THE RELATIONSHIP BETWEEN BREAST CANCER WITH LUNG CANCER FOR WOMEN AGE 50-60

1. THE RELATIONSHIP BETWEEN
BREAST CANCER WITH LUNG
CANCER
FOR WOMEN AGE 50-60
IN THE CENTRAL OF JAKARTA,2008
MARTIN RENYUT NISNONI
030.09.146
TRISAKTI UNIVERSITY
FACULTY OF MEDICINE

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. 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. 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. 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.

6. I.6. FRAME OF WRITING
PREFACE
CHAPTER I . INTRODUCTION
I.1. BACGROUND
I.2. PROBLEMS
I.3. LIMITATION OF PROBLEMS
I.4. OBJECTIVES
I.5. METHODS OF WRITING
I.6. FRAME OF WRITING
CHAPTER II DISCUSSION I:BREAST CANCER
II.1. DEFINITON
II.2. ETIOLOGY
II.3. SYMPTOMS
II.4. RISK FACTORS
II.5. TEST AND DIAGNOSIS
II.6. TREATMENTS AND DRUGS
II.7. COPINGAND SUPPORT
II. 8. PREVENTION
CHAPTER III DISCUSSION II:LUNGS CANCER
III.1. DEFINITON
III.2. ETIOLOGY
III.3. SYMPTOMS
III.4. RISK FACTORS
III.5. TEST AND DIAGNOSIS
III.6. TREATMENTS AND DRUGS
III.7. COPINGAND SUPPORT
III. 8. PREVENTION
CHAPTER IV DISCUSSION I AND II
CONCLUSION
REFERENCES

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. 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. 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. 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. 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. 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. 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 BreastCancer.org.
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. • 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. 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. 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. 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. • 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. 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. 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. • 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. • 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. 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. 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. • 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. 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. • 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. • 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. 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. 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. 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.

32. REFERENCES
Tempo Interaktif. Sepertiga Resiko Kanker Parudara Dapat
Dikurangi (updated March 26,2010). Available at:
http://www.tempointeraktif.com/hg/kesehatan/2010/03/26/brk,201
00326-235682,id.html. Accessed June 21,2010.
Gizi.net. Deteksi Dini Kanker Payudara(updated April 4,2006).
Available at: http://www.gizi.net/cgi-
bin/berita/fullnews.cgi?newsid1144042916,55145. Accessed June
21,2010.
Medicastore. Kanker Payudara(Updated August 21,2009).
Available at:
http://medicastore.com/penyakit/103/Kanker_Payudara.html.
Accessed June 21, 2010.
Medicastore. Kanker Paru-Paru(Updated March 3,2010). Available
at: http://medicastore.com/penyakit/6/Kanker_Paru.html. Accessed
June 21,2010.
CDC. Breast Cancer(Updated April 5,2010).
Available at: http://www.cdc.gov/cancer/breast/.
Accessed June 21, 2010.
CDC. National Breast And Cervical Cancer Early Detection
Program (NBCCEDP)(updated May 21,2010). Available at:
http://www.cdc.gov/cancer/nbccedp/. Accessed June 21, 2010.
E-healtharticles. Cancer Lung (Updated April
7,2006). Available at: http://www.e-
healtharticles.com/Detailed/1017.html. Accessed
March 24,2010.
WHO. Cancer lung (Updated March 30,2010). Available at:
http://www.who.int/indoorair/health_impacts/disease/en/. Accessed
March 31,2010.

33. MayoClinic. Cancer Lung (Updated November 10,2009).
Available at: http://www.mayoclinic.com/health/lung-
cancer/DS00038. Accessed March 24,2010.
MedlinePlus. Cancer Lung (Updated 2010). Available at:
http://www.nlm.nih.gov/medlineplus/lungcancer.html. Accessed
March 24,2010.
NIHSeniorHealth. Lung Cancer (Updated November 13,2008).
Available at: http://nihseniorhealth.gov/lungcancer/toc.html.
Accessed March 24,2010.
Tanyadokter. Kanker Paru-paru (Updated 2009). Available at:
http://www.tanyadokter.com/disease.asp?id=1001136. Accessed
March 24,2010.
MayoClinic. Breast Cancer(Updated February 3,2010). Available
at: http://www.mayoclinic.com/health/inflammatory-breast-
cancer/DS00632. Accessed June 21, 2010.
MedlinePlus. Breast Cancer (Updated June 18,2010). Available at:
http://www.nlm.nih.gov/medlineplus/breastcancer.html. Accessed
June 21, 2010.