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  2. 2. PREFACE Praise the writer turning to God Almighty, for the blessing of His mercy and grace so that the paper with the title " THE RELATIONSHIP BETWEEN BREAST CANCER WITH LUNG CANCER FOR WOMEN AGE 50-60 IN THE CENTRAL OF JAKARTA,2008" can be resolved properly in accordance with the time allowed. A big thank you goes to all those who have patiently helped the author in completing the writing of this paper. The author realizes that the papers that had been developed there are still many shortcomings. To the authors expect criticism and constructive suggestions from readers that the author can arrange the next paper better. Hopefully all the information contained in this paper can be useful for readers in their life. Jakarta June 21,2010 Author
  3. 3. CHAPTER I INTRODUCTION I.1. BACKGROUND First, the author will discuss about breast cancer. Breast cancer is a malignant tumor that grows in the breast tissue. Cancer can grow in the milk glands, milk ducts, fatty tissue and connective tissue in the breast In Indonesia ranked second breast cancer after cervical cancer, the most widely attacked Indonesian women. One way to prevent it is by self awareness for breast examination early. It is said that if 85% of breast lumps found by women themselves Furthermore, the author will discuss lung cancer. Most lung cancers derived from cells in the lungs, but lung cancer can also come from cancer in other parts of the body that spreads to the lungs. Lung cancer is the most common cancer, in both men and women. Lung cancer is the leading cause of cancer deaths. Until now, lung cancer remains a major problem in medicine. Lung cancer is difficult because no symptoms were detected at an early stage. The size of the lungs to cause cancer to grow undetected for years and only detected when already advanced stage. In Indonesia, lung cancer is one of the main causes of death of men, but that does not mean women can not practically be separated from lung cancer.
  4. 4. I.2. PROBLEMS Up to one third of breast cancer cases in developing countries can be avoided if women are eating less and doing more physical activity. Approximately one of eight women potentially affected by breast cancer. Obese women up to 60 percent more will be affected than women with normal body such as the British researchers noted in 2006. Other lifestyle factors such as smoking can cause lung cancer could also be a supporter for breast cancer. Breast cancer patients generally come to the hospital in an advanced stage. The number is quite large, around 70%. Breast cancer is the most common cancer in women. In Europe, there are about 421 000 new cases and nearly 90.000 deaths in the year 2008, which is the latest available data. In America last year more than 190 000 new cases and 40,000 deaths. In Indonesia? This disease ranks second only to cervical cancer. For this reason the author in writing this paper, we want to discuss about breast cancer and its association with lung cancer. I.3. LIMITATION OF PROBLEMS  What causes breast cancer?  What causes lung cancer?  Is there a relationship between breast cancer with lung cancer?  How treatment of both diseases
  5. 5. I.4. OBJECTIVES The purpose of this paper is made for:  Providing additional knowledge to the public about breast cancer.  Providing additional knowledge to the public about lung cancer.  Providing additional knowledge to the public about the relationship between breast cancer with lung cancer.  Provide information to communities about how to handle and prevention of breast cancer and lung cancer. I.5. METHODS OF WRITING In writing this paper, the author uses the method of writing in the form of literature and the internet.
  7. 7. CHAPTER II DISCUSSION I : BREAST CANCER II.1 DEFINITION Inflammatory breast cancer is a rare type of breast cancer that develops rapidly, making the affected breast red, swollen and tender. Inflammatory breast cancer occurs when cancer cells block the lymphatic vessels in the breast, causing the characteristic red, swollen appearance of the breast. Inflammatory breast cancer is considered a locally advanced cancer — meaning it has spread from its point of origin to nearby tissue and possibly to nearby lymph nodes. Inflammatory breast cancer can easily be confused with a breast infection. Seek medical attention promptly if you notice skin changes on your breast, to help distinguish a breast infection from other breast disorders, such as inflammatory breast cancer. II.2 ETIOLOGY It's not clear what causes inflammatory breast cancer. Doctors know that inflammatory breast cancer begins with one abnormal cell in one of the breast's ducts. Mutations within the abnormal cell's DNA command it to grow and divide rapidly. The accumulating abnormal cells infiltrate and clog the lymphatic vessels in the skin of your breast. The blockage in the lymphatic vessels causes red, swollen and dimpled skin — a classic sign of inflammatory breast cancer.
  8. 8. II.3 SYMPTOMS Signs and symptoms of inflammatory breast cancer include: • Rapid change in the appearance of one breast, over the course of days or weeks • Thickness, heaviness or visible enlargement of one breast • Discoloration, giving the breast a red, purple, pink or bruised appearance • Unusual warmth of the affected breast • Dimpling or ridges on the skin of the affected breast, similar to an orange peel • Itching • Tenderness, pain or aching • Enlarged lymph nodes under the arm, above the collarbone or below the collarbone • Flattening or turning inward of the nipple Inflammatory breast cancer doesn't commonly form a lump, as occurs with other forms of breast cancer. When to see a doctor,Make an appointment with your doctor if you notice any signs or symptoms that worry you. Other more common conditions have signs and symptoms resembling those of inflammatory breast cancer. A breast injury or breast infection (mastitis) may cause redness, swelling and pain.
  9. 9. II.4. RISK FACTORS Factors that increase the risk of inflammatory breast cancer include: • Being a woman. Women are more likely to be diagnosed with inflammatory breast cancer than are men. But men can develop inflammatory breast cancer. • Being black. Black women have a higher risk of inflammatory breast cancer than do white women. Older age. The risk of inflammatory breast cancer increases with age. Most women with inflammatory breast cancer are diagnosed in their 50s — a few years younger than for other types of breast cancer. II.5 TEST AND DIAGNOSIS Diagnosing inflammatory breast cancer :Tests and procedures used to diagnose inflammatory breast cancer include: • A physical exam. Your doctor will examine your breast to look for redness and other signs of inflammatory breast cancer. • Removing a sample of tissue for testing. A biopsy is a procedure to remove a small sample of suspicious breast tissue for testing. The tissue is analyzed in a laboratory to look for signs of cancer. • Imaging tests. Your doctor may recommend a breast X-ray (mammogram) or a breast ultrasound to look for signs of cancer in your breast, such as thickened skin.
  10. 10. Staging inflammatory breast cancer ,If you have inflammatory breast cancer, your doctor will work to determine the extent (stage) of your cancer. This process is called staging. Additional tests that may be used to stage your cancer include: • Computerized tomography (CT) scan • Chest X-ray • Bone scan The stages of inflammatory breast cancer are: • Stage IIIB. At this stage, cancer is considered to be locally advanced cancer — meaning it has spread to nearby lymph nodes and to the fibrous connective tissue inside the breast. Stage IV. At this stage, cancer has spread to other parts of your body. II.6. TREATMENTS AND DRUGS Treatment for inflammatory breast cancer often begins with chemotherapy, followed by surgery and radiation therapy. After these treatments, additional treatments may be used to reduce the risk that inflammatory breast cancer will return. Chemotherapy:Chemotherapy uses chemicals to kill cancer cells. You receive chemotherapy drugs through a vein (intravenously), in pill form or both. Chemotherapy is often used prior to surgery for inflammatory breast cancer. This presurgical treatment, referred to as neoadjuvant therapy, aims to shrink the
  11. 11. cancer before the operation and increase the chance that surgery will be successful. Chemotherapy can also be used after surgery. Surgery:After chemotherapy, women with inflammatory breast cancer usually have an operation to remove the affected breast (mastectomy). Most women with inflammatory breast cancer undergo a modified radical mastectomy, which involves removing the entire breast and several nearby lymph nodes. The lymph nodes are tested for signs of cancer. Radiation therapy:Radiation therapy uses high-powered energy beams, such as X-rays, to kill cancer cells. During radiation therapy, you lie on a table while a large machine moves around you, directing the energy beams to your cancer. Radiation therapy can be used after chemotherapy and surgery to kill any cancer cells that might remain around the breast and under the arm. Hormone therapy:If your inflammatory breast cancer relies on your body's hormones for fuel, your doctor may recommend hormone therapy. Hormone therapy treatments can include: • Medications that block hormones from attaching to cancer cells. Tamoxifen is a type of drug called a selective estrogen receptor modulator (SERM). SERMs act by blocking any estrogen present in the body from attaching to the estrogen receptor on the cancer cells, slowing the growth of tumors and killing tumor cells. Tamoxifen can be used in both pre- and postmenopausal women. • Medications that stop the body from making estrogen after menopause. Called aromatase inhibitors, these drugs block the action of an enzyme that converts androgens in the body into estrogen. These drugs are effective
  12. 12. only in postmenopausal women. Aromatase inhibitors include anastrozole (Arimidex), letrozole (Femara) and exemestane (Aromasin). Targeted therapy:Targeted therapies kill cancer by focusing on the cancer cells' particular vulnerabilities. For inflammatory breast cancer cells with a certain genetic mutation, the medication trastuzumab (Herceptin) may be a treatment option. Trastuzumab targets a protein called HER2 that helps some inflammatory breast cancer cells grow and survive. If your inflammatory breast cancer cells make too much HER2, trastuzumab may help block that protein and cause the cancer cells to die. Trastuzumab can be combined with chemotherapy and used before and after surgery. II.7 COPING AND SUPPORT Inflammatory breast cancer progresses rapidly. Sometimes this means you may need to start treatment before you've had time to process everything. This can feel overwhelming. To cope, try to: • Learn enough about inflammatory breast cancer to make treatment decisions. Ask your doctor for the facts about your cancer and treatment. Ask what stage your cancer is and what treatment options you have. Also ask your doctor about good sources of information where you can learn more. Start with the National Cancer Institute and the American Cancer Society. • Seek support. It might comfort you to talk about your feelings as you begin cancer treatment. You might have a close friend or family member who is a good listener. Or your doctor can refer you to a counselor who works with cancer survivors.
  13. 13. Connect with other cancer survivors. Other people with cancer can provide a unique source of support. Cancer survivors can offer practical advice on what to expect and how to cope during your treatment. Ask your doctor about support groups in your community. Or try the online message boards run by organizations such as the American Cancer Society or II.8. PREVENTION Can healthy eating and regular exercise really contribute to breast cancer prevention? So far, the evidence says yes. What's more, if you combine these risk- reducing habits with limiting your exposure to substances that promote the disease, you'll benefit even more. When it comes to breast cancer prevention, the risks you can't control — such as your age and genetic makeup — may loom large. But there are some breast cancer prevention steps you can always take on your own. Although these measures provide no guarantee that you won't develop the disease, they'll give you a start toward breast cancer prevention. Diet and exercise tips for breast cancer prevention Among the easiest things to control are what you eat and drink and how active you are. Here are some strategies that may help you decrease your risk of breast cancer: • Limit alcohol. A link exists between alcohol consumption and breast cancer. How strong a link remains to be determined. The type of alcohol consumed — wine, beer or mixed drinks — seems to make no difference. To protect yourself from breast cancer, consider limiting alcohol to less than one drink a day or avoid alcohol completely.
  14. 14. • Maintain a healthy weight. There's a clear link between obesity — weighing more than is appropriate for your age and height — and breast cancer. This is especially true if you gain the weight later in life, particularly after menopause. Experts speculate that estrogen production in fatty tissue may be the link between obesity and breast cancer risk. • Stay physically active. Regular exercise can help you maintain a healthy weight and, as a consequence, may aid in breast cancer prevention. Aim for at least 30 minutes of exercise on most days of the week. If you haven't been particularly active in the past, start your exercise program slowly and gradually work up to a greater intensity. Try to include weight-bearing exercises such as walking, jogging or aerobics. These have the added benefit of keeping your bones strong. • Consider limiting fat in your diet. Results from the most definitive study of dietary fat and breast cancer risk to date suggest a slight decrease in risk of invasive breast cancer for women who eat a low-fat diet. But the effect is modest at best. However, by reducing the amount of fat in your diet, you may decrease your risk of other diseases, such as diabetes, cardiovascular disease and stroke. And a low-fat diet may protect against breast cancer in another way if it helps you maintain a healthy weight — another factor in breast cancer risk. For a protective benefit, limit fat intake to less than 35 percent of your daily calories and restrict foods high in saturated fat.
  15. 15. Hormone therapy: Long-term use may undermine breast cancer prevention Talk with your doctor about discontinuing long-term hormone therapy. Study results from the Women's Health Initiative (WHI) raised concerns about the use of hormone therapy for symptoms of menopause. Among other problems, long-term treatment with estrogen-progestin combinations, such as those found in the drug Prempro, increased the risk of breast cancer in women who participated in the trial. If you're taking hormone therapy for menopausal symptoms, ask your doctor about your options. You may be able to manage your menopausal symptoms with exercise, dietary changes or nonhormonal therapies that have been shown to provide some relief. If none of these is effective, you may decide that the benefits of short-term hormone therapy outweigh the risks. In that case, consider using the lowest dose of hormone therapy that's effective for your symptom relief and plan on using it only temporarily, not long term.
  16. 16. CHAPTER III DISCUSSION II : LUNGS CANCER III.1. DEFINITION Lung cancer is a type of cancer that begins in the lungs. Your lungs are two spongy organs in your chest that take in oxygen when you inhale and release carbon dioxide when you exhale. Lung cancer is the leading cause of cancer deaths in the United States, among both men and women. Lung cancer claims more lives each year than colon, prostate, ovarian, lymph and breast cancers combined. People who smoke have the greatest risk of lung cancer. The risk of lung cancer increases with the length of time and number of cigarettes smoked. If you quit smoking, even after smoking for many years, you can significantly reduce your chances of developing lung cancer. III.2. ETIOLOGY Smoking causes the majority of lung cancers — both in smokers and in people exposed to secondhand smoke. But lung cancer also occurs in people who never smoked and in those who never had prolonged exposure to secondhand smoke. In these cases, there may be no clear cause of lung cancer. Doctors have identified factors that may increase the risk. How smoking causes lung cancer:Doctors believe smoking causes lung cancer by damaging the cells that line the lungs. When you inhale cigarette smoke, which is full of cancer-causing substances (carcinogens), changes in the lung tissue begin almost immediately. At first your body may be able to repair this damage. But with each repeated exposure, normal cells that line your lungs are
  17. 17. increasingly damaged. Over time, the damage causes cells to act abnormally and eventually cancer may develop. Types of lung cancer:Doctors divide lung cancer into two major types based on the appearance of lung cancer cells under the microscope. Your doctor makes treatment decisions based on which major type of lung cancer you have. The two general types of lung cancer include:  Small cell lung cancer. Small cell lung cancer occurs almost exclusively in heavy smokers and is less common than non-small cell lung cancer.  Non-small cell lung cancer. Non-small cell lung cancer is an umbrella term for several types of lung cancers that behave in a similar way. Non-small cell lung cancers include squamous cell carcinoma, adenocarcinoma and large cell carcinoma. III.3. SYMPTOMS Lung cancer can cause complications, such as: • Shortness of breath:People with lung cancer can experience shortness of breath if cancer grows to block the major airways. Lung cancer can also cause fluid to accumulate around the lungs, making it harder for the lungs to expand fully when you inhale. • Coughing up blood:Lung cancer can cause bleeding in the airway, which can cause you to cough up blood (hemoptysis). Sometimes bleeding can become severe. Treatments are available to control bleeding.
  18. 18. • Pain:Advanced lung cancer that spreads to the lining of the lung or to another area of the body can cause pain. Tell your doctor if you experience pain. Pain may initially be mild and intermittent, but can become constant. Medications, radiation therapy and other treatments may help make you more comfortable. • Fluid in the chest (pleural effusion):Lung cancer can cause fluid to accumulate in the space that surrounds the lungs in the chest cavity (pleural space). Pleural effusion can result from cancer spreading outside the lungs or in reaction to lung cancer inside the lungs. Fluid accumulating in the chest can cause shortness of breath. Treatments are available to drain the fluid from your chest and reduce the risk that pleural effusion will occur again. Cancer that spreads to other parts of the body (metastasis). Lung cancer often spreads (metastasizes) to other parts of the body — most commonly the opposite lung, brain, bones, liver and adrenal glands. Cancer that spreads can cause pain, nausea, headaches or other signs and symptoms depending on what organ is affected. In some cases, treatments are available for isolated metastasis, but in most cases, the goal of treatment for metastasis is only to relieve signs and symptoms.
  19. 19. III.4. RISK FACTORS A number of factors may increase your risk of lung cancer. Some risk factors can be controlled, for instance, by quitting smoking. And other factors can't be controlled, such as your sex. Risk factors for lung cancer include: • Smoking:Smoking remains the greatest risk factor for lung cancer. Your risk of lung cancer increases with the number of cigarettes you smoke each day and the number of years you have smoked. Quitting at any age can significantly lower your risk of developing lung cancer. • Exposure to secondhand smoke:Even if you don't smoke, your risk of lung cancer increases if you're exposed to secondhand smoke. • Exposure to radon gas:Radon is produced by the natural breakdown of uranium in soil, rock and water that eventually becomes part of the air you breathe. Unsafe levels of radon can accumulate in any building, including homes. Radon testing can determine whether levels are safe. • Exposure to asbestos and other chemicals:Workplace exposure to asbestos and other substances known to cause cancer — such as arsenic, chromium, nickel and tar — also can increase your risk of developing lung cancer, especially if you're a smoker. • Family history of lung cancer:People with a parent, sibling or other first- degree relative with lung cancer have an increased risk of the disease. • Excessive alcohol use:Drinking more than a moderate amount of alcohol — no more than one drink a day for women or two drinks a day for men — may increase your risk of lung cancer. Certain lung diseases. People with certain lung diseases, such as chronic obstructive pulmonary disease, may have an increased risk of lung cancer.
  20. 20. III.5 TEST AND DIAGNOSIS Testing healthy people for lung cancer:Doctors aren't sure whether people with no signs or symptoms of lung cancer should undergo screening for the disease. Even if you have an increased risk of lung cancer — for instance, if you're a smoker — it isn't clear that a chest X-ray or computerized tomography (CT) scan can be beneficial. Some studies show that these tests can find cancer earlier, when it may be treated more successfully. But other studies find that these tests often reveal more benign conditions that require invasive testing and expose people to unnecessary risks. Screening for lung cancer is controversial among doctors. Studies are ongoing to determine what types of tests may be helpful and who would benefit from lung cancer screening. In the meantime, talk with your doctor if you're concerned about your risk of lung cancer. Together you can determine strategies to reduce your risk and decide whether screening tests are appropriate for you. Tests to diagnose lung cancer:If there's reason to think that you may have lung cancer, your doctor can order a number of tests to look for cancerous cells and to rule out other conditions. In order to diagnose lung cancer, your doctor may recommend: • Imaging tests:An X-ray image of your lungs may reveal an abnormal mass or nodule. A CT scan can reveal small lesions in your lungs that might not be detected on an X-ray. • Sputum cytology:If you have a cough and are producing sputum, looking at the sputum under the microscope can sometimes reveal the presence of lung cancer cells.
  21. 21. • Tissue samples (biopsy):A sample of abnormal cells may be removed in a procedure called a biopsy in order to diagnose lung cancer. Your doctor can perform a biopsy in a number of ways, including bronchoscopy, in which your doctor examines abnormal areas of your lungs using a lighted tube that's passed down your throat and into your lungs; mediastinoscopy, in which an incision is made at the base of your neck and surgical tools are inserted behind your breastbone to take tissue samples from lymph nodes; and needle biopsy, in which your doctor uses X-ray or CT images to guide a needle through your chest and into a suspicious lump or nodule to collect cells. A biopsy sample may also be taken from lymph nodes or other areas where cancer has spread, such as your liver. Lung cancer staging:Once your lung cancer has been diagnosed, your doctor will work to determine the extent, or stage, of your cancer. Your cancer's stage helps you and your doctor decide what treatment is most appropriate. Staging tests may include imaging procedures that allow your doctor to look for evidence that cancer has spread beyond your lungs. These tests include CT scans, magnetic resonance imaging (MRI), positron emission tomography (PET) and bone scans. Not every test is appropriate for every person, so talk with your doctor about which procedures are appropriate for you. Stages of non-small cell lung cancer • Stage I. Cancer at this stage has invaded the underlying lung tissue but hasn't spread to the lymph nodes. • Stage II. This stage cancer has spread to neighboring lymph nodes or invaded the chest wall or other nearby structures.
  22. 22. • Stage IIIA. At this stage, cancer has spread from the lung to lymph nodes in the center of the chest. • Stage IIIB. The cancer has spread locally to areas such as the heart, blood vessels, trachea and esophagus — all within the chest — or to lymph nodes in the area of the collarbone or to the tissue that surrounds the lungs within the rib cage (pleura). • Stage IV. The cancer has spread to other parts of the body, such as the liver, bones or brain. Stages of small cell lung cancer • Limited. Cancer is confined to one lung and to its neighboring lymph nodes. Extensive. Cancer has spread beyond one lung and nearby lymph nodes, and may have invaded both lungs, more-remote lymph nodes, or other organs, such as the liver or brain. III.6 TREATMENTS AND DRUGS You and your doctor choose a cancer treatment regimen based on a number of factors, such as your overall health, the type and stage of your cancer, and your preferences. Options typically include one or more treatments, including surgery, chemotherapy, radiation therapy or targeted drug therapy. In some cases you may choose not to undergo treatment. For instance, you may feel that the side effects of treatment will outweigh the potential benefits. When that's the case, your doctor may suggest comfort care to treat only the symptoms the cancer is causing, such as pain.
  23. 23. Treatment options for non-small cell lung cancers Stage Common options I Surgery, sometimes chemotherapy II Surgery, chemotherapy, radiation IIIA Combined chemotherapy and radiation, sometimes surgery based on results of treatment IIIB Chemotherapy, sometimes radiation IV Chemotherapy, targeted drug therapy, clinical trials, supportive care Treatment options for small cell lung cancers Stage Common options Limited Combined chemotherapy and radiation, sometimes surgery Extensive Chemotherapy, clinical trials, supportive care Surgery:During surgery your surgeon works to remove the lung cancer and a margin of healthy tissue. Procedures to remove lung cancer include: • Wedge resection to remove a small section of lung that contains the tumor along with a margin of healthy tissue • Segmental resection to remove a larger portion of lung, but not an entire lobe • Lobectomy to remove the entire lobe of one lung • Pneumonectomy to remove an entire lung If you undergo surgery, your surgeon may also remove lymph nodes from your chest in order to check them for signs of cancer. Lung cancer surgery carries risks, including bleeding and infection. Expect to feel short of breath after lung surgery. Your lung tissue will expand over time and make it easier to breathe. Your doctor may recommend a respiratory therapist who can guide you through breathing exercises to aid in your recovery.
  24. 24. Chemotherapy:Chemotherapy uses drugs to kill cancer cells. One or more chemotherapy drugs may be administered through a vein in your arm (intravenously) or taken orally. A combination of drugs usually is given in a series of treatments over a period of weeks or months, with breaks in between so that your body can recover. Chemotherapy can be used as a first line treatment for lung cancer or as additional treatment after surgery. In some cases, chemotherapy can be used to lessen side effects of your cancer. Radiation therapy:Radiation therapy uses high-powered energy beams, such as X-rays, to kill cancer cells. Radiation therapy can be directed at your lung cancer from outside your body (external beam radiation) or it can be put inside needles, seeds or catheters and placed inside your body near the cancer (brachytherapy). Radiation therapy can be used alone or with other lung cancer treatments. Sometimes it's administered at the same time as chemotherapy. Targeted drug therapy:Targeted therapies are newer cancer treatments that work by targeting specific abnormalities in cancer cells. Targeted therapy options for treating lung cancer include: • Bevacizumab (Avastin). Bevacizumab stops a tumor from creating a new blood supply. Blood vessels that connect to tumors can supply oxygen and nutrients to the tumor, allowing it to grow. Bevacizumab is usually used in combination with chemotherapy and is approved for advanced and recurrent non-small cell lung cancer. Bevacizumab carries a risk of bleeding, blood clots and high blood pressure.
  25. 25. • Erlotinib (Tarceva). Erlotinib blocks chemicals that signal the cancer cells to grow and divide. Erlotinib is approved for people with advanced and recurrent non-small cell lung cancer that haven't been helped by chemotherapy. Erlotinib side effects include a skin rash and diarrhea. Clinical trials:Clinical trials are studies of experimental lung cancer treatment methods. You may be interested in enrolling in a clinical trial if lung cancer treatments aren't working or if your treatment options are limited. The treatments studied in a clinical trial may be the latest innovations, but they don't guarantee a cure. Carefully weigh your treatment options with your doctor. Your participation in a clinical trial may help doctors better understand how to treat lung cancer in the future. Supportive care:When treatments offer little chance for a cure, your doctor may recommend you avoid harsh treatments and opt for supportive care instead. If you're receiving supportive care, your doctor may treat signs and symptoms to make you feel more comfortable, but you won't receive treatment aimed at stopping your cancer. Supportive care allows you to make the most of your final weeks or months without enduring treatment side effects that can negatively impact your quality of life.
  26. 26. III.7 COPING AND SUPPORT A diagnosis of lung cancer is devastating. It may take some time to come to terms with your feelings. When you're ready, you can take steps to take control of your situation. Taking an active role in your health care may make you feel more empowered in coping with lung cancer. Try to: • Learn all you can about lung cancer:Find out everything you can about your lung cancer — the type, the stage, your treatment options and their side effects. The more you know, the more active you can be in your own care. Write down questions and ask them at your next appointment. Ask your health care team about additional sources of information. The National Cancer Institute answers questions from the public. You can reach them at 800-4-CANCER (800-422- 6237), or contact the American Cancer Society (ACS) at 800-227-2345. • Take an active role in your treatment:Although you may feel tired and discouraged, don't let others — including your family or your doctor — make important decisions for you. Take an active role in your treatment and work with your doctors to make your health care decisions. • Build a strong support system:A strong support system helps you cope with everyday difficulties, such as fatigue and pain. Friends and family are worried about you and want to help, so learn to accept help when you need it. Staying connected with friends and family helps them cope with your illness, and it gives you a chance to talk about your hopes and fears. Sometimes you'll feel like your friends and family can't understand your feelings if they've never had cancer. In these cases, support groups — both in your community and on the Internet — can be a good source for practical information and support. You may also find that you develop deep and lasting bonds with people who are going through the same things you are.
  27. 27. • Set reasonable goals:Having goals helps you feel in control and can give you a sense of purpose. But don't choose goals you can't possibly reach. You may not be able to work a 40-hour week, for example, but you may be able to work at least half the time. In fact, many people find that continuing to work can be helpful. • Take time for yourself:Eating well, relaxing and getting enough rest can help combat the stress and fatigue of cancer. Also, plan ahead for the downtimes when you may need to rest more or limit what you do. Stay active. A diagnosis of cancer doesn't mean you have to stop doing the things you enjoy. For the most part, if you feel well enough to do something, go ahead and do it. III.8 PREVENTION There's no sure way to prevent lung cancer, but you can reduce your risk if you: • Don't smoke:If you've never smoked, don't start. Talk to your children about not smoking so that they can understand how to avoid this major risk factor for lung cancer. Many current smokers began smoking in their teens. Begin conversations about the dangers of smoking with your children early so that they know how to react to peer pressure. • Stop smoking:Stop smoking now. Quitting reduces your risk of lung cancer, even if you've smoked for years. Talk to your doctor about strategies and stop-smoking aids that can help you quit. Options include nicotine replacement products, medications and support groups.
  28. 28. • Avoid secondhand smoke:If you live or work with a smoker, urge him or her to quit. At the very least, ask him or her to smoke outside. Avoid areas where people smoke, such as bars and restaurants, and seek out smoke-free options. • Test your home for radon:Have the radon levels in your home checked, especially if you live in an area where radon is known to be a problem. High radon levels can be remedied to make your home safer. For information on radon testing, contact your local department of public health or a local chapter of the American Lung Association. • Avoid carcinogens at work:Take precautions to protect yourself from exposure to toxic chemicals at work. In the United States, your employer must tell you if you're exposed to dangerous chemicals in your workplace. Follow your employer's precautions. For instance, if you're given a face mask for protection, always wear it. Ask your doctor what more you can do to protect yourself at work. Your risk of lung damage from these carcinogens increases if you smoke. • Eat a diet full of fruits and vegetables:Choose a healthy diet with a variety of fruits and vegetables. Food sources of vitamins and nutrients are best. Avoid taking large doses of vitamins in pill form, as they may be harmful. For instance, researchers hoping to reduce the risk of lung cancer in heavy smokers gave them beta carotene supplements. Results showed the supplements actually increased the risk of cancer in smokers. • Drink alcohol in moderation, if at all:Limit yourself to one drink a day if you're a woman or two drinks a day if you're a man. Anyone age 65 and older should drink no more than one drink a day.
  29. 29. Exercise:Aim to achieve at least 30 minutes of exercise on most days of the week. Check with your doctor first if you aren't already exercising regularly. Start out slowly and continue adding more activity. Biking, swimming and walking are good choices. Add exercise throughout your day — park farther away from work and walk the rest of the way or take the stairs rather than the elevator.
  30. 30. CHAPTER IV DISCUSSION I AND II As already writer talked about in the previous section that cancer can happen if one part of the body affected by cancer and spread to a specific section so named. Cancer is a disease which usually difficult to detect. For a woman who has over 50 years will be vulnerable to getting breast cancer, it is far from lung cancer only occurs in men because most contributing factor is from cigarettes, but can not be denied that a passive smokers also get lung cancer , so the chance for a woman to get lung cancer can also. This could happen as a woman who got breast cancer first and then spread to other body parts such as the lungs, so the risk of breast cancer and lung cancer can occur. Or get lung cancer as nonsmokers first, then spread to the breast causing the breast cancer. In Indonesia, the disease is a dangerous disease, but we can be sure that their relationship could occur because of the spread. Especially for a woman who lived in a city full of pollution and a variety of risk factors triggering this cancer can not deny, that both can happen simultaneously.
  31. 31. CONCLUSSION Based on the problems faced, the conclusions drawn are:  Breast cancer is a malignant tumor that grows in the breast tissue. Cancer can grow in the milk glands, milk ducts, fatty tissue and connective tissue in the breast  Lung cancer is the leading cause of cancer deaths. Until now, lung cancer remains a major problem in medicine. Lung cancer is difficult because no symptoms were detected at an early stage. The size of the lungs to cause cancer to grow undetected for years and only detected when already advanced stage.  Both the disease is so dangerous disease prevention needs to be done early. Both diseases can occur due to spread of disease from one part of the bodyto other body parts. As of the breast to the lungs, or vice versa.
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