Breast Cancer Treatment Cost in Tunisia

Breast cancer is a type of cancer that originates in the cells of the breast. While it can occur in men as well, it is far more prevalent in women.

Following skin cancer, breast cancer stands as the second most frequently diagnosed cancer among women in the United States. However, it's crucial to recognize that breast cancer is not exclusive to women, as everyone is born with some breast tissue, making it a condition that can affect individuals of any gender.

Improved breast cancer screening techniques enable healthcare providers to detect the presence of breast cancer at an earlier stage. Early cancer detection greatly increases the chances of effective therapy and recovery.

The exact reason that causes breast cancer is unclear, even though every eighth woman suffers from it. However, several factors have been associated with the development of breast cancer. Some of the breast cancer risk factors include:

• Prolonged use of birth control pills
• Obesity
• Use of hormone replacement therapy
• High breast density
• Alcohol addiction
• No history of pregnancy
• Pregnancy after 35
• Exposure to radiation

The risk of breast cancer naturally increases as women age. The risk is also higher in women who have a family history of breast or ovarian cancer, possess BRCA1 and BRCA2 genes, or have had their periods before the age of 12.

The main types of breast cancer are based on where the cancer begins, whether it's in the ducts or lobules of the breast, and whether it has spread beyond its original location. The two broad categories are in situ (confined to the site of origin) and invasive (has spread beyond the original location). Here are some common types:

• Ductal Carcinoma In Situ (DCIS): This is a non-invasive cancer where abnormal cells are found in the lining of a breast duct but have not invaded nearby tissues.
• Lobular Carcinoma In Situ (LCIS): LCIS is a non-invasive condition where abnormal cells are found in the lobules, but they do not penetrate the lobular walls
• Invasive Ductal Carcinoma (IDC): This is the most common type of breast cancer, representing about 80% of invasive cases. IDC begins in the milk ducts but then invades nearby tissues in the breast.
• Invasive Lobular Carcinoma (ILC): ILC starts in the milk-producing glands (lobules) but can invade nearby tissues in the breast. It is the second most common type of invasive breast cancer.

Most commonly, as a part of treatment for breast cancer, surgery is conducted to remove the cancerous lump or growth from the breasts. Depending on the extent of the cancer and its stage, surgery may be accompanied by another form of treatment as well, which is conducted either before or after the surgery.

The doctor decides upon a breast cancer treatment plan that is most suitable for the patient. The decision may depend upon the extent of spread, the overall health of the patient, the stage, and the type of breast cancer (inflammatory, cancer during pregnancy, lobular carcinoma, ductal carcinoma, and invasive breast cancer).

The team that conducts breast cancer treatment includes a surgeon, a medical oncologist, and a radiation oncologist. The different breast cancer treatment options are divided into two types:

Local Treatment: This type of treatment is localized, that is, it is only used to treat one specific location or primary site affected by cancer. It does not have any impact on the rest of the body.

The following are the two types of local treatment:

1. Surgery: It is the most common form of treatment that targets to remove as much cancer from the primary location as possible. There are different types of surgeries, which can be selected by the doctor depending upon the requirement.

• Mastectomy: In this type of breast cancer removal surgery, the entire breast is removed to eliminate cancer cells. It can involve either one or both breasts.
• Breast-conserving surgery: In this type of surgery, only the part of the breast containing cancer is removed. The goal is to remove just cancer and some part of surrounding healthy tissues and leave the rest of the breast as is.
• Lymph node removal: This type of surgery is sometimes conducted in addition to either of the first two types of surgeries, in case cancer has spread to the nearby lymph nodes.
• Breast reconstruction: This type of surgery is conducted after the removal of cancer, in case the patient demands to improve the appearance of the breast mounds after the removal surgery.
• Radiation therapy: Radiation is required by some breast cancer patients, mostly in addition to other types of treatment. It is typically used in the case of patients who have undergone mastectomy, breast-conserving surgery, or if cancer has spread to other parts of the body. Delivering high-dose radiation to the affected part of the body helps reduce the chances of cancer recurrence.

The radiation can either be delivered externally or by placing a small radioactive pallet in the affected area internally. The latter form of radiation therapy is known as brachytherapy.

II. Systemic Treatment: This type of treatment involves the use of drugs that can be administered either orally or intravenously. The choice of drugs depends on the type of systemic treatment opted for, which, in turn, is dependent upon the extent and the type of cancer.

• Chemotherapy, targeted therapy, and hormone therapy are the three primary types of systemic therapy for breast cancer treatment. Among these, chemotherapy is the most frequently used. Chemotherapy is recommended before the surgery to reduce the size of the tumor and after the surgery to kill off the remaining cancer cells. It involves the intravenous administration of specific anti-cancer drugs.
• Hormone therapy is most commonly used when the patient has tested HER-2 positive in the biopsy. Targeted therapy, on the other hand, is less commonly used.

The recovery journey following breast cancer treatment, though generally less painful and traumatic than some other critical cancers, brings about certain adjustments for patients. These changes encompass various aspects of their physical and emotional well-being:

1. Prolonged Medication Use: Post-treatment, patients may require continued medication for several years to prevent cancer cell regrowth. Recovery from the after-effects of cancer treatment can span months, necessitating patience and resilience.
2. Management of Side Effects: The side effects of cancer treatment, including weakness, reduced appetite, weight loss, hair loss, and compromised immunity, present challenges. Symptoms like vomiting, nausea, headache, and joint pain are effectively addressed through appropriate medications.
3. Menstrual Cycle Disruption: Breast cancer patients often undergo temporary menopause during chemotherapy and radiation therapy, lasting several months post-treatment. Symptoms akin to menopause, such as fatigue, mood swings, and hot flashes, may be experienced during this period.
4. Impact on Fertility: Treatment can affect a woman's fertility, necessitating not only physical but also substantial emotional support during the recovery phase.
5. Body Image and Confidence: Surgical removal of one or both breasts can impact a woman's self-confidence due to altered physical appearance.

Options like cosmetic surgery provide avenues for individuals to regain a sense of normalcy.The unique challenges that breast cancer survivors face underscore the importance of comprehensive support, encompassing physical, emotional, and psychological aspects. While the journey may have its complexities, addressing these changes with a tailored and holistic approach contributes to individuals' overall well-being and resilience in their recovery.