Metastatic Breast Cancer Research Paper

Below is a research paper I wrote for the English Composition I class I am taking this summer.  I thought you might be interested in reading it.  Don't worry -- it's only 5 1/2 pages!  :)

These are the comments my professor gave me --  the only downside is that I used APA instead of MLA.  He's not counting off for that, though.  

This is an excellent Research Paper, Tammy. I am pleased with how this turned out.

The good news is I am not going to recommend revision because you successfully met the main outcomes of this assignment. Your essay is purposeful and focused. It demonstrates a reason for your research.

Metastatic Breast Cancer

 

Cancer is cancer is cancer, right?   This is the prevailing thought about cancer; but it is not necessarily so.  There are many nuances to cancer.  There are types, subtypes, stages, and receptors.  There are many different treatment options based on these types, subtypes, stages, and receptors.  Strides have been made over the years, so that metastatic cancer is not necessarily the imminent death sentence it used to be.  Society’s perception of metastatic cancer is that once diagnosed, it is time to get one’s affairs in order.  Some feel that once cancer has reached Stage IV, life is over.  Contrary to that belief, though, people (people, not women; men get breast cancer, too) are living long, fruitful lives with metastatic breast cancer.  One thing is for sure: you can stay “alive at Stage IV” – this is not your grandmother’s breast cancer.

What is metastatic breast cancer?  Metastatic cancer is cancer that has spread from its origin point to other points in the body (Wyant, 2020).  The cancer cells travel through the lymph system to form tumors in other parts of the body, such as the lungs, liver, kidney, bones, or brain.  Although these tumors manifest themselves in other parts of the body, they are still considered the type of cancer primarily diagnosed; for instance, breast cancer that metastasizes in the lungs is still breast cancer.  Metastatic breast cancer is also known as Stage IV breast cancer, and is considered terminal.  There are also Stages I, II, and II breast cancer.  The lower the number, the less the cancer has spread (Wojciechowski, 2021).   There are distinct differences in the stages of breast cancer, and the treatment at each stage. 

            Stage I breast cancer is breast cancer where the tumor is smaller than two centimeters and cancer has not spread outside of the breast.  There is no lymph node involvement.  Stage II breast cancer is breast cancer that is larger than two centimeters but not larger than five centimeters.  There is no lymph node involvement.  Stage III breast cancer has the cancer moving out into the lymph nodes under the arm.  Stage IV breast cancer has the cancer moving out through those lymph nodes to other areas of the body, and it has now become deadly.  Stage IV breast cancer at original diagnosis is called “de novo”, meaning that it occurred at the start, or at diagnosis.  In the United States, approximately one in eight people will are diagnosed with breast cancer per day.  Of those one in eight, approximately three will go on to metastasize.

            Treatment for breast cancer will depend on the stage and on the receptors.  The receptors for breast cancer are as follows: “ER-positive: Breast cancers that have estrogen receptors are called ER-positive (or ER+) cancers.  PR-positive: Breast cancers with progesterone receptors are called PR-positive (or PR+) cancers.  Hormone receptor-positive: If the cancer cell has one or both of the receptors above, the term hormone-receptive positive (also called hormone-positive or HR+) breast cancer may be used.  Hormone receptor-negative: If the cancer cell has neither the estrogen nor the progesterone receptor, it's called hormone-receptor negative (also called hormone-negative or HR-)” (Wyant, 2019).  For example, a person whose receptors are all positive will most likely be on a regime of Taxotere, Herceptin, and Perjeta.  Taxotere is a chemotherapy medication, and Herceptin and Perjeta are considered monoclonal antibodies.

Protocol for Taxotere is that it be given for six cycles, then a CT scan will be performed to gauge how it is working.  If the tumor has not shrunk significantly and the patient is tolerating the treatment well, the patient will continue with Taxotere for a few more treatments, then another CT scan will be performed to again gauge how it is working.  Once the tumor has shrunk significantly, Taxotere will be stopped so that surgery can be performed to remove the remainder of the tumor.  If the tumor has plateaued Taxotere may be stopped so that surgery can be performed.  The reason that Taxotere is used before surgery is performed with metastatic breast cancer (as opposed to after surgery with Stages I, II, and III breast cancer) is specifically to shrink the tumor for surgery, as to cause the least amount of trauma to the body.  After Taxotere has served to shrink the tumor(s), a combination Herceptin, Perjeta, and Tamoxifen is one of the options for the course of treatment for the ER+ PR+ Her2+ pre-menopausal metastatic breast cancer patient.  Herceptin and Perjeta are given to Stage I, II, and III breast cancer patients for one year, and Tamoxifen for five years.  Stage IV (metastatic) breast cancer patients will be on these medications for life, or until they stop working.  Once these medications stop working, another line of therapy will be tried.  When that stops working, another, and so on, until there are no more options left.  There are metastatic breast cancer patients who have been on more than twenty lines of treatment.  When there are no more options left in regard to treatment, that is when it is time for the patient to enter Hospice care.  Hospice care can be done at a Hospice center, or at the patient’s home.  Nurses and other trained professionals will care for the patient and make him/her as comfortable as possible for the last days, weeks, months.  These incredible people will also care for and counsel the patient’s family as much as they can to ease the pain and suffering, and help them through the grief they already feel as their loved one lays dying.  Yes, the family will feel grief before the patient actually dies.  As the patient most likely drifts off into a coma, the grief is there as if the patient is already gone.

Although the thought of having metastatic breast cancer sounds horrible and dire, strides have been made, so that metastatic cancer is not necessarily an imminent death sentence anymore.  There are organizations focusing on eradicating this disease, and are making an impact.  Metavivor is an organization that facilities research.  Metavivor concentrates their efforts solely on metastatic breast cancer.  All monies donated to Metavivor are funneled into research.  Metavivor, every year, reviews research grant proposals, and allocates the monies donated to these research grants.  In 2019, for instance, Metavivor granted 32 awards totaling $5,000,000 (Board Members, 2019).  Grant recipients are listed on Metavivor’s website (www.metavivor.org/research/grants-awarded/). 

Genentech is one of many pharmaceutical companies concentrating on research to eradicate cancer.  I am a metastatic breast cancer patient myself, and visited Genentech a few years ago (Payne, 2016).  As I spoke to the employees there, I learned that one particular woman had been working at Genentech for the previous 17 years, and was there when Perjeta went to the Food and Drug Administration (FDA) for approval.   She was overjoyed to meet a patient who was doing well on the medication that she had a hand in manufacturing.  I, in turn, was overjoyed to meet the people who were manufacturing the medication that is keeping my cancer cells from growing, effectively extending my life.

Herceptin is a medication that works in conjunction with Perjeta, and is also manufactured by Genentech.  Herceptin and Perjeta work together to target cancer cells, keeping them from growing.  I know firsthand that Genentech employees work very hard on research to improve cancer medications.  The employees, from the top board members to the cleaning staff, are patient oriented.  For instance, instead of hosting a company picnic for their employees, every two years they invite twelve patients to their campus to speak to their employees.  The employees sign up to see their patient of choice speak.  In addition to speaking to the employees, the patients have photos taken.  The photos end up being larger than life and placed on buildings around the Genentech campus (Genentech, 2016).  Some of the photos are also placed inside the buildings, in such places as employee break rooms.

Because employees like those I met at Genentech are so focused on research, and such strides continue to be made, people (people, not women; men get breast cancer, too) (2018) are living long, fruitful lives with metastatic breast cancer.  The side effects of the medication nausea, neuropathy, exhaustion, among others, can be a hindrance, patients learn to live with these side effects and adjust their lives around them.  For instance, taking afternoon naps or early bedtimes can help with exhaustion.  Nausea can be curbed with an anti-nausea medication such as Zofran.  Neuropathy can be managed with medications and supplements.  Sometimes a cane, a walker, or even a wheelchair might be necessary.  These side effects may be annoying, and some can be incredibly difficult to handle sometimes, but they are, for the most part, manageable.  With a metastatic breast cancer diagnosis, a patient’s life will change drastically.  It will change, but it will not end as soon as it might have if diagnosis had happened even twenty years ago. 

Each year, 200,000 Americans are diagnosed with breast cancer. Six to ten percent of these diagnoses are metastatic, or stage 4. Another 30% progress from stages 0, 1, 2 and 3 to develop stage 4 – maybe immediately or maybe 30 years down the line. The median life span of a metastatic breast cancer patient is approximately three years.  Approximately 116 people in the United States die every day as the result of metastatic breast cancer.  With medications such as Herceptin and Perjeta, metastatic breast cancer patients are living much longer lives.  There are some, who we call outliers, who have lived more than twenty years so far with metastatic breast cancer.

Cancer is a devastating disease.  With so many researchers working on eradicating it, why has a cure not yet been found?  Because cancer is not just one disease.  Cancer has may types.  Within each type of cancer are subtypes and differences.  Metastatic breast cancer is the term for Stage IV breast cancer.  Metastatic breast cancer is breast cancer that has metastasized, or spread, to other parts of the body (lungs, liver, kidney, bones, brain).  Having metastatic breast cancer is not necessarily the imminent death sentence that it was years ago.  With the treatment options available, metastatic breast cancer patients are living long, vibrant lives.  There are, of course, life adjustments to be made.  There is no end to treatment; that is, until the last treatment option has failed.  The life of a metastatic breast cancer patient revolves around treatment (usually every three weeks), scans (usually every three months), a myriad of appointments with an oncologist, a surgeon, and other specialists depending on the needs, and sometimes debilitating side effects.   A metastatic breast cancer patient adjusts his/her life to accommodate these medical necessities, and a metastatic breast cancer patient LIVES! 

https://www.multivu.com/players/English/7656751-metastatic-breast-cancer-alliance/

References:

Newswire, M. V.- P. R. (n.d.). Metastatic Breast Cancer Alliance Launches New Public Awareness Campaign Focusing on Lack of Understanding of Metastatic Breast Cancer. Multivu. https://www.multivu.com/players/English/7656751-metastatic-breast-cancer-alliance/.

Research. METAvivor. (n.d.). https://www.metavivor.org/research/.

Wojciechowski, B. (2021, May 11). Stages of Breast Cancer: Understand Breast Cancer Staging. American Cancer Society. https://www.cancer.org/cancer/breast-cancer/understanding-a-breast-cancer-diagnosis/stages-of-breast-cancer.html.

Wyant, T. (2019, September 20). Breast Cancer Hormone Receptor Status: Estrogen Receptor. American Cancer Society. https://www.cancer.org/cancer/breast-cancer/understanding-a-breast-cancer-diagnosis/breast-cancer-hormone-receptor-status.html.

Wyant, T. (2020, September 20). Understanding Advanced and Metastatic Cancer. American Cancer Society. https://www.cancer.org/treatment/understanding-your-diagnosis/advanced-cancer/what-is.html.