Running head: BREAST CANCER
Breast Cancer
The mere utterance of the disease breast cancer sends chills down the spine of many women around the world. Indeed, Breast cancer is one disease that has caused great pandemonium among women the world over. In many cases, it results in high rates of morbidity eventually leading to significant mortality rates. According to viable information from the International Agency for Research on Cancer (IARC) , cancer occurrences all over the world have markedly increased to an all-time high, primarily due to various variables. In the case of breast cancer, high incident rates were especially found in the United States and Europe. In the U.S., the ratio according to IARC is 101 cases in 100,000 women while in Europe the ratio is 85 cases in 100,000 women. Countries located in Asia recorded the lowest cancer rates with 21 cases in 100,000 women. In Africa, the ratio represented did not reflect an accurate estimation due to improper registries and inaccurate data; however, the ratio agreed upon was 23 cases in 100,000 women (Porter, 2008). Moreover, according to estimates by the American Cancer Society in 2013, the number of American women to be diagnosed with this deadly disease w as expected to reach more than 230,000 and that of these, 40,000 would have succumbed to breast cancer. These estimates are quite alarming and present an entirely new level of challenge in healthcare. To make matters more morbid, further estimation indicates that more than one million current cases will be diagnosed globally (Porter, 2008).
Presently, the demography of breast cancer in the U.S. is quite upsetting. About 12% of the women population in America will in due course be affected by breast cancer. In 2017 alone, estimates of invasive and non-invasive breast cancers are expected to reach more than 300,000. An acute increase in breast cancer incidents has led women in America to experience more breast cancer deaths than any other type of cancer, including lung cancer. This trend is highly sickening considering the advances in healthcare technologies that are presumed to reduce cancer morbidity and mortality rates. In America, breast cancer is common in women who are below 45 years of age. Of these age group, African Americans experience more breast cancer than white women and are highly likely to die from the disease than even Hispanics, Asians, or Native American women ("U.S. Breast Cancer Statistics | Breastcancer.org", 2017). This disposition is partly due to challenges in healthcare access, failure of early diagnosis and a host of other variables. Overall, breast cancer has become an impending problem on health care progress globally.
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Breast cancer can result from epigenetic changes within genes. Epigenetic changes refer to alterations within molecules that represent an individual cellular phenotype. These changes involve gene expressions of a cell, which are heritable when it comes to somatic cell divisions. Although epigenetic changes include alterations within cell expressions, such change s do not affect the sequence of the DNA. Through several mechanisms that are molecular, the epigenetic phenomena in breast cancer can be controlled. These mechanisms include Polycomb or trithorax complexes in proteins, histone modifications and much more. Such changes are intertwined and are extremely critical when it comes to customary growth and progression of genes. Furthermore, they affect and condition the transcriptional gene potential. These epigenetics are especially vital in understanding attributes of breast carcinogenesis and ultimately, in applying the findings to treatment, prognosis and diagnosis decisions. For quite some time now, scientists and other specialized fields have come up with a proven hypothesis of the involvement of gene mutation in the development of breast cancer. While genetic code alterations are mutations, they are exceedingly rare and may be hereditary or acquired through the lifetime of individuals depending on their lifestyle, which is inclusive of diet and activities undertaken.
In the case of breast cancer, both genetic and epigenetic views are relevant and applicable. Any particular gene state is typically expressed by resolving the packaging in its DNA supervisory regions and through the occurrence of transcription factors and modifying chromatin factors. Therefore, the genetic paths of numerous cancers are particularly straightforward and involve the mutation of oncogenes and suppressors, which in turn results to a gain or loss of function and subsequently resultant abnormal expressions. However, epigenetics does not provide a simple solution to the problem of carcinogenesis, especially when it comes to breast cancer. Normally the determination of epigenetics is through an in-depth evaluation of the chromatin structure, which encompasses DNA methylation, modifications, and variants in the histone structure (You & Jones, 2012). In breast cancer, during the process of tumor commencement and inevitable progression, the epigenome experiences rapid manifold changes, which include loss of DNA methylation also known as hypomethylation, modification of gene profiles and changes in occupancy within the nucleosome. Moreover, recent research indicates interesting phenomena that epigenetic and genetic mechanisms are not entirely separate events in the development of breast cancer; on the contrary, this two events intertwine and complement each other during the elaboration of a tumor. Concisely, while mechanisms in epigenetics alter, gene mutations occur, and this leads to a scrambled epigenome; eventually, paving the way for carcinogenesis (You & Jones, 2012).
Epigenetic changes in transformed cells encompas s alterations in DNA methylation, nucleosomal reshaping, and modified histone tail variations (Jovanovica, Rønnebergb, Tostc & Kristensena, 2010). Here, DNA methylation refers to a n enzyme-driven change and one that transpires at CG or CpG dinucleotides among mammals (Jovanovica, Rønnebergb, Tostc & Kristensena, 2010). DNA hypomethylation that frequently occurs in breast cancer cases refer to an occurrence associated with the reactivation of genes and an instability of chromosomal activity; consequently, leading to an overexpression of proto-oncogenes, a loss in inactivation of the X-chromosome, increased mutation and recombination rates and eventually a loss of imprinting. Similarly, DNA hypermethylation frequently occurs in cancerous cases, especially breast cancer, and is characterized by instability in the genome and overall gene repression. Events of DNA hypermethylation in breast cancer cases often result in the silencing or the suppression of tumor-suppressor genes such as the Retinoblastoma gene or Rb and chromatin compaction. This , in turn , results in an uncontrolled multiplication of cancerous cells, which eventually leads to an abnormal growth of tumors. In addition, related to DNA methylation are the histone tail alterations. This epigenetic modification mechanism usually modifies the structure of chromatins thereby regulating gene expression. Furthermore, regulators that govern remodeling within the nucleosomal also affect prior DNA methylation mechanisms and histone modifications 4(Jovanovica, Rønnebergb, Tostc & Kristensena, 2010). Therefore, to further the progress of breast cancer diagnostics, prognostics, and therapy, a proper understanding of epigenetic changes is imperative.
Treatment of breast cancer as in the case of treating chronic ailments works best through early detection. Therefore, it is of utmost significance to get an accurate screening test occasionally to detect and treat tumors before the progression of carcinogenesis. The prompt diagnosis of breast cancer is usually through self-examination. As a cancer screening option, self-examination enables women to detect early warning signs of cancer while in their 20s. By feeling the breast and standing in front of a mirror to check for dimples on the breasts and changes is their symmetry, women can quickly perform self-examinations. Additional self-tests include applying light pressure on the breast surface to look for lumps, the gentle pinch of the nipple and the surrounding areola, which may or may not discharge fluids. When an individual notices bloody discharge, a cause for alarm is merited, and they should subsequently seek medical help. To make self-examination effective, women are typically advised to use these techniques three or five days after the end of their periods . Another practical test is the use of mammograms. By far, this is the most efficient way to detect breast cancer as it can detect up to two years before the formation of lumps in the breast. Aside from these two tests is the genetic diagnosis, which can detect the BRCA1 and BRCA2 gene mutations. Genetic diagnosis is adequate and should be put into consideration in families that have a history of impeding mutations present in their genome. Treatment of breast cancer involves different plans used at various stages of the disease. In stage 0, treatment plans include Lobular Carcinoma in Situ (LCIS) and Ductal Carcinoma in Situ (DCIS). As the breast cancer progresses, surgery, chemo, and radiotherapy along with other drug therapies are normally considered. Presently, stem cell therapies are providing breakthroughs to the overall treatment of breast cancer.
Ultimately, when it comes to healthcare, cancer is still a bubble that has not yet been pricked. Although numerous stories are emerging indicating the likelihood of a vaccine and an eventual solution to the malignant issue of cancer, according to mainstream medicine and science, such prospects have not been met entirely. Nonetheless, progress in genetics research is proving otherwise. Animal research as well is proving non-futile in the potential to develop inexpensive treatment formulas that work efficiently in completely eradicating cancerous cells. Through careful analysis of genetic code in patients, medical researchers are able to devise optimal treatment plans for each patient. Such studies are pivotal in guaranteeing the potential value of genes in designing treatment plans . From a biblical perspective, the treatment options for breast cancer such as gene therapy and stem cell therapy are considered to be morally wrong and therefore unethical since it is believed that they result in significant alterations of body tissue. However, it must be emphasized that such treatment options focus on availing drugs that suppress the growth of malignant cells by targeting specific epigenetic mechanisms. According to the Canadian Stem Cell Foundation, the application of stem cell research to breast cancer is moving toward a bright future, and some of these requests are being inculcated to clinical trials. Therefore, although breast cancer is a fatal infirmity, through informed diagnosis and treatment, eradication of this malignant disease in our society is possible.
References
Jovanovica, J., Rønnebergb, J., Tostc, J., & Kristensena, V. (2010). The epigenetics of breast cancer. Molecular Oncology , 4, 242-254.
Porter, P. (2008). “Westernizing” Women's Risks? Breast Cancer in Lower-Income Countries. New England Journal Of Medicine , 358 (3), 213-216. http://dx.doi.org/10.1056/nejmp0708307
U.S. Breast Cancer Statistics | Breastcancer.org . (2017). Breastcancer.org . Retrieved 22 July 2017, from http://www.breastcancer.org/symptoms/understand_bc/statistics
You, J., & Jones, P. (2012). Cancer Genetics and Epigenetics: Two Sides of the Same Coin?. Cancer Cell , 22 (1), 9-20. http://dx.doi.org/10.1016/j.ccr.2012.06.008
