Über die Autorin bzw. den Autor

Barbara L. Gordon, Ph.D., is Associate Professor of English at Elon University in North Carolina.

Heather S. Shaw, M.D., was a breast oncology clinician, from 1999 to 2009, and Assistant Professor of Medicine at Duke University Medical Center in the Multidisciplinary Breast Program of the Duke Comprehensive Cancer Center. She is pursuing a Master of Public Health degree at the University of North Carolina, Chapel Hill.

David J. Kroll, Ph.D., is Professor and Chair of Pharmaceutical Sciences at North Carolina Central University, Adjunct Associate Professor of Medicine at Duke University, and Adjunct Associate Professor of Pharmacology at the University of North Carolina, Chapel Hill.

Brooke Ratliff Daniel, M.D., is a private practice medical oncologist at Chattanooga Oncology and Hematology Associates in Tennessee.

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""Breast Cancer Recurrence and Advanced Disease" provides a lot of relevant information to women with the condition. It discusses tools and resources to deal with a scary diagnosis, is practical and easy to read, and is written in an objective manner about medicine, daily living, and dying. Women struggling with the condition will find strength and guidance in this book."--Helena Chang, M.D., Ph.D., Director of the Revlon/UCLA Breast Center

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Breast Cancer Recurrence and Advanced Disease

Duke University Press

Contents

List of Online Resources.....................................................................................xiPreface......................................................................................................xvAcknowledgments..............................................................................................xxiiiIntroduction.................................................................................................1Chapter 1. Local and Distant Recurrence......................................................................5Common Questions about Recurrence............................................................................6Predictors of Recurrence.....................................................................................9Recurrence Statistics........................................................................................20Reducing Chances of Recurrence...............................................................................24Local and Regional Recurrence................................................................................34Distant Recurrence/Metastatic Cancer.........................................................................42Chapter 2. Immediate Concerns and Best Care..................................................................51Emotional Self-Care..........................................................................................52Getting the Best Care........................................................................................56Researching Your Disease and Treatment.......................................................................68Exploring Treatment Options..................................................................................72Chapter 3. Medical Treatments................................................................................83Physical and Emotional Considerations in Determining Treatment...............................................84Local Treatment Aimed at Specific Tumor Sites................................................................89Treatment Aimed at Cancer Cells throughout the Body—Systemic Treatment.................................93Monitoring Treatment.........................................................................................110Supportive/Palliative Treatment..............................................................................111Chapter 4. Understanding Cancer Development, Treatment, and Emerging Therapies...............................115Understanding Cancer Development.............................................................................116How Current Treatments Fight Cancer..........................................................................129How Targeted Therapies Fight Cancer..........................................................................134The Future...................................................................................................145Chapter 5. Complementary, Alternative, and Integrative Care..................................................153Comparison of CAM and Standard Western Medical Practices.....................................................155Nature's Pharmacy in Cancer Treatment........................................................................157Biologically Based Practices.................................................................................160Whole Alternative Medical Systems............................................................................168Exercise and Manipulative Practices..........................................................................170Mind-Body Interventions......................................................................................172Energy Therapies.............................................................................................173Considerations in Using a CAM Practice.......................................................................175Selecting a Complementary Health-Care Practitioner...........................................................180Chapter 6. Managing Pain and Understanding the Dying Process.................................................185Pain from Metastatic Cancer..................................................................................186Describing and Evaluating Pain...............................................................................188Attacking the Causes and Symptoms of Pain....................................................................191Euthanasia and Suicide.......................................................................................196Choices in Dying.............................................................................................200How We Die...................................................................................................203Chapter 7. Practical Matters.................................................................................211Medical Rights...............................................................................................211Paying for and Managing Medical Expenses.....................................................................219Final Arrangements: Will, Durable Power of Attorney, Advance Directive, Memorial Service.....................245Chapter 8. Emotional and Spiritual Well-Being................................................................263Responding to Loss...........................................................................................264Interrelating with Others: Those You See Occasionally........................................................273Interrelating with Those Closest to You......................................................................276At Ease near Life's End......................................................................................283Reflections on Death.........................................................................................293Appendix A: Absolute and Relative Risk.......................................................................297Appendix B: Diet and Breast Cancer...........................................................................301Appendix C: CAM Centers......................................................................................311Glossary of Medical and Scientific Terms.....................................................................317References...................................................................................................331Index........................................................................................................345

Chapter One

Do not be anxious about tomorrow; tomorrow will look after itself. —Matthew 6:34

Even cowards can endure hardship; only the brave can endure suspense. —Mignon McLaughlin, A Woman's Notebook

Over millennia the word "cancer" has inspired concern. Humankind has wrestled with its nature, seeking to define, understand, and overcome it. Physicians thousands of years ago in ancient Greece recognized the disease, calling...