Pink: A flower for cancer

October is around the world the month dedicated to breast cancer awareness, this includes the perpetual remembrance of those women and men who have lost the battle and the unison shout for a cure that would prevent to our friends, mothers, daughters, granddaughters, nieces or any person to suffer by this or any other form of cancer.

All human beings have the likelihood of being diagnosed with any form of cancer at any age, although 77% of cases occur in people over the age of 54, this you can present from childhood, even a fetus may develop malignant cells. Statistics indicate that one of every two men and one in three women will get cancer at some point in their life, but it is estimated that 14% of the time the cancer is preventable.

World Health Organization estimated that by the year 2030 worldwide will be per year could be 27 million of new cases with a mortality rate of 17 million. The number of cases is currently 12 million cases reported and 7.6 million will die, some organizations estimate that cancer causes one of every eight deaths worldwide, with a greater rate of mortality than AIDS, tuberculosis and malaria combined.

Cancer is caused by abnormalities in the genetic material of cells and it is defined as a cell that has lost its normal control mechanisms and acquires beyond normal limits uncontrolled growth. Cancer is not a disease but a group of diseases caused by physical, chemical, or biological agents which produce the body begins to generate malignant cells. All have an uncontrolled growth of abnormal cells, which fought its own development, leading to the formation of a tumor that extends and propagated as a common expression.

Cancer cells develop from a single normal cell that undergoes the sum of multiple mutations in a complex process called transformation. 

The first step in the transformation occurs when it is a cell begins the process of initiation, where a change in the genetic material of the cell prepares to become cancerous. 

 This change is caused by a known carcinogen, which may be a chemical, a virus, radiation, or sunlight. However, not all cells are equally susceptible to carcinogens. It may also occur due to a genetic alteration in the cell or other agent, known as promoter. Cells without a division order, misinterpret their own signals were detected in this sense. It has discovered that even a chronic physical irritation, can increase the ability of cells to become cancerous.

The next step is the promotion and in this step a cell which has started a change and becomes cancerous, however, the promotion has no effect on the cells that have not been subjected to the process of initiation, in this way, several factors are required for to start the process, often the combination of a susceptible cell and a carcinogen never occurs, and in other cases, just need this to cause cancer.

Once a group of cells expands, press to adjacent tissue, which produces a chemical signal that stops the division, but malignant cells ignore all messages, and in a healthy cell  this genetic damage sends an alert message level where critical it overflows and these activates a program that indicates the cellular suicide, but sometimes the immune system fails to sort the self-destruction of these cells, so continue their way. A cancerous cell requires of oxygen and nutrients to survive and it will find this by blood vessels which will seek to continue the branch. 

Healthy cells cannot be split more than 70 times, but the malignant require more divisions to produce tumors, so work with systems such as Telomeres that are at the end of chromosomes that lets you exceed the limit reproductive. Once they succeed in breaking the system, they are able to expand beyond the tissue that gave them room and populate other bodies that eventually, if it is not stopped, can interfere with the functioning of vital organs.

This process is marked by natural selection, and is what makes it so difficult to cancer as a disease, since unlike other diseases caused by viruses or bacteria, which can be found sophisticated ways of attacking the human body, the cancer damages own cells that fight without control who nourishes them, and although the evolution has provided the human being of means of defense against cancer, our body has not succeeded in eliminating all forms of attack.

The problem is that each cell that divides runs the risk of becoming a cancerous cell, but it requires multiple mutations, which over time tend to produce chromosomal aberrations, which are generated either by successive replication cycles or external factors inducing carcinogenesis (chemical, physical or biological); thus, where there is damage specifically in the sequence of tumor suppressor genes, which are responsible for regulating the cell cycle and programmed cell death known as apoptosis. 

This cell death is comparable to a suicide, in order to preserve the cellular integrity of the fabric while retaining only healthy cells in the same. However if at the end of the division, DNA also undergoes changes and these variations in the genetic material of cells are often difficult to detect, except with current techniques which can detect a change in the size or shape of a particular chromosome which can indicate a certain type of cancer.

Technically any cell in the human body is susceptible to lose control, but statistically, there are some more delicate than other tissues, for example, the heart is a very immune tissue, one explanation is that heart cells are limited to the blood pumping and are not divided as frequently as the cells of the lungs, skin, mouth, or bones.

Depending on the country, the statistics vary on the types of cancer that can occur in a specific population, but lung, colon, prostate and breast cancer are the most common. While in the case of children, leukemias, tumors of the central nervous system, retinoblastoma, and cancer in the bones are more frequent. This is the reason this kind of cancer have more treatments and better prognosis of survival if they are detected on time. But prevention is the best cure for diseases.

In the specific case of breast cancer, various risk factors can combine, some can be modified, and others not, the factors include:

-Age: Chances of having a breast cancer increase after age 40, although this factor has been in recent years that it can be altered, as are women between 20 and 40 years with a positive diagnosis of breast cancer.

-Gene: there are two major genes that are inherited from generation to generation, BRCA1 and BRCA2, which greatly increases the risk. Women who have a family history of breast or ovarian cancer should have closer medical follow-up. 

Here you should also now that there are  chromosomal alterations that occur due to causes not inherited, as it is the case of the oncogene HER2/neu. Oncogenes are responsible for the transformation of a normal cell in a malignancy that is capable of developing a certain type of cancer. 

-Other genetic changes that increase the risk of breast cancer include gene mutations (Cowden syndrome) PTEN, STK11 (Peutz-Jeghers Syndrome Syndrome) and CDH1 (cadherin-E), but still need much research in this regard.

-Personal factors: factors associated with female hormones and a greater frequency of breast cancer include earliness in sexual maturity (before age 12), menopause that occurs after 50 years old, not to have children and the first pregnancy to term achieved after 30 or 35 years.^[] On the other hand, if the first menstruation occurs after age 12, menopause is before age 50, or the first pregnancy occurs before the age of 10-20 follows the first menstrual period, the risk of breast cancer is lower

-Other risk is exogenous estrogen, which are especially used in the therapy of hormone replacement with genetic predisposition, and contraceptives are the heavier elements in the occurrence of breast cancer.

-Hormone therapy: many women take this type of therapy to reduce the symptoms of menopause, but you have higher risk of breast cancer if you have received hormone therapy for a few years.

-Environmental factors: it has found that smoking an consumption of alcohol increases the risk.

Other factors:

-Delivery: A woman who have never had children or who had babies after age 30 has an increased risk of developing breast cancer. Become pregnant more than once or at an early age reduces the risk of developing this type of cancer.

-Obesity: This has been associated with breast cancer, although this link is controversial. The theory is that obese women produce more estrogen, which can stimulate the development of this cancer.

-Radiation: If you received radiation therapy as a child or young adult to treat cancer of the chest area, there is a risk, significantly more than for breast cancer. The younger has been to start radiation, greater the risk, especially if the radiation was given when women were developing breasts.

Thus, the breast self-exam should be part of routine care as well as brushing your teeth or cut the nails. This simple self-examination, helps to learn how their breasts normally feel, know the spots, or determine if a spot grows, so if they encounter a bump or if fluid coming from the nipple is easy to know if it's something that should be discussed with your doctor.

I read on a website, that there is no evidence of practice these exams save lives by detecting breast cancer, so if you don't feel comfortable reviewing moms, don't worry. But in the event you find a lump, a stain or a strange fluid, consider the time that will elapse from that call your family doctor, up that it can be diagnosed or ruled out as a malignant growth, and in the case of breast cancer caused by oncogene HER2, time is precious, in only 4 months, a lump the size of a small pea can grow as much as 10 centimeters and reach the lymph nodes, jeopardizing life. Why is the care of the body must not be minimized, but above all, don't feel afraid to see a doctor to rule out suspicions, remember that this body is yours and no one else may be responsible for it. Not all lumps that one can find are malignant, they are sometimes deposits of grease or water that only it is necessary to drain, but his life is risk if they are not ruled out possibilities in time with medical studies. Prevention is the key.

Breast self-examination should be consideration of 3-5 days after the onset of the menstrual period, when your breasts are not as sensitive or less lumpy due to the hormonal charge. 

To carry it out, you lie face up and place your right hand behind your head. With three fingers in the middle of the left hand should press slowly but firmly, making small movements to examine the entire right breast. Then, while sitting or standing, you have to examine the armpit, since breast tissue extends to this area. Gently press the nipples, verifying if there is drainage or coloration misses and then repeats the process on the left breast.

Then, standing in front a mirror and with arms to the sides, supported on the waist, have to look at Moms directly and in the mirror for changes in texture (skin that looks like peel of Orange, dimpling, creases, dents), reviewing the shape and contour of skin or depressed nipple. Do the same with arms raised above the head.

Another good reason to be familiar with the breasts is getting inflammatory breast cancer, or IBC, for its acronym of Inflammatory Breast Cancer. The IBC is between 1 and 6 percent of all types of invasive breast cancer, although this statistic is the United States. Typically, both the women and their doctors overlooked the IBC, since you can develop without any package and their symptoms can be mistaken for an infection. If you notice any of the following changes in their breasts, you must communicate immediately with your doctor to be sure you get the correct diagnosis: 
 

Unusual and rapid increase in the size of the breast;

• Redness, rash, or spots in the breast;
• Persistent itching in the nipple or breast;
• Packages or thickening of the tissues of the breast;
• Stabbing pain or burning sensation in the breast;
• Temperature high in the breast, such as fever;
• Dimples or ridges in the breast;
• Flattening or retraction of the nipple;
• Discharge from the nipple or a change in the aureola (the pigmented around the nipple area);
• Inflammation of the lymph nodes located under the arm or on the clavicle.

Many of these symptoms may be overlooked by a woman who is not familiar with your body. For this reason, it is important to take the time to familiarize yourself with every inch of his body and make frequent exams taking into account not only the packages and all the other symptoms. Remember: no one knows your body like you, so that you have the better chance of discover changes in early and save his life.

I would like to have a pink flower by every cancer survivor and one for each of those who have lost the battle, but I only have the desire that no one else has to go through the news and treatments, but if you must do it, hopefully have the fabulous support that my mom and my husband gave me. Thanks to them, today I have flowers to share.

Alma Dzib Goodin
If you want to know a little bit more about my work visit my website: http://www.almadzib.com

REFERENCES:

Collins, F. y Barker, A. (2008) Mapping cancer genome. Scientific American: New answers for cancer. 18 (3). 22-29.

Esteva, F. y Hortobagyi, G. (2008) Gaining ground on breast cancer. Scientific American: New answers for cancer. 18 (3). 88-96.

American Cancer Society: www.cancer.org

Zimmer, C. (2008) Evolved for cancer? Scientific American: New answers for cancer. 18 (3). 14-21.

Wayt Gibbs, W. (2008) Roots of cancer, Scientific American: New answers for cancer. 18 (3).  31-39.

Roche Vida: http://www.cancerdemamaroche.com/category/roche/

 Chávarri-Guerra, Y., Villareal-Garza, C., Liedke, P., Knaul, F., Mohar, A., Finkelstein, DM., and Gross, PE. (2012) Breast cancer in Mexico: a growing challenge to health and health system. The Lancet Oncology.  3 (8) e335-e343.

Robson, M., and Offit, K. (2007) Clinical practice. Management of an inherited predisposition to breast cancer. N Engl. J. Med. 357 (2) 154-162.

Khatcheressian, JL., Wolff, AC., Smith, TJ., Grunfeld, E., Muss, HB., Vogel, VG, et al. (2006) American Society of Clinical Oncology: Update of the breast cancer follow up and management guidelines in the adjuvant setting. J Clin Oncol. 24 (31) 5091-5097.

Abeloff, MD., Wolff, AC.,Weber, BL., Zaks, TZ., Sacchini, V., McCormick, B. (2008) Cancer of the breast. In Abeloff, MD., Armitage, JO., Niederhuber, JE., Kastan, MB., & McKena, WG. eds. Clinical oncology. 4th ed.  Elsevier Churchill Livingston.
Philadelphia. USA.

 García Manero, M., & Martínez Regueira, F. (2008) Cáncer de mama. Revista Médica Universodad de Navarra. 52 (1) 3.

   

Gerson, R.,  Serrano, A., Villalobos, A.,  Sánchez-Forgach, E.,  Sánchez- Basurto, G.,  Murillo, A. &  Ortiz-Hidalgo, C. (2002) Biomarcadores en el pronóstico y respuesta al tratamiento en cáncer mamario. Gáceta Médica de México.138 (1) 16-25.