Despite all the best care

By Richard P. Holm MD
 
Doctor Mary Helen Harris MD was a college friend. We worked together on student union committees and I grew to appreciate her musical talent, her 4.0 grade average, and her way of supporting others around her. She was accepted into the Med School class one year after me, and we had been friends ever since. I took care of her Mom and Dad living in nearby Volga, but after they were gone, I still touched base with Mary Helen every once in a while.
 
Dr. Harris discovered she had spread-to-lymph-node breast cancer maybe 15 years ago, and after a significant struggle through the years, despite all the best care, she passed away this last week, leaving saddened family and friends. 
 
The most common cancer in women starts in the breast, and affects about twelve percent of all women in their lifetime. It’s more common in developed countries because of available screening and longevity. 
 
The Egyptians thought breast cancer occurred as divine punishment for some bad deed and the Greeks thought it was a build-up of too much black bile. By the 1700s, people thought breast cancer came from too little or too much sex, too little or too much breast feeding, breast infections, restrictive clothing and even from the act of fearing cancer. Now, although we know risk factors, we recognize that we don’t know why anyone gets breast or any cancer.
 
By the late 1800s, people were living longer; and, since risk increases with age, breast cancer was on the rise. Surgeons began to radically excise cancerous breasts along with adjacent muscle and lymph tissue, which raised the survival rate from 10 percent up to 50 percent. Although more breast cancer patients survived with radical surgery, often they suffered with lymph-swollen painful arms.
 
Presently breast-sparing surgery is done, where just the lump and only a few lymph nodes are removed, resulting in much less arm edema. And with the advent of safe breast implants, chest deformity is not such a problem. Along with these innovations in surgery have come advancements in screening, and better treatments in radiation, hormone, and chemo-therapy, with incredible improvements in survival. Now, many more women with breast cancer are alive at five years. And when caught early enough, the life span of those with breast cancer are the same as those without.
 
Still, cancer can kill despite all the best care anywhere; and I believe my doctor friend Mary Helen had all that best care. I regret I didn’t have the chance to touch base with her one more time.