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Thursday, July 28, 2016
The Michigan Daily — michigandaily.com NEWS
Doctors say surgery
is case-based and not
for everyone
By MEHRUNISA KHAN
Daily Staff Reporter
When it comes to a patient’s
decision on how to treat a health
threat, knowledge is key to
navigate through a myriad of
treatment options.
Each year, more than 230,000
women are diagnosed with breast
cancer, and more than 40,000
will die from the disease. It is
considered a common medical
condition in women; one in eight
women will be diagnosed with
breast cancer sometime in their
life.
Steven Katz, University of
Michigan professor of internal
medicine, explained that the
treatment
process
can
be
stressful, since there are different
options for patients, including
surgery, radiation, chemotherapy
and
pills.
Information
for
treatment recommendations has
become increasingly complicated,
as it now includes stages of cancer,
its spread and the biological
characteristics of the cancer.
“All women have the decision
about surgery, and it’s not that
easy to do because they have to
consider the choices they have
for surgery and all of the other
treatments that go into the
management of breast cancer,”
Katz said.
One possible breast cancer
treatment is bilateral, or double,
mastectomy,
which
removes
both breasts to prevent cancer.
The number of women who
underwent double mastectomies
performed has tripled in the past
10 years. In 1998, 3.6 percentof
women younger than 40 had
the procedure, but, in 2011, the
percentage jumped to 33 percent.
In spite of this increase, double
mastectomies do not necessarily
improve chances of survival, Katz
said.
Michael Sabel, University chief
of surgical oncology, wrote in
an e-mail to the Daily that some
double
mastectomies
can
be
warranted. Genetic testing looks
for changesin a patient’s genes,
proteins or chromosomes. For
breast cancer, mutations in genes
called BRCA1 and BRCA2 put
patients at a higher risk for breast
cancer. Younger women who have
the cancer or are at a higher risk
for developing breast cancer in
the future may choose to undergo
double mastectomies to prevent a
second or first incident of breast
cancer, respectively.
“In
2002,
genetic
testing
became available for decision
making prior to surgery and
so younger women with breast
cancer, or women with very strong
family histories, could undergo
genetic testing, and, if they
harbored a genetic mutation, they
stood a high chance of developing
a (second) cancer and thus opted
for bilateral mastectomy to not
only treat the known cancer but
also prevent a second cancer in the
future,” Sabel wrote. “However,
genetic testing is (im)perfect —
there are young women or women
with very strong family histories
who test negative for a genetic
mutation, and we don’t know
every gene responsible for breast
cancer, so many women who are
considered high-risk may also opt
for bilateral mastectomies.”
Sabel said, in addition to genetic
testing, other factors — such as
imaging from MRIs or improved
reconstruction surgery — could
be involved in the decision to
have a double mastectomy.
However, Sabel wrote there
is still misinformation on the
benefits of a double mastectomy
that can mislead women in their
decisions.
Sabel
cited
media
coveragesof
celebrities
who
have had double mastectomies,
and other social media outlets
as possible sources that spread
misinformation.
“While doing the more drastic
surgery may reduce risk of a
(second) cancer, for most breast
cancer patients that risk is not
that high and it is important to
note that bilateral mastectomy
does not improve survival over
other options, such as breast
conservation,”
Sabel
wrote.
“These ideas likely come from
multiple
sources.
We
just
wrote an article studying the
possible impact of celebrity news
reporting on perpetuating this.
There are more blogs, support
groups,
websites,
etc.
about
breast cancer that may propagate
this. There is also likely word of
mouth from family or friends who
have gone through breast cancer
treatment.”
Katz
explained
that
the
pressure of the situation tends
to make patients react quickly
— going with their guts and
the recommendations of their
doctors.
Sometimes
these
decisions are made after one visit.
“In
that
context,
people,
men or women can prefer or
favor an extensive treatment
‘U’ experts weigh pros and
cons of double mastectomy
Incumbent defends
seat against two
challengers
By ISHI MORI
Daily Staff Reporter
City
Councilmember
Sumi
Kailasapathy (D–Ward 1) faces
two different challengers — Jason
Frenzel and Will Leaf — in next
week’s Democratic primary for
City Council elections.
Incumbent Kailasapathy is a
fiscally conservative pragmatist
who has held her City Council
seat since 2012. A child of Sri
Lankan academics, Kailasapathy
came to the United States to
attend college and is currently
an accountant at Edwards, Ellis,
Armstrong & Company, P.C.,
an accounting firm based in
downtown Ann Arbor.
As a candidate with a financial
background, Kailasapathy said
there are low-hanging fruits
when it comes to increasing
revenue and cutting costs in
city government. She named
revisiting the tax capture policies
of the Downtown Development
Authority
and
the
Local
Development Funding Authority
to make their revenue cap $4
million instead of the current $6
million as one way to increase
revenue.
In a July 12 televised candidate
forum, she pointed out that
revenue
for
these
entities
increased by 50 percent over
the last four years, advocating
and redirecting that income to
city funds. She says there are
challenges, however.
“I think a lot of council
members feel indebted to the
DDA members because a lot of
them support the candidates
who are running for City Council
and they really don’t want to
step on their toes,” Kailasapathy
said in an interview with the
Daily. “Anything to do with the
DDA, council members are very
hesitant to take action even
though there was all this extra
money this year that was beyond
projection.”
This commitment to fighting
existing
structures
was
showcased
in
the
televised
forum when the candidates were
discussing the portions of emails
regarding the construction of a
planned Amtrak station redacted
by city staff members in June.
City
Council
candidate
Jason Frenzel said that, though
he
supported
maximum
transparency, he felt there was
a justified reason for city staff in
withholding information.
“I
think
in
(the
e-mail)
conversation we need to realize
what’s the situation,” Frenzel said.
“We don’t as a public understand
what that conversation is and
what it was, why it was redacted.
In my honest opinion, I know our
staff to be strong, professional
leaders in their industry … and I
think challenging our staff in a
public forum isn’t necessarily a
valid way for an organization to
behave.”
Kailasapathy quickly pounced
on Frenzel’s ambiguity, stating
that she supports a Freedom
of
Information
Act
request
concerning the redacted portions,
especially because the documents
in question do not reveal the
location
of
highly
classified
government nuclear plants.
“This is not national security
issues we’re talking about, spies
or spying on other countries,”
Kailasapathy said in an interview
with the Daily. “This is about that
train station, and if you want the
train station to serve best for our
people’s needs, at every stage it
should be transparent.”
Kailasapathy also suggested
Frenzel
cannot
make
the
necessary
reforms
for
transparency
because
of
his
financial and family ties.
“DDA
reforms,
having
oversight, term limits … I doubt
Jason Frenzel will be able to do
that because I think his backing
comes from the DDA and his
stepmother (Sandi Smith) was the
head of the DDA.”
Candidates for City
Council’s first Ward
maintain split visions
ANN ARBOR
See MASTECTOMY, Page 9
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