Monday, September 20, 2010

On Breast Cancer Worldwide

This October marks the 25th annual celebration of Breast Cancer Awareness Month, during which organizations in the U.S. and worldwide will hold events aimed at raising awareness and providing education about breast cancer. In spite of ongoing efforts to inform the public about breast cancer, it continues to be a major health concern worldwide. According to the National Cancer Institute (NCI), in 2010, there will be 209,060 new cases of breast cancer in the United States. Reports from the World Health Organization (WHO) indicate that incidence rates vary worldwide, however as the adoption of “western lifestyles” increase in the developing world, breast cancer has become more common. Due to the lack of adequate diagnosis and treatment facilities in these regions, survival rates are often also significantly lower. In 2004 an estimated 519,000 women died worldwide due to breast cancer, with 69 percent of these deaths occurring in developing nations. By ensuring that information about breast cancer and early detection programs are available, treatment outcomes worldwide can be greatly improved.



Like other types of cancer, breast cancer develops when abnormal cells divide in an uncontrolled fashion and spread to surrounding tissue (metastasize). Breast cancer is a malignant form of tumor growth which can develop in both men and women, but is approximately 100 times less common in men. An estimated one in every eight women will be diagnosed with breast cancer during their lifetime, making it the second most commonly diagnosed cancer after skin cancer in women in the United States. There are many types of breast cancer, but two of the most common are ductal carcinoma, which begins in the cells that line the milk ducts of the breast; and lobular carcinoma, which begins in the lobes or lobules of the breast. Unlike less common forms of breast cancer, including inflammatory breast cancer which is marked by heat, redness, and swelling of the breast, these common types of breast cancer tend to manifest similarly.

The first signs of breast cancer may include a lump in the breast or thickening of breast tissue, change in shape of the breast, changes in the breast or nipple skin, or bloody discharge from the nipple. Tumors in the breasts may be detected during clinical breast exams, mammograms and other imaging tests, or self breast exams. A mammogram is a black-and-white image of the breast similar to an X-ray. Though some recommendations differ, the American Cancer Society suggests that women undergo yearly mammograms beginning at age 40. Though mammography has proven to be an effective screening method and can help ensure early diagnosis of breast cancer, the Centers for Disease Control and Prevention (CDC) indicates that more than 7 million women in the United States have not had a recent mammogram.

Following the identification of a tumor within the breast, a determination must be made regarding how advanced the spread of the cancer is so that it can be effectively treated. The “Stages” into which breast cancer are categorized – from Stage 0, defined by abnormal cells that are not invasive cancer, to Stage IV, defined by cancer which has spread throughout the tissues of the body. The Stages indicate how aggressively the cancer is spreading within the breast, to the surrounding tissue and lymph nodes, and throughout the rest of the body. Depending on the progression of the cancer, treatment options may include chemotherapy and surgery. Chemotherapy is a drug treatment that uses powerful chemicals to slow the growth of cancer in the body or kill off the cancer cells. Though it is effective, chemotherapy, which can produce a number of side effects, including nausea, vomiting, hair loss, and fatigue, is often used in combination with surgical interventions. Breast-sparing surgeries, which aim to remove cancer from the breast while preserving the surrounding tissue; and mastectomies, in which the entire breast is removed, are often employed.

Though breast cancer treatment can be physically and emotionally painful, there are currently over 2.5 million breast cancer survivors in the U.S. and many more around the world. Breast cancer can occur at any age, but the risk of its development increases as an individual gets older. While the cause is still unknown, there are a number of factors linked to an increased risk of developing breast cancer including the presence of certain “breast cancer genes,” a woman’s age, family history, and age at the onset of menstruation and menopause can increase their risk of developing breast cancer. While little can be done about some of these factors, some women with a genetic predisposition to developing cancer have opted to undergo preventative mastectomies to reduce their risk. Individuals can also help to reduce their risk by maintaining a healthy lifestyle.

By ensuring that individuals are made aware of the importance of regular clinical and self breast evaluations and that early detection and diagnosis programs are made available, treatment outcomes can be greatly improved.

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Wednesday, September 1, 2010

Flooding in Pakistan

Reports indicate that recent flooding in Pakistan has affected the lives of at least 15.4 million people and left a third of the nation – including approximately 7.9 million acres of cultivated land900,000 homes have been destroyed by surges of water, and a reported six million people do not have access to food, shelter, and potable water. In addition, the United Nations indicates that 1,600 have died and more lives are at risk as the threat of water-borne illness continues to rise.



Floods began in late July following a period of particularly heavy monsoon rains and have continued through August. Many have sought shelter in camps established by aid organizations, but public health experts warn that the crowding associated with displaced persons camps could exacerbate the spread of disease. Scabies, a skin infection caused by mites that burrow and cause pimple-like irritation, is becoming increasingly common in the camps. According to some reports, tens of thousands of infected individuals are among the 600,000 people in relief camps set up in Sindh province. In these tented camps which have been established in army compounds, schools, and public buildings, healthcare providers are struggling to contain outbreaks of acute diarrhea, the precursor to fatal cholera.

According to Mark Ward, acting director of the U.S. Agency for International Development’s office for foreign disaster assistance, “When you are dealing with this much water and that many people it [cholera] is almost unavoidable.” In addition, the World Health Organization (WHO) has reported 204,000 cases of acute diarrhea, 263,300 cases of skin diseases, and 204,600 cases of acute respiratory diseases in flood-affected regions. Thousands of cases of suspected malaria have also been documented and the conditions for mosquito-borne as well as water-borne illness are present.

The delivery of treatment for these fast-spreading communicable diseases has been compounded by the lack of adequate clinical facilities. Reports indicate that 200 health facilities were damaged or destroyed. Vaccination programs have been established in Charsadda and Peshawar regions and more than 100,000 children have received polio shots. Despite these efforts, millions, including 3.5 million children are at risk of contracting disease, and require water, shelter, or emergency care. Radio and text messaging campaigns have also been put in place to distribute information about the importance of hand washing and good hygiene.

While funding for humanitarian aid has been limited to date, the UN and other international organizations continue their efforts to garner support. Assuring that food, water, shelter, and medical treatment are available for those who need them is the primary concern of aid organizations currently working in Pakistan. By delivering effective medical treatment in a timely fashion while also working to prevent the spread of diseases, outbreaks can be contained.

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