However, they can become cancerous with time. Cancer cells can be high or low grade. High-grade cells are more likely to grow and spread, while low-grade cells are not likely to grow and are not a cause for concern. (4)

Risk factors (1)

• Age: The risk of prostate cancer increases after the age of 50, but it is rare before 45.
• Race or ethnicity: The condition is more common in Black people than white people. Asian and Hispanic people have a lower risk than Black or white people.
• Family history: A person with a close relative who has a history of prostate cancer has a higher chance of developing it themselves.
• Genetic factors: Inherited features, including changes to the BRCA1 and BRCA2 genes, may increase the risk. Mutations in these genes also increase the chance of breast cancer. Men born with Lynch syndrome also have a higher risk of prostate and other cancers.
• Diet: Some evidence suggests that high-fat diets may increase the risk of prostate cancer.

Other factors that may influence prostate cancer risk include:(5)

• obesity
• smoking
• alcohol consumption
• exposure to chemicals, such as the herbicide Agent Orange
• inflammation of the prostate
• sexually transmitted infections
• vasectomy surgery

Stages

Staging typically describes how much cancer is present in the body and how serious the cancer is. Knowing the stage of prostate cancer can help a person understand what to expect and will inform decisions about treatment.

Cancer staging is complex and accounts for many different factors. Usually, the lower the number, the less cancer has spread. Stages may include:(5)

• Stage I: Cancer is only present in the prostate gland.
• Stage II: Cancer has not yet spread from the prostate, but a person will have a higher PSA level.
• Stage III: Cancer may have spread to nearby tissues.
• Stage IV: Cancer may have spread to distant parts of the body.

How Is Prostate Cancer Treated? (6)

Different types of treatment are available for prostate cancer. You and your doctor will decide which treatment is right for you. Some common treatments are:

• Expectant management. If your doctor thinks your prostate cancer is unlikely to grow quickly, he or she may recommend that you don’t treat cancer right away. Instead, you can choose to wait and see if you get symptoms in one of two ways:
  • Active surveillance. Closely monitoring prostate cancer by performing prostate specific antigen (PSA) tests and prostate biopsies regularly, and treating cancer only if it grows or causes symptoms.
  • Watchful waiting. No tests are done. Your doctor treats any symptoms when they develop. This is usually recommended for men who are expected to live for 10 more years or less.
• Surgery. A prostatectomy is an operation where doctors remove the prostate. Radical prostatectomy removes the prostate as well as the surrounding tissue.
• Radiation therapy. Using high-energy rays (similar to X-rays) to kill cancer. There are two types of radiation therapy—
  • External radiation therapy. A machine outside the body directs radiation at the cancer cells.
  • Internal radiation therapy (brachytherapy). Radioactive seeds or pellets are surgically placed into or near cancer to destroy the cancer cells.

Other therapies used in the treatment of prostate cancer that is still under investigation include—

• Cryotherapy. Placing a special probe inside or near the prostate cancer to freeze and kill the cancer cells.
• Chemotherapy. Using special drugs to shrink or kill cancer. The drugs can be pills you take or medicines given through your veins, or, sometimes, both.
• Biological therapy. Works with your body’s immune system to help it fight cancer or to control side effects from other cancer treatments. Side effects are how your body reacts to drugs or other treatments.
• High-intensity focused ultrasound. This therapy directs high-energy sound waves (ultrasound) at cancer to kill cancer cells.
• Hormone therapy. Blocks cancer cells from getting the hormones they need to grow.

Can Prostate Cancer Be Prevented? (7)

There is no sure way to prevent prostate cancer. Many risk factors such as age, race, and family history can’t be controlled. But there are some things you can do that might lower your risk of prostate cancer.

• Get to and stay at a healthy weight.
• Keep physically active.
• Follow a healthy eating pattern, which includes a variety of colorful fruits and vegetables and whole grains, and avoid or limit red and processed meats, sugar-sweetened beverages, and highly processed foods.

Vitamin E and selenium: Some early studies suggested that taking vitamin E or selenium supplements might lower prostate cancer risk.

Makkah Pharmacy recommends:

Soy and isoflavones: Some early research has suggested possible benefits from soy proteins (called isoflavones) in lowering prostate cancer risk.

Taking any supplements can have both risks and benefits. Before starting vitamins or other supplements, talk with your doctor.

References:

1. Rock CL, Thomson C, Gansler T, Gapstur SM, McCullough ML, Patel A v., et al. American Cancer Society guideline for diet and physical activity for cancer prevention. CA Cancer J Clin. 2020 Jul;70(4):245–71. 
2. What Are the Symptoms of Prostate Cancer? | CDC [Internet]. [cited 2022 Sep 4]. Available from: https://www.cdc.gov/cancer/prostate/basic_info/symptoms.htm
3. What Is Screening for Prostate Cancer? | CDC [Internet]. [cited 2022 Sep 4]. Available from: https://www.cdc.gov/cancer/prostate/basic_info/screening.htm
4. Prostate cancer: Symptoms, treatment, and causes [Internet]. [cited 2022 Sep 4]. Available from: https://www.medicalnewstoday.com/articles/150086#causes
5. Prostate cancer: Symptoms, treatment, and causes [Internet]. [cited 2022 Sep 4]. Available from: https://www.medicalnewstoday.com/articles/150086#risk-factors
6. How Is Prostate Cancer Treated? | CDC [Internet]. [cited 2022 Sep 4]. Available from: https://www.cdc.gov/cancer/prostate/basic_info/treatment.htm
7. Rock CL, Thomson C, Gansler T, Gapstur SM, McCullough ML, Patel A v., et al. American Cancer Society guideline for diet and physical activity for cancer prevention. CA Cancer J Clin [Internet]. 2020 Jul [cited 2022 Sep 4];70(4):245–71. Available from: https://www.cancer.org/cancer/prostate-cancer/causes-risks-prevention/prevention.html