Listen: Breast Cancer, Oregon, Chemo discussed on Healthcare Triage Podcast
"To make the argument that women who had more babies or women who spent more time nursing or women who spent more time either in pregnancy had a lower chance of breast cancer. And therefore they were making argument. I don't know if it's right wrong. Which is why masking you that when women were having more children spending more time pregnant that there were lower rates of breast cancer. Now that we have a different society with less time spent pregnant with a debt breast cancer rate types, lowered I have no idea if that is a complete myth that been put forward by people who think that women are not spending enough time pregnant or or having babies or if it is actually true tweet. Do we have any idea that is that is that been why there's been a change or has there been no chance, it's a great question. I do think there's been a definitive fluctuation in likelihood of death from breast cancer. I think one of the. Good things is now that we are better at treating things like heart disease patients actually live longer and more likely to die of other things like cancer, the other I would say is that I think are tracking of cancer deaths was not all that good until more recently. So I think in some ways hard to go back and understand that I do think we know one of the major inflection points in likelihood of risk relates to use of hormone replacement therapy, and our subsequent understanding of that. And so there's definitely been downward trend more recently, why does breast cancer kill it. This is know something about it before it's seems like the cells divide, we have chemo, we have radiation. We have surged we've wasted. But but it's still in the breasts. So so why does cancer eventually kill you? You know, that's a it's a really important question. And I think it becomes one of the most fundamental topics of discussion that I have with my patients when we talk about chemotherapy, certainly makes sense to cut the cancer out. And I think most patients they of course, I want to get this. Tumor out. But then when we talk about doing chemotherapy, many of them asked me, why do we do anything else? And the answer is we know that many tumors for whatever reason early on in its inception. Also seed its way into the bloodstream, and so once a cancer cell has left the site where it started and makes its way to the bloodstream. It has the opportunity to see it up into different Oregon's at when this happens, it becomes very very difficult to Aratu Kate. Yeah, absolutely metastases. The number one killer of all cancers, and here is a huge amount of research right now trying to figure out the biology metastasis is interestingly, very inefficient process as Brian mentioned early on in the exception to tumor actually in the order millions of cells will enter the bloodstream, but only very few will actually see metastasis in a distant organ that process of being able to get into the bloodstream get out of the bloodstream reside in a resident tissue that has nothing to do with its normal biology where it came from. And then be able to form a tumor requires significant amounts of Lucien of that cancer to be able to do that. Unfortunately, you know, once it begins to grow in those tumors, starring those resin areas like the brain or the kidney, obviously that those that growth in peace normal function in no one ever thought about that. And so I think let me let me make sure I get this. So 'cause I envision metastatic cancer like it's a fully operational robot ready to go it get knows how to go somewhere else. Grab on develop a blood supplies. So, but it doesn't I would imagine just to sell, and it's it's it's a modified breasts Ellen. If it went someone else wouldn't know how to latch onto wouldn't add command and it was so how does it a literally evolves? And you know, it's interesting some research that is hopefully soon to be published a u actually discovered that these cells metastasis distant organs, actually, begin to gain certain characteristics of the organ that metastasized to that the gene expression, it's it's repertoires genomic repertoire changes to be able to be hospitable to that new environments, very.."