Breast cancer is the second most common cancer diagnosed among women in the United States, with more than 200,000 women diagnosed each year. It is most often diagnosed among women older than 50 years of age, but younger women have been diagnosed just like Kristina. Breast cancers that are diagnosed in women of less than 50 years of age account for 21% of the breast cancers diagnosed each year, but these cases are generally more aggressive and require more aggressive treatment.
As a health scientist at the Centers for Disease Control and Prevention, my work in the Division of Cancer Prevention and Control has made me appreciate that there are individual women and their families behind these statistics. Breast cancer impacts the lives of individuals and families, similar to this week's Parenthood episode involving Kristina's breast cancer treatment. Kristina is not alone in her treatment; her family is also affected emotionally and physically by her diagnosis.
When Kristina was diagnosed with breast cancer, her medical oncologists, or cancer specialists, likely worked with her to determine the best methods for treating her cancer. There are several possible treatment methods for breast cancer: surgery, chemotherapy, hormone therapy, radiation and targeted therapy. Kristina's doctors determined that surgery and chemotherapy would be the best method to treat her cancer. While very valuable as a treatment, chemotherapy has side effects that can take a toll on the patient's body. Kristina has been experiencing nausea, vomiting and fatigue caused by her treatment. Her immune system has also been weakened by the treatment, so Kristina developed a serious case of pneumonia. She was taken to the hospital and had to stay in the intensive care unit because of her illness.
Patients undergoing chemotherapy should be aware of their risk for infection, the ways to prevent infections and the signs and symptoms of infections to watch out for. An infection during cancer treatment, even if it is minor, can lead to hospitalization or even death. Adam, Kristina's husband and primary caregiver, was keenly aware of Kristina's declining condition and got her to the hospital quickly, even though Kristina did not want to go because it was Christmas Eve. There are steps that cancer patients, their caregivers and physicians can take to prevent infections during cancer treatment. Visit the Preventing Cancer Infections website to learn more.
In addition to providing us with insight into the struggles faced by many breast cancer patients during treatment, this episode also underscores the important roles of caregivers such as, family, friends and other loved ones in supporting cancer patients. We see Adam serving as Kristina's primary caregiver by taking care of her and filling in the gaps when she is unable to care for herself or others. Like many caregivers, Adam tries to do this while continuing his normal daily activities. Caring for a cancer patient or person who has been sick for a long time may cause the caregiver to feel stress, anxiety and a host of other emotions like sadness, loneliness, guilt or anger. Caregivers sometimes struggle to ask for the help that they need. During the last few episodes, we have watched Adam ask for help in caring for Kristina and his family. Adam's family took care of the children, covered for Adam at work and filled in a lot of gaps caused by Kristina's hospitalization. However, this level of support may not always be available for cancer patients and their caregivers. In those instances, breast cancer patients may need to rely on additional support services such as:
• Health care coordination and patient support provided by oncology social workers, patient navigators and others connected to hospitals or cancer treatment centers
• Spiritual or emotional support provided by the faith community
• Educational, financial and community support from national cancer organizations whose mission is to provide support for cancer patients and their families.
Although this episode covers Kristina's treatment with chemotherapy, it is important to remember that detecting breast cancer early with regular screening is the key to saving lives. Mammograms make a difference in detecting breast cancer early. If a lack of insurance is keeping you from getting a mammogram, there are special services available for low-income, uninsured and underinsured women. The Affordable Care Act provides preventative benefits and coverage of mammograms without co-pays in many health plans and, beginning in 2014, the law will expand access to health insurance coverage for 30 million previously uninsured Americans. CDC supports breast cancer research and provides free or low-cost mammograms to underserved women in all 50 states and the District of Columbia. To find these services in your area, please visit the CDC breast cancer website.
Temeika L. Fairley, Ph.D. and Cheryll C. Thomas, M.S.P.H.,
Centers for Disease Control and Prevention,
Division of Cancer Prevention and Control