"Knowledge is power. Information is liberating. Education is the premise of progress, in every society , in every family." "
-Kofi Annan
Be Informed, Be Educated
Currently, there are 7.4 million people suffering from Breast Cancer and Alzheimer’s disease in the United States. The need to have accurate information available for people to become informed about these diseases is crucial. From symptoms to diagnosis to treatments and coping, CARE for a Cure is invested in supplying a resource destination for people to learn about these diseases in order to be informed and educated.
Breast Cancer
Before discussing breast cancer, it's important to be familiar with the anatomy of the breast. The normal breast consists of milk-producing glands that are connected to the surface of the skin at the nipple by narrow ducts. The glands and ducts are supported by connective tissue made up of fat and fibrous material. Blood vessels, nerves, and lymphatic channels to the lymph nodes make up most of the rest of the breast tissue. This breast anatomy sits under the skin and on top of the chest muscles.
As in all forms of cancer, the abnormal tissue that makes up breast cancer is the patient's own cells that have multiplied uncontrollably. Those cells may also travel to locations in the body where they are not normally found. When that happens, the cancer is called metastatic.
Breast cancer develops in the breast tissue, primarily in the milk ducts (ductal carcinoma) or glands (lobular carcinoma). The cancer is still called and treated as breast cancer even if it is first discovered after the cells have travelled to other areas of the body. In those cases, the cancer is referred to as metastatic or advanced breast cancer.
Breast cancer usually begins with the formation of a small, confined tumor (lump), or as calcium deposits (microcalcifications) and then spreads through channels within the breast to the lymph nodes or through the blood stream to other organs. The tumor may grow and invade tissue around the breast, such as the skin or chest wall. Different types of breast cancer grow and spread at different rates -- some take years to spread beyond the breast while others grow and spread quickly.
What is Breast Cancer?
Risk Factors and Causes
Women with certain risk factors are more likely than others to develop breast cancer. A risk factor is something that may increase the chance of getting a disease. Some risk factors (such as drinking alcohol) can be avoided. But most risk factors (such as having a family history of breast cancer) can’t be avoided. Having a risk factor does not mean that a woman will get breast cancer. Many women who have risk factors never develop breast cancer.
According to the World Health Organization, breast cancer is the most common cancer among women worldwide, claiming the lives of hundreds of thousands of women each year and affecting countries at all levels of modernization.
Although the precise causes of breast cancer are unclear, we know the main risk factors. Still, most women considered at high risk for breast cancer do not get it, while many with no known risk factors do develop breast cancer. Among the most significant factors are advancing age and a family history of breast cancer. Risk increases for a woman who has certain types of benign breast lumps and increases significantly for a woman who has previously had cancer of the breast or the ovaries.
A woman whose mother, sister, or daughter has had breast cancer is two to three times more likely to develop the disease, particularly if more than one first-degree relative has been affected. Researchers have identified two genes responsible for some instances of familial breast cancer. These genes are known as BRCA1 and BRCA2. About one woman in 200 carries the genes. Having one of them predisposes a woman to breast cancer but does not ensure that she will get it.
Generally, women over age 50 are more likely to get breast cancer than younger women, and African-American women are more likely than Caucasians to get breast cancer before menopause.
A link between breast cancer and hormones is clear. Researchers think that the greater a woman's exposure to the hormone estrogen, the more susceptible she is to breast cancer. Estrogen tells cells to divide; the more the cells divide, the more likely they are to be abnormal in some way, possibly becoming cancerous.
Symptoms
The signs and symptoms of breast cancer include:
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A lump or thickening in or near the breast or in the underarm that persists through the menstrual cycle
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A mass or lump, which may feel as small as a pea
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A change in the size, shape, or contour of the breast
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A blood-stained or clear fluid discharge from the nipple
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A change in the feel or appearance of the skin on the breast or nipple (dimpled, puckered, scaly, or inflamed)
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Redness of the skin on the breast or nipple
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An area that is distinctly different from any other area on either breast
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A marble-like hardened area under the skin
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These changes may be found during a breast self-exam.
Medical organizations don't agree on the recommendation for breast self-exams, which is an option for women starting in their 20s. Doctors should discuss the benefits and limitations of breast self-exams with their patients.
Stages
he stages are the number zero and the Roman numerals I, II, III, or IV (often followed by A, B, or C). In general, the higher the number, the more advanced the cancer. But there’s more to it than that.
Stage 0. The cancer has been diagnosed early. It started in the breast ducts or milk glands and has stayed there. You’re likely to hear or see the words in situ, meaning “in the original place.”
Stage I. Starting at this level, breast cancer is called invasive, meaning it has broken free to attack healthy tissue.
Stage 1A means the cancer has spread into the fatty breast tissue. The tumor itself is no larger than a shelled peanut, or there may be no tumor.
Stage IB means some cancer cells, but just tiny amounts, have been found in a few lymph nodes.
Stage II. The cancer has grown, spread, or both.
IIA means the tumor in the breast is still small, if there's one at all. There may be no cancer in the lymph nodes, or it may have spread to as many as three.A stage IIB breast tumor is bigger -- it may be the size of a walnut or as big as a lime. It may or may not be in any lymph nodes.
Stage III. The cancer has not spread to bones or organs, but it’s considered advanced, and it’s harder to fight.
IIIA means the cancer has been found in up to nine of the lymph nodes that form a chain from your underarm to your collarbone. Or it has spread to or enlarged the lymph nodes deep in your breast. In some cases there is a large tumor in the breast, but other times there’s no tumor.
IIIB means the tumor has grown into the chest wall or skin around your breast, even if it hasn’t spread to the lymph nodes.
IIIC means cancer has been found in 10 or more lymph nodes, or has spread above or below your collarbone. It’s also IIIC if fewer lymph nodes outside the breast are affected but those inside it are enlarged or cancerous.
Stage IV. Breast cancer cells have spread far away from the breast and lymph nodes right around it. The most common sites are the bones, lungs, liver, and brain. This stage is described as “metastatic,” meaning it has spread beyond the region of the body where it was first found.
Facts and Figures
One is 8 women will be diagnosed with breast cancer in their lifetime
Breast cancer is the second leading cause of cancer death among women.
Each year it is estimated that over 230,000 women in the United States will be diagnosed with breast cancer and more than 40,000 will die.
Over 2.9 million breast cancer survivors are alive in the United States today.
When breast cancer is detected early (localized stage), the 5-year survival rate is 99.9%
Alzheimer's Disease
What is Alzheimer's?
Alzheimer's is a disease that robs people of their memory. At first, people have a hard time remembering recent events, though they might easily recall things that happened years ago.
As time goes on, other symptoms can appear, including:
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Trouble focusing
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A hard time doing ordinary activities
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Feeling confused or frustrated, especially at night
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Dramatic mood swings -- outbursts of anger, anxiety, and depression
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Feeling disoriented and getting lost easily
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Physical problems, such as an odd walk or poor coordination
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Trouble communicating
People with Alzheimer's might forget their loved ones. They might forget how to dress themselves, feed themselves, and use the toilet.
The disease makes brain tissue break down over time. It usually happens to people over age 65.
A person can live with Alzheimer's disease for just a few years or for a few decades. More often, however, people live with it for about 9 years. About 1 in 8 people age 65 and over has the disease. Women are more likely to have it than men.
Causes of Alzheimer's
People who get Alzheimer's disease are usually older, but the disease isn’t a normal part of aging. Scientists aren’t sure why some people get it and others don’t. But they do know that the symptoms it causes seem to come from two main types of nerve damage:
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Nerve cells get tangles, called neurofibrillary tangles.
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Protein deposits called beta-amyloid plaques build up in the brain.
Researchers aren’t sure what causes this damage or how it happens, but it could be a protein in blood called ApoE (for apolipoprotein E), which the body uses to move cholesterol in the blood.
There are a few types of ApoE that may be linked to a higher risk of Alzheimer's. It could be that certain forms of it cause brain damage. Some scientists think it plays a role in building the plaques in the brains of people with Alzheimer’s.
Whether or not ApoE partly causes Alzheimer's, genes almost certainly play a role in the disease. Someone with a parent who had the disease is more likely to have it, too.
There is some evidence that people with high blood pressure and high cholesterol have a greater chance of getting Alzheimer's. More rarely, head injuries may be a reason, too -- the more severe they are, the greater the risk of Alzheimer's later in life.
Scientists are still studying many of these theories, but it’s clear that the biggest risks linked to Alzheimer's disease are being older and having Alzheimer's in your family.
Symptoms
Mild Alzheimer's
The first stage usually lasts from 2 to 4 years. The symptoms include:
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Having less energy and drive to do things
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Less interest in work and social activities and spending more time just sitting, watching TV, or sleeping
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Loss of recent memories, like forgetting conversations and events that just happened
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Language problems, like trouble putting their thoughts into words or understanding others
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Mild coordination problems, such as trouble writing or using familiar objects.
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A hard time with everyday tasks, such as following a recipe or balancing a checkbook
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Mood swings that involve depression or a lack of interest
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Trouble with driving, like getting lost on familiar routes
When a person has one or a few of these issues, it doesn’t necessarily mean he has Alzheimer's. There are other medical conditions that can cause the same problems, such as:
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Conditions that affect metabolism, such as a thyroid problem
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Drug abuse
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Taking medications that don’t work well together
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Parkinson's disease
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Stress
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Depression
A doctor can check on these symptoms and do tests to know if a person has Alzheimer’s or something else.
Moderate Alzheimer's
This is when memory loss gets worse and starts to cause problems in daily life. This stage can last from 2 to 10 years.
Someone with moderate Alzheimer's may start to forget details about his life, like where he went to high school or when he got married. He may not recognize or remember family members and friends. He might also forget where he leaves things and can’t retrace his steps to find them.
Other symptoms at this stage can include:
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Rambling speech
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Trouble coming up with the right words and using the wrong ones
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A hard time planning or solving problems
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Confusion about time or place. He may get lost in places he’s been before. Once he’s there, he may not know how or why he got to that place.
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Not dressing for the weather
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Getting angry or upset easily, sometimes lashing out at family or caregivers
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Trouble sleeping
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Wandering
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Delusions, such as thinking a caregiver is trying to hurt him
Some people with moderate Alzheimer’s also become more aware that they’re losing control of their lives, which can make them even more frustrated or depressed.
Severe Alzheimer's
The third stage, also known as late Alzheimer's, is the most severe. It typically lasts 1 to 3 years. People in this phase might have some or all of these symptoms:
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Major confusion about what’s in the past and what’s happening now
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Can’t express themselves, remember, or process information
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Problems with swallowing and control of their bladder and bowels
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Weight loss, seizures, skin infections, and other illnesses
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Extreme mood swings
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Seeing, hearing, or feeling things that aren’t really there, called hallucinations
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Can’t move easily on their own
Treatments
Today, there is no cure for Alzheimer's. Researchers are still trying to fully understand how the disease leads to memory loss and other problems with thinking and behavior. They hope to one day reverse those changes to prevent or stop the disease.
But if you or a loved one has Alzheimer’s, there are treatments that can make a difference. Some therapies ease the symptoms and help people do better for longer. Because the disease’s effects change over time, people often need to have their treatments adjusted by the doctor, or they need to start new ones as different problems emerge.
Medications
Different types of drugs can treat memory loss, behavior changes, sleep problems, and other Alzheimer’s symptoms. They don’t stop the disease, but they can keep the problems from getting a lot worse for a few months or even years. All of them can have side effects, which can be more of a problem for older people.
Doctors may recommend one or more types of medicines depending on a person’s symptoms:
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Some drugs treat problems with mood, depression, and irritability. Those include citalopram (Celexa), fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft).
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For people who have anxiety or restlessness, medicines that can help include alprazolam (Niravam, Xanax), buspirone (BuSpar), lorazepam (Ativan) and oxazepam (Serax).
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Doctors might prescribe medications to ease confusion, aggression, agitation or hallucinations (seeing, hearing, or feeling things that aren’t there). Options include aripiprazole (Abilify), haloperidol (Haldol), and olanzapine (Zyprexa). It's important to note that studies have linked some of these “antipsychotic drugs” to a higher risk of death for people with dementia. The FDA has placed a "black box" warning on these drugs describing these problems. They can be helpful for many people, though.
Other Therapies
Many people have explored other ways outside of medication to treat Alzheimer’s disease or handle its symptoms. The science on whether or not they work has been mixed.
Vitamin E . Scientists once thought this antioxidant might protect nerve cells from damage. But many doctors no longer recommend it for people with Alzheimer’s, because there’s little evidence that it works.
Hormone replacement therapy (HRT). At one time, studies suggested that women who took hormone replacement therapy after menopause had a lower risk for Alzheimer's. The female hormone, estrogen, was thought to help nerve cells connect with each other, and keep the brain from making plaques that build up between brain cells. But more recent research found that HRT doesn’t help, and one study even showed that estrogen use might actually raise the risk of Alzheimer's rather than protect against it. HRT also may increase a person’s chances for heart attack, stroke, and breast cancer.
Art and music therapies. Some science shows that these treatments, which stimulate the senses, can improve mood, behavior, and day-to-day function for people with Alzheimer’s. Art and music may help trigger memories and help people reconnect with the world around them.
Supplements. Some people have tried alternative remedies, including coenzyme Q10, coral calcium, huperzine A, and omega-3 fatty acids to prevent or treat Alzheimer's disease. There’s not yet enough research to show if they do or don’t work.
Care Givers
Caring for someone with Alzheimer’s disease is a balancing act. You keep your loved one safe and comfortable, keep track of their medications and doctor’s appointments, and give them your love and support. But your life matters, too. It’s just as important to keep up with your work, family, and social life.
In your role as a caregiver, do what you can to be well informed and prepared, and ask for help and support when you need it.
It helps to keep in mind how the disease affects people who have it. If you know what changes to expect, it can help you understand how your role may be different with time.
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Alzheimer’s disease is different for everyone who has it. A person’s condition can change a lot. There may be times when your loved one seems pretty normal and can handle their usual activities. Other times, they may be very dependent. The way medications affect them also can vary. The changes can be confusing and may make your loved one seem demanding or dishonest. But it’s just a natural part of the disease.
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Your loved one’s symptoms will get worse as years go by. While medicines can slow down this progress, they can’t stop it.
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Depression is a part of Alzheimer's as well. It can make symptoms worse and change how well your loved one manages day to day. It’s important to know the signs they might be depressed and let his doctor know right away.
Use these tips to improve your connection to your loved one and your life as a caregiver:
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Take time for yourself. Ask other family members, friends, or someone you hire to step in, even just for a few hours, while you run errands, get some exercise, or just relax. You can also look into adult day care programs in your area.
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Learn as much as you can about your loved one's disease so you’ll know how you can help. You'll also understand what changes to expect in their behavior or symptoms.
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Don’t do everything for them. People with Alzheimer’s can’t do everything they used to, but they can do some things with a little help. Let your loved one handle some tasks, like getting dressed or folding laundry. Give them time to finish it on his own, but step in when they needs help. Help him set goals for completing tasks, and celebrate when they reach them.
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Talk to your loved one about his family affairs. You should know your loved one's wishes about a living will, durable power of attorney, and do-not-resuscitate (DNR) order. Try to talk to them about these things as early in his disease as you can.
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Don’t put your life on hold. Meet with friends, keep up your hobbies, and stick to as normal a schedule as possible. You’ll be more energized and are less likely to feel resentful in the long run.
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Have someone you can talk to. You’re there to listen to your loved one and offer support. But you need someone to vent to, too. Talk openly and honestly with a friend or family member. Join a support group to share with others who are also dealing with Alzheimer’s. It helps to know that you are not alone and that other people feel the same things you do.
Care Giver Tips
Your mom or dad has been diagnosed with Alzheimer's disease. While your first feeling may be worry, you can get support to help you guide your parent’s care and manage costs. That way you can make the most of your time together.
Several local, national, and online resources can help you find care for your parent, along with discounts, delivered meals, and legal or financial tips. Here are some leads on how to get started.
Your first step is to draw up a plan for your parent’s future care. Talk to a social worker trained in Alzheimer’s care or to a support group to help you make a checklist. You can contact a social worker at your local hospital, community center, nursing home, or assisted living center.
You should address now your plan for down the road. Your plan may change as your parent’s health or needs change. Most importantly, involve the person with the disease in these conversations. Understand their wants and choices, and incorporate these into your plan.
Your plan might include:
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Day care, long-term care, or home health care
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Assisted living or memory care housing
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A financial plan to cover costs
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Power of attorney and living will documents
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End-of-life care decisions
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Which family members will help with care
Different types of care can vary greatly in cost. Your choices may be limited by your financial resources, and insurance might not cover some choices. You'll simply do the best you can to honor your parent's wishes. Some things might not be possible because of financial constraints. See more tips on how to cover costs below.
Tap into a local support group of other caregivers of parents with Alzheimer’s disease or dementia, says Shelly Eisenstadt, a licensed clinical social worker at the William Breman Jewish Home in Atlanta. Your parent’s doctor or social worker, a local senior center, or the Alzheimer’s Association can refer you to groups in your community.
You'll be able to meet people who are going through situations very similar to yours. Many support groups are led by a social worker or therapist trained in Alzheimer’s care. This professional can help you understand your parent’s symptoms. “Remember, every person’s story is unique,” Eisenstadt says.
If you have siblings and you're sharing caregiving duties or costs, make choices as a team to avoid conflicts that stress you out. Alzheimer’s is a family disease, even though it affects only one person. It affects everybody.