Sathishkumaar,+Pradyumna

Cancer is one of the most enigmatic of all the ailments in the medical world. It occurs in a variety of forms and functions almost like a living system. Cancer’s main objective is to multiply and grow; yet we suffer as a result of its actions. Victims who unfortunately fall prey to cancer can come from a variety of different age and ethnic groups, though most victims are those who are in failing health or partake in certain activities such as binge drinking, smoking, drugs, etc. that could compromise one’s health. However, in some instances, individuals regardless of age, who lead normal or healthy lifestyles, could also get cancer, such as the case with a close family friend. Mrs. Krishnan is a seventy-year-old south Indian woman, who currently lives in the tranquil city of Peoria, Illinois. Despite her age, she is a very active individual, who doesn’t possess even a single trace of any bad habits in her system. She enjoys waking up extremely early in the morning around 4:30am after which she then takes a brisk stroll around her neighborhood. During her free time she enjoys listening to classical music and tending to her favorite flowers and orchards in her garden in the backyard. As for her profession, she is an extremely knowledgeable medical doctor, specifically a radiation oncologist. Taking into consideration her overall lifestyle, it shocked us all when we heard the news that she was diagnosed with breast cancer. When asked how it all started, she stated that she was walking in her garden one day and stepped onto a gardening rake, which then slammed into her chest area. At the time she condemned the gardening tool, but she later stated that it was a blessing in disguise, as the throbbing pain in her chest resulted in her paying a visit to the doctor’s office, which lead to a shocking discovery. During the examination the doctor first asked her numerous questions regarding her condition, in order to pinpoint a probable conclusion. “Have you been noticing any abnormalities in your chest area prior to this incident such as lumps, redness, discharge?” Mrs. Krishnan replied stating that she initially hadn’t noticed much other than some mild sensitivity around her breast, but it had increased slightly over the course of a few days, she also stated that as the pain increased she noticed small lumps. She also mentioned that she was planning on getting it checked. The doctor thought for a bit and replied stating they may need to further investigate her chest via ultrasound. After that procedure the doctor concluded that there was evidence of cancerous cells within the site of injury, which would explain the abnormally painful throbbing sensation that she felt after being struck by the rake, along with the initial sensitivity. The doctor’s final diagnosis was a specific type of breast cancer known as ductal carcinoma. She stated that as a result of the cancerous growth in the breast area, sensitivity of the breast is a common initial symptom. The doctor also stated that since in this case, since no other major symptoms such as discharge or massive lumps have been noticed, the cancer is in its initial stages and can be treated via chemotherapy, and a surgery known as mastectomy. As per a probable reason as to why Mrs. Krishnan got the cancer, it could be due to the nature of her profession. As a radiation oncologist, she is more exposed to radiation than other individuals, thus increasing the risk of her getting cancer, in this case breast cancer. Breast cancer in general is defined as a type of cancer that affects the tissue and cells that are located in the breast area. There are two main types of breast cancer, ductal carcinoma, and lobular carcinoma. “Ductal carcinoma is the most common form of breast cancer in which the cancer originates in the thin inner walls of the milk ducts in the breast. The other variant of breast cancer, lobular carcinoma affects the milk producing glands of the breast, known as lobules.” (Cancer.Gov) Breast cancer also has the potential to be invasive, meaning cancerous cells could enter the lymphatic system near the breast tissue, and spread to other parts of the body and metastasize. Breast cancer when addressed in its earlier stages, is not very aggressive and can be treated; however, invasive breast cancer is significantly more aggressive, and treatment options such as chemotherapy, radiation therapy, and surgery are not as helpful, since at this point the cancer has metastasized in different areas of the body, and can only provide temporary relief, and help one live longer by a few years. The general prognosis for breast cancer is that if recognized early, patients have a very high likelihood that they will survive; however, said likelihood decreases significantly if the condition is recognized late. According to the “American Cancer Society’s five-year survival rate (which is essentially the percentage of patients who live about five years after the diagnosis), patients with Stage I, II, III, and IV breast cancer, have 100%, 93%, 72%, and 22% five-year survival rates, respectively” (American Cancer Society). Ultimately, Mrs. Krishnan took the news in her stride, using her knowledge as a medical professional, chemotherapy, mastectomy surgery, and maintaining her healthy lifestyle, she ultimately managed to overcome cancer and survive. She continues to work as a radiation oncologist at her private practice in Peoria Illinois to this day.
 * __ Mrs. Krishnan’s Ductal Carcinoma: __**
 * __ Part.1 (Intro) __**

It was about several years ago when our beloved family friend Mrs. Krishnan was diagnosed with cancer, specifically a type of breast cancer known as ductal carcinoma. After the initial diagnosis, the doctor discussed in great detail various treatment options that would be available for Mrs. Krishnan to partake in. Mrs. Krishnan was willing to cooperate to the full extant, and was willing to partake in all the various necessary treatment options in order to recover from her breast cancer. Luckily for Mrs. Krishnan, her ductal carcinoma breast cancer was diagnosed very early; specifically her cancer had been only between stages I and Stage II, which is in the initial stages of cancer. Due to this fact, treatment options were plentiful, and the overall chances of recovery were a lot higher than it normally would have been, if her cancer were to have been diagnosed at a much later stage. The usual treatment options that are available to cancer patients include but are not limited to; radiation therapy, chemotherapy, hormone therapy, targeted therapy, surgery, as well as post surgical lymph node biopsy. Those diagnosed with breast cancer have the option of choosing standard treatment (any of the treatment options listed above), or choosing to be part of a clinical trial. Clinical trials are experimental studies that are carried out in order to augment current treatment options, or to ascertain data on possible new cancer treatments. According to the National Cancer Institute, “When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment”( //National Cancer Institute// ). Mrs. Krishnan underwent different treatment options in order to be successfully alleviated of her cancer, through the form of chemotherapy, radiation therapy, and breast-conserving surgery. One of the forms of treatment that Mrs. Krishnan underwent was chemotherapy, a type of treatment that utilizes various drugs specific to the cancer type that inhibit the growth of cancer cells by either eliminating them or by compromising their ability to replicate. The type of chemotherapy and the manner in which the drugs can be administered varies depending on the type of cancer. In Mrs. Krishnan’s case, since her cancer didn’t metastasize, she was treated with regional chemotherapy, during which the drugs are administered directly into the main site of the cancer, in this case the breast area, where the drugs target those specific cancer cells. Another form of chemotherapy that is available to patients diagnosed with more advanced stages of cancer are treated with drugs that are “taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body, this is known as systemic chemotherapy” (NCI). Some of the drugs that were used in order treat Mrs. Krishnan are those that “are used for early breast cancer, such as anthracyclines, such as doxorubicin/Adriamycinand epirubicin/Ellence ®, and the taxanes such as paclitaxel/Taxol ® and docetaxel/Taxotere ® , these may be used in combination with certain other drugs, like fluorouracil 5-FU, cyclophosphamide Cytoxan ® , and carboplatin” ( //American Cancer Society// ). Mrs. Krishnan was offered chemotherapy both before and after her surgery. Chemotherapy provided prior to surgery is called neoadjuvent chemotherapy, which helps reduce the size or even eliminate cancer cells in order to reduce the extensiveness of the surgery, especially when dealing with large or extensive cancerous tumors. Chemotherapy offered after surgery is called adjuvant chemotherapy, which serves to eliminate any cancer cells that remain even after the surgical procedure, this helps reduce the chances of the malignant tumor reforming. Mrs. Krishnan was also offered radiation therapy in order to help combat her breast cancer after the surgical procedure in order to prevent cancer from resurfacing. Radiation therapy is a form of cancer treatment that involves the use of radiation via x-rays in order to kill or inhibit the growth of cancer cells. Radiation therapy can be provided in two possible ways, either externally via “a machine outside the body to send radiation toward the cancer” ( //National Cancer Institute// ), or internally by using “a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer” ( //National Cancer Institute// ). The method of administration depends on the cancer type and stage; in Mrs. Krishnan’s case she was treated with internal radiation therapy to better target the cancer cells in her breast tissue. One of the most intensive treatments that Mrs. Krishnan received was surgery; specifically she went through a type of surgery called breast-conserving surgery, during which only the cancerous tumor and part of the breast tissue are removed. Breast cancer patients can either undergo breast-conserving surgery, total mastectomy, or modified radical mastectomy. Those who have stage I or II breast cancer usually choose to undergo breast-conserving surgery because of the smaller size of the tumors, and to reduce the amount of scarred tissue post surgery. Breast conserving surgery is composed of two parts, a lumpectomy, during which the small tumor and small amount of surrounding tissue are removed, and a partial mastectomy, “to remove the part of the breast that has cancer and some normal tissue around it, the lining over the chest muscles below the cancer may also be removed, this procedure is also called a segmental mastectomy” ( //National Cancer Institute// ). The other surgical procedures are carried out for patients with more advanced stages of cancer, such as the case with total mastectomy and modified radical mastectomy. The purpose of a total mastectomy is “to remove the whole breast that has cancer, this procedure is also called a simple mastectomy, some of the lymph nodes under the arm may be removed for biopsy at the same time as the breast surgery or after, this is done through a separate incision”( //National Cancer Institute// ). The other type of surgery, called modified radical mastectomy is done “to remove the whole breast that has cancer, many of the lymph nodes under the arm, the lining over the chest muscles, and sometimes, part of the chest wall muscles”( //National Cancer Institute// ). These later procedures are better suited for the more advanced stages of breast cancer because in such cases, the cancerous tumors are larger and have the potential to spread. After receiving the surgery, as mentioned earlier, Mrs. Krishnan received both adjuvant chemotherapy and post surgical internal radiation therapy; however, since she didn’t receive a total mastectomy, she did not undergo breast reconstruction surgery. She was also given the option to take part in a clinical trial; however, due to possible risk factors involved in clinical trials since these trials are usually carried out in an experimental fashion in order to determine if certain cancer treatments work or not, Mrs. Krishnan chose not to be part of one. With all the treatment she had received from the dedicated doctors, along with a love and support from her family and friends, Mrs. Krishnan was able to fully recover from her condition and carry on with her life.
 * __Part.2 (Treatment)__**






 * __Refrences (Part2):__**
 * "Breast Cancer Treatment." //National Cancer Institute//. N.p., n.d. Web. 29 Apr. 2015. .
 * "How Is Breast Cancer Treated?" //American Cancer Society//. N.p., 25 Sept. 2014. Web. 29 Apr. 2015. .


 * __ References (Part1): __**
 * "Breast Cancer." //National Cancer Institute//. N.p., n.d. Web. 16 Apr. 2015. .
 * "Breast Cancer Survival Rates by Stage." //Breast Cancer Survival Rates by Stage//. American Cancer Society, 25 Sept. 2014. Web. 16 Apr. 2015. .
 * "Ductal Carcinoma Images and Graphics." //Ductal Carcinoma Images, Graphics, Comments and Pictures//. N.p., n.d. Web. 16 Apr. 2015. .
 * "Symptoms and Signs :: The National Breast Cancer Foundation." //Www.nationalbreastcancer.org//. N.p., n.d. Web. 16 Apr. 2015. .
 * "What Is Invasive Ductal Carcinoma?" //Cabarrus County Red Cress//. N.p., 15 Jan. 2015. Web. 16 Apr. 2015. . (Image A)