Cancer is a major health problem in both men and women because it can spread to other tissues through metastasis if the diagnosis is late. Moreover, most cancers have good prognoses when the health care providers detect them early (Kohler et al. 2017). However, an early detection of a cancerous tissue relies on the patients’ understanding of the risk factors and the available preventive services. Particularly, breast cancer has specific risk factors with corresponding preventive services that all women at risk should identify. Therefore, nurses should remain at the forefront in educating patients about their risk factors of cancers and direct the patients to the suitable preventive services. The purpose of this paper is to describe the preventive services for breast cancer, the factors influencing preventive care decisions, and the various drug treatment options.
Preventive Services for Breast Cancer
Providers can recommend services that alleviate the risk of breast cancer such as mammography, prevention medication, and nutritional therapy. According to the U.S Preventive Services Task Force, mammography is one of the radiological studies of the breast tissues using X-rays (Wharam et al. 2015). The X-rays would detect any changes in the density of the breast while more advanced technologies such as magnetic resonance imaging (MRI) are very sensitive to any malignant changes in the breast. The practitioner may also recommend prevention medications to women at a high risk of breast cancer. Medications such as raloxifene and tamoxifene selectively modulate estrogen receptors to reduce the overall risk of estrogen receptor-positive breast cancers (Moyer, 2014). Finally, nutritional therapy is a breast cancer preventive service that can help women to control their body weight and reduce their cancer risk.
Factors Impacting Decisions Related To Preventive Services
First, age has an impact on the application of mammograms for breast cancer screening due to the changes in breast density with age. For example, screening women using mammograms at a younger age below 50 years is unrecommendable because it increases their exposure to radiation and might lead to overdiagnosis (American Academy of Family Physicians, 2018). On the other hand, genetics impacts the core focus of the preventive services by determine the level of risk of breast cancer. A family history of breast cancer and genetic variations such as estrogen receptor mutations constitute a high risk. Patients with such high risks that are linkable to genetic compositions are good candidates for preventive medications. The benefits of the medications will outweigh their adverse effects in this case.
Drug Treatment Options and Their Implications
The drug treatment options for breast cancer include chemotherapy, hormonal treatment, and targeted therapeutic agents. Chemotherapy is a systemic treatment option whereby the drug moves into the bloodstream and throughout the body after its administration. Chemotherapy comprises of cytotoxic agents that target and kill the entire malignant cells (Kareva, Waxman, & Klement, 2015). However, hormonal therapies such as tamoxifene block estrogen receptors in the breast to stop the proliferative stimulus (estrogen) from activating the cells. Targeted therapy such as Herceptin binds HER2receptors to inhibit growth factor signaling (Nuciforo et al. 2015). Despite the selective toxicity of these treatments, their effects on the body can be immense. The short-term implications of chemotherapy include vomiting, nausea, diarrhea, and taste changes. In the long-term basis, chemotherapy can lead to anemia and infections due to its cytotoxic effect to the bone marrow. Similarly, tamoxifene can cause a significant blockage of estrogen receptors that interferes with women’s reproductive health.
In conclusion, breast cancer among women is easier to prevent than to manage. Some of the preventive services available to women at high risk of breast cancer are mammography, medications, and nutritional therapy. Even though these services offer remarkably screening benefits, the patient’s age and genetics influence the practitioner’s choice of the preventive service. Upon confirmation of a diagnosis of breast cancer, chemotherapy, hormonal treatment, and targeted therapy are the drug treatment options available to the health care provider. However, knowledge of the long-term and short-term implications of these treatments is paramount in the management of breast cancer patients.
American Academy of Family Physicians. (2018). Breast cancer. Retrieved from https://www.aafp.org/patient-care/clinical-recommendations/all/breast-cancer.html.
Kareva, I., Waxman, D. J., & Klement, G. L. (2015). Metronomic chemotherapy: an attractive alternative to maximum tolerated dose therapy that can activate anti-tumor immunity and minimize therapeutic resistance. Cancer letters, 358(2), 100-106.
Kohler, R. E., Gopal, S., Miller, A. R., Lee, C. N., Reeve, B. B., Weiner, B. J., & Wheeler, S. B. (2017). A framework for improving early detection of breast cancer in sub-Saharan Africa: A qualitative study of help-seeking behaviors among Malawian women. Patient education and counseling, 100(1), 167-173.
Moyer, V. A. (2014). Medications for risk reduction of primary breast cancer in women: US Preventive Services Task Force recommendation statement. Annals of internal medicine, 159(10), 698-708.
Nuciforo, P. G., Aura, C., Holmes, E., Prudkin, L., Jimenez, J., Martinez, P., & Piccart-Gebhart, M. J. (2015). Benefit to neoadjuvant anti-human epidermal growth factor receptor 2 (HER2)-targeted therapies in HER2-positive primary breast cancer is independent of phosphatase and tensin homolog deleted from chromosome 10 (PTEN) status. Annals of Oncology, 26(7), 1494-1500.
Wharam, J. F., Landon, B., Zhang, F., Xu, X., Soumerai, S., & Ross-Degnan, D. (2015). Mammography rates 3 years after the 2009 US Preventive Services Task Force guidelines changes. Journal of Clinical Oncology, 33(9), 1067-1074.
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