Abstract
Being diagnosed with breast cancer is a complicated and disruptive experience for many. Apart from the effects of cancer on their physiological state, patients are required to make important life-changing decisions within a short period of time. To most patients, their physicians act as the main source of medical treatment information. While physicians maintain their trusted role as being the key source of medical treatment information, patients find that their physicians do not provide all the answers to their questions. The Internet is a convenient and inexpensive information resource that assists patients and their care-givers in the decision-making process by providing them with answers to queries that come to mind, detailed explanation of medical jargon and cancer treatment options. Due to the limited time that physicians have with their patients and the power imbalance inherent in their possession of medical knowledge, patients and their care-givers turn to the Internet to seek for more detailed information to supplement the medical advice provided by their physicians. Apart from that, the Internet also provides patients with enhanced capacity to engage in constructive discourse with their healthcare providers thereby bringing new issues and concerns to the patient-physician relationship.
TopBackground
The cancer burden afflicting the world today continues to be one of the most difficult and dreaded life-changing events for many people all around the world (O'Hair, Villagran, Wittenberg, Brown, Ferguson, Hall, & Doty, 2003). In the United Kingdom, cancer is a major cause of morbidity and 276,678 new cancer cases were reported in 2003 alone (Cancer Research UK, 2006, p. 1). 1,444,920 new cancer cases were estimated in 2007 with 559,650 estimated deaths attributable to cancer in the USA (National Cancer Institute, 2008b). In Malaysia, there were 21,464 new cancer cases reported in 2003, comprising 9,400 males and 12,064 females (Lim & Halimah, 2004, p. 34). Cancer remains as one of the main causes of death in these countries with many men and women facing the prospect of a cancer diagnosis in their lifetime (Cancer Research UK, 2006; Lim & Halimah, 2004; National Cancer Institute, 2008b; O'Hair et al., 2003).
There are more than 200 different types of cancer, but breast, lung, colorectal and prostate cancers are the most common and collectively they account for approximately half of all cancer cases in the UK, Malaysia and the US (Cancer Research UK, 2006; Lim & Halimah, 2004; National Cancer Institute, 2008b). The statistics indicate that breast cancer is the most common cancer in the UK despite the fact that it is rare in males (Cancer Research UK, 2006, p. 1) and accounts for 31% of cancer cases among women in Malaysia (Lim & Halimah, 2004, p. 48). According to the Malaysian Oncological Society (2008), ‘breast cancer is the most common form of cancer affecting women in Malaysia. About one in 19 women in this country are at risk, compared to one in eight in Europe and the United States’.
Key Terms in this Chapter
Inflammatory Breast Cancer (IBC): ‘A type of breast cancer in which the breast looks red and swollen and feels warm. The skin of the breast may also show the pitted appearance called peau d’orange (like the skin of an orange). The redness and warmth occur because the cancer cells block the lymph vessels in the skin’ (National Cancer Institute, 2008a).
Metastasis: ‘The spread of cancer from one part of the body to another. A tumor formed by cells that have spread is called a “metastatic tumor” or a “metastasis.” The metastatic tumor contains cells that are like those in the original (primary) tumor’ (National Cancer Institute, 2008a).
Mastectomy: ‘Surgery to remove the breast (or as much of the breast tissue as possible)’ (National Cancer Institute, 2008a).
Biopsy: ‘The removal of cells or tissues for examination by a pathologist. The pathologist may study the tissue under a microscope or perform other tests on the cells or tissue. There are many different types of biopsy procedures. The most common types include: (1) incisional biopsy, in which only a sample of tissue is removed; (2) excisional biopsy, in which an entire lump or suspicious area is removed; and (3) needle biopsy, in which a sample of tissue or fluid is removed with a needle. When a wide needle is used, the procedure is called a core biopsy. When a thin needle is used, the procedure is called a fine-needle aspiration biopsy’ (National Cancer Institute, 2008a).
Complementary and Alternative Medicine (CAM): ‘Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices generally are not considered standard medical approaches. Standard treatments go through a long and careful research process to prove they are safe and effective, but less is known about most types of CAM. CAM may include dietary supplements, megadose vitamins, herbal preparations, special teas, acupuncture, massage therapy, magnet therapy, spiritual healing, and meditation’ (National Cancer Institute, 2008a).
Ductal Carcinoma In Situ (DCIS): ‘A noninvasive condition in which abnormal cells are found in the lining of a breast duct. The abnormal cells have not spread outside the duct to other tissues in the breast. In some cases, ductal carcinoma in situ may become invasive cancer and spread to other tissues, although it is not known at this time how to predict which lesions will become invasive. Also called DCIS and intraductal carcinoma’ (National Cancer Institute, 2008a).
Adjuvant Therapy: ‘Treatment given after the primary treatment to increase the chances of a cure. Adjuvant therapy may include chemotherapy, radiation therapy, hormone therapy, or biological therapy’ (National Cancer Institute, 2008a).
Malignant: ‘Cancerous. Malignant tumors can invade and destroy nearby tissue and spread to other parts of the body’ (National Cancer Institute, 2008a).
Breast Cancer: ‘Cancer that forms in tissues of the breast, usually the ducts (tubes that carry milk to the nipple) and lobules (glands that make milk). It occurs in both men and women, although male breast cancer is rare’ (National Cancer Institute, 2008a).
Breast Reconstruction: ‘Surgery to rebuild the shape of the breast after a mastectomy’ (National Cancer Institute, 2008a).
Chemotherapy: ‘Treatment with drugs that kill cancer cells’ (National Cancer Institute, 2008a).
Benign: ‘Not cancerous. Benign tumors may grow larger but do not spread to other parts of the body’(National Cancer Institute, 2008a).
Radiation Therapy/Radiotherapy: ‘The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiotherapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body’ (National Cancer Institute, 2008a).
Frozen Section: ‘A technique to obtain a quick pathological diagnosis during a surgical procedure’ (NSW Breast Cancer Institute, 2008).
Breast-Conserving Surgery: ‘An operation to remove the breast cancer but not the breast itself. Types of breast-conserving surgery include lumpectomy (removal of the lump), quadrantectomy (removal of one quarter, or quadrant, of the breast), and segmental mastectomy (removal of the cancer as well as some of the breast tissue around the tumor and the lining over the chest muscles below the tumor)’ (National Cancer Institute, 2008a).
Cancer: ‘A term for diseases in which abnormal cells divide without control. Cancer cells can invade nearby tissues and can spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord’ (National Cancer Institute, 2008a).
Benign Breast Disease: ‘A common condition marked by benign (noncancerous) changes in breast tissue. These changes may include irregular lumps or cysts, breast discomfort, sensitive nipples, and itching. These symptoms may change throughout the menstrual cycle and usually stop after menopause. (National Cancer Institute, 2008a) .
Lumpectomy: ‘Surgery to remove the tumor and a small amount of normal tissue around it’ (National Cancer Institute, 2008a).
Lobular Carcinoma In Situ (LCIS): ‘A condition in which abnormal cells are found in the lobules of the breast. Lobular carcinoma in situ seldom becomes invasive cancer; however, having it in one breast increases the risk of developing breast cancer in either breast’ (National Cancer Institute, 2008a).
Mastitis: ‘When the ducts under the nipple become inflamed and infected; this is periductal mastitis. A benign condition, periductal mastitis can affect women of all ages but is more common in younger women’ (Care, 2008).