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Women and Breast, Lung and Colorectal Cancer

Ann Witt, M.D., and Natalie Staats Reiss, Ph.D., edited by Benjamin McDonald, MD

Breast Cancer:

Because of earlier detection and better available treatment options, cancer is not necessarily life-threatening. Mammograms diagnose most cases of breast cancer before symptoms begin. Therefore, with routine mammograms, most breast cancers are diagnosed when the cancer is located in the breast (rather than spread throughout the body) and the treatment is most likely to be successful.

upset womanThe survival rate is higher when the cancer is found only in the breast (local disease) than when it has spread just beyond the breast tissues to the lymph nodes at the time of diagnosis. Lymph nodes contain white blood cells and are part of the body's defense against infection and foreign substances. The survival rate is much lower if the breast cancer has spread throughout the body (i.e., the cancer is metastatic) at the time of diagnosis.

Impact on Mental Health:

As with many cancers, women who have breast cancer have an increased risk of developing depression. The factors that influence the development of depression in breast cancer patients need further study. One study suggested that a woman's level of involvement in her treatment decisions is associated with levels of depression. Depending on their type of cancer, women might be able to choose between a mastectomy (complete removal of the breast) and lumpectomy (removal of the cancerous part of the breast tissue only). The rate of depression was lower if the women themselves chose a mastectomy than if the surgeon either recommended or chose mastectomy to treat the breast cancer. This study suggests that a woman might be less depressed if she, rather than her doctor, guided the choice of surgery.

Some other studies suggest that depressed breast cancer patients have a lower rate of survival than non-depressed patients. For more information about the relationship between depression and cancer, please see our additional discussion below (cancer and mental health). For a detailed discussion of symptoms, diagnosis, and treatment please see our topic center devoted to cancer.

Lung Cancer:

As mentioned previously, more women die from lung cancer than breast cancer. Lung cancer rates are a reflection of smoking rates.

In the early 20th century, fewer women smoked cigarettes. Unfortunately, as the years have passed, the gap between the numbers of men and women who smoke has continued to narrow. Obviously, the best preventative strategy for lung cancer (and other cancers caused by nicotine) is to stop smoking (or to avoid starting in the first place). The prognosis for lung cancer is poor compared to breast cancer.

Please see our topic center on cancer for more details on types of lung cancer, diagnosis, and treatment.

Colorectal cancer:

Colorectal cancer is another common type of cancer in women. The rates of colorectal cancer have decreased since 1985, in part because of improved screening practices.

A woman can be screened for colorectal cancer by having a colonoscopy every 10 years, having a sigmoidoscopy every 5 years, or with yearly testing of the stool for blood. During a colonoscopy, a tube with a camera on the end is inserted through the anus to examine the entire colon. This procedure allows the physician to look for unusual growths. A colonosocopy typically requires several days of preparation prior to the procedure to clean out the entire colon of stool. Typically, a person must have only clear fluids, and then use a laxative. Patients are usually sedated during a colonoscopy (i.e., they are almost put to sleep) and often do not remember the procedure.

A sigmoidoscopy also uses a tube with a camera, but this procedure is used to examine only the end portion of the colon where cancers more commonly occur. For a sigmoidoscopy, the end of the colon (rather than the entire colon) needs to be clean of stool.  This means the person follows a clear liquid diet for approximately a day before the procedure and uses a laxative. During sigmoidoscopy people are usually awake and alert. Neither a colonoscopy nor a sigmoidoscopy requires a hospital stay and a person typically goes home the same day. These screening tests help diagnose the cancer at earlier stages. Earlier diagnosis increases the likelihood of responding to treatment. Ninety percent of women will be alive 5 years after their diagnosis of colon cancer (5-year survival rate) if the cancer has not spread at the time of diagnosis. The 5-year survival rate drops considerably if the cancer has spread to the abdominal area or if the cancer has spread throughout the body at the time of diagnosis.

Please see our topic center on cancer for more details on diagnosis and treatment.