Shadowing Practice: Will I need Chemotherapy for My Breast Cancer? - Learn English Speaking with Video
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165 משפטים
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Want to learn the essentials about if you're going to need chemotherapy for your breast cancer?
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We will teach you all about it.
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When you are diagnosed with breast cancer, one of the first questions you're going to ask yourself, will I need chemotherapy?
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Will I lose my hair?
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How serious is this?
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Well, be assured most will never need chemotherapy,
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but it is essential that you learn as soon as possible from your breast surgeon or medical oncologist,
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the moment that they know that you will likely need chemotherapy.
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We want to teach you a few principles about whether you will benefit from chemotherapy for your breast cancer.
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In this lesson, I'm gonna tell you what chemotherapy is what to expect.
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I'm going to go over some of the general indications for chemotherapy in breast cancer.
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I'm going to give you a little overview about tumor receptors
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which really can guide whether or not you're going to benefit from chemotherapy.
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I'm going to tell you a little bit about what cancer
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when found in the lymph nodes means and I'm also going to tell you about a cutting-edge advance called genomic assays.
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It takes a deeper look into your cancer cell to determine whether or not you may or may not benefit from chemotherapy.
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And lastly, I'm going to explain to you about neoadjuvant chemotherapy, chemotherapy before surgery rather than after surgery for some,
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and there's some distinct benefits.
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So let's get started.
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So what is chemotherapy?
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Well chemotherapy for breast cancer is generally today well tolerated,
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but it is sort of the chemotherapy you probably already expect.
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Come in as an outpatient, get an infusion of the medication, come back two or three weeks later.
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During this time period you can work and generally do that over about a three month period of time.
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And of course it has side effects and hair loss is one of them.
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It is different than hormonal therapy which is usually Not an infusion, but a pill form medication, an estrogen blocking medication.
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And it's obviously less intense, but has its own side effects.
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So let me give you the larger concept.
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The general benefit to you of chemotherapy, if you need it, is this.
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When you walk into your surgeon's office with a diagnosis of breast cancer, we can take the tumor out very quickly.
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But the real threat to you and your life is that it's possible that cancer cells have already spread to your bone,
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your brain, your liver, that we don't know of and can't find yet, that will grow in the future.
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And so the goal of chemotherapy is to get these medications, hormonal therapy too, to those cancer cells.
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We don't know if they're there or not, but it's possible to either suppress them or kill them
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and make you live longer or lessen the chance of you dying from your breast cancer.
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So, chemotherapy is one of the most complex decision processes in all of medicine
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and it's one that you and your medical oncologist will work together to number one, determine if you benefit from chemotherapy and whether
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or not you can tolerate it and exactly what type of chemotherapy to give for your unique breast cancer situation.
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What are the general indications for chemotherapy?
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Well, I'm going to go through some of the more straightforward indications in breast cancer.
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And these are not generally the most common indications, but these kind of just simply make sense.
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If you present with inflammatory breast cancer, a large fast-growing cancer, generally involving your skin,
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lymph nodes, you need chemotherapy and before surgery called neoadjuvant chemotherapy.
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If you have a more advanced breast cancer, a very large tumor, tumor, may be found before or after surgery to have cancer in a number,
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a lot of lymph nodes in your axillary lymph nodes underneath your arm, you will likely benefit from chemotherapy.
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Metastatic breast cancer, stage 4 breast cancer, cancer that has gone and grown that we have found in other parts of the body,
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does not necessarily mean that you have to have chemotherapy, but many are offered it as the best treatment.
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If you have a large tumor when you come see your surgeon
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and really they can't get around it or it's involving parts of the body but they cannot remove surgically well,
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they generally will offer you chemotherapy to shrink the tumor to make the surgery possible.
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Next I'm going to dive deeper into tumor receptors
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which really is one of the major factors for early stage breast cancer
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that helps you and your medical oncologist determine if you will need chemotherapy.
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How are tumor receptors in breast cancer so important in determining whether or not you will need chemotherapy?
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This is an essential part of the information
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that your doctors find out from the initial biopsy where they put a needle into the tumor, pull out, determine you have a cancer.
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And on that tissue, the pathologist run three receptors,
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estrogen receptors, progesterone receptors, and HER2 receptors.
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There are some others, but those are the three main ones.
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And let me just explain why they're so important.
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Each of these, the way to think about it, on a single cancer cell, and in a tumor there are millions, if not billions of cancer cells together to make a mass.
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But on a individual cancer cell, they tend to have little growth switches,
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like light switches that when turned on drive the cell to divide cells make a tumor larger and grow.
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So estrogen receptor, progesterone receptor, HER2 receptor.
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And so not only can we find that information, and it tells us kind of what kind of cancer it is, but we have drugs to go after the estrogen receptor
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and the HER2 receptor and the progesterone receptor to not only suppress the cancer from dividing the groin, but also kill the cancer altogether.
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So that's the general concept.
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So with chemotherapy, I'm going to give you a couple of general principles with receptors.
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Estrogen receptor, most of the time, 80% of the time, it's positive.
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But if it is negative, 20% of the time, you will likely be offered chemotherapy.
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Her two receptors, 20% of the time, it's positive.
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And in that 20%, you generally benefit from chemotherapy paired with or followed with targeted immunotherapy.
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It's a real advance in cancer care.
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The third tumor type you need to know about is triple negative, meaning estrogen, progesterone, HER2 receptors are not on the cell surface.
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And those are real aggressive cancers.
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The best way to treat them is with chemotherapy, in addition to surgery and other treatments.
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So, engage your breast surgeon early on.
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Ask them, what are my receptors and if they're not sure they're not back call them back and ask them.
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You want to know because you want to know when they know if you're going to need chemotherapy.
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Make sure to take our video lessons on tumor receptors triple
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negative breast cancer HER2 positive breast cancer at at the breast cancer school for patients if any of this
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seems to apply to your unique situation.
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What if they find cancer in my lymph nodes?
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Will I need chemotherapy?
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Well, the answer generally is yes in this situation, but not always.
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So let me explain.
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If you have a tumor in your breast, the fact that if cancer is found underneath your arm in the axillary lymph nodes,
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meaning it's traveled through the lymphatics lodged in a lymph node and stayed there and grown and then we can find it.
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It sort of tells us that your cancer is a little bit more aggressive than
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if it has not spread to the lymph nodes.
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So for many many years everyone with cancer and lymph nodes we gave chemotherapy.
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We are learning that there are few people
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that have a small amount of cancer in one or two nodes
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that may not benefit from chemotherapy
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and we're trying to figure out best how to separate them out
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and not give them chemotherapy genomic assays which I'll talk about shortly help with
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that but general concept
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if you're found to have lymph nodes before surgery ask for an axillary ultrasound see
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if they can see any grossly enlarged lymph nodes
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but most of the time we find lymph nodes at the
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time of your breast cancer surgery with what we call a
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sentinel lymph node the biopsy where we check the first one
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or two or three lymph nodes out of the 10 or 20 underneath your arm.
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Most of the time there's no cancer there.
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But if there is cancer there, you and your medical oncologist will put that information together with the size of your tumor,
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with your tumor receptors and your health to determine best if you will benefit from chemotherapy in your unique situation.
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What are genomic assays in breast cancer?
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Genomic assays is a cutting-edge technology that really is a leap forward in our ability
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to determine whether or not your cancer will either need chemotherapy or not, or need, in some situations, radiation or not.
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It does not apply to all, but it might apply to you.
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And I'm going to give you a couple of situations where it might.
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So the most common situation is you have a early stage breast cancer, one that has not spread to the lymph nodes,
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and it has all the favorable receptors that are not suggesting chemotherapy like I just shared with you.
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So an estrogen receptor positive tumor, progesterone receptor positive tumor, possibly, and a HER2 negative tumor.
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So generally all that's looking like no chemotherapy.
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But we now know that we can use these genomic assays,
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which basically look deeper into the cancer cell to determine whether your cancer will or will not benefit from chemotherapy or not.
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So, let me explain.
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You have a one centimeter breast cancer.
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You are healthy.
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You have no cancer in your lymph nodes.
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You go see your medical oncologist.
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They're probably not going to offer you chemotherapy because you're estrogen receptor positive and HER2 negative.
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But if you get a genomic assay, in a 20% of the time,
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it can pull you out of this no chemotherapy and say, you know what, you have a much higher risk cancer,
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cancer coming back, and we know there's benefit from chemotherapy, and offer you chemotherapy.
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Also, the majority end up in a situation where the genomic assay suggests you just need to take hormonal therapy
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and it's incredibly reassuring going forward that your cancer is a lower risk cancer of threatening your life.
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So engage your breast surgeon.
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Will I benefit from a genomic assay to determine whether or not I benefit from chemotherapy?
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And engage your medical oncologist also.
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These tests take about two weeks to come back
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so the best time to order one is
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when you're coming back to see your breast surgeon after your surgery to make sure
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if things heal enough about a week later
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and say do I qualify for a genomic assay
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and then you can get the results right back right before you visit the medical oncologist
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and make a definitive decision at one time about whether or not you need chemotherapy.
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What is neoadjuvant chemotherapy?
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In a small subset of patients we can identify you early on
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when you're with your breast surgeon before surgery
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that you are definitely going to benefit from chemotherapy
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and in some of these patients there are distinct benefits to
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giving you chemotherapy before surgery starting the systemic therapy potentially killing cancer cells elsewhere
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that we don't know about rather than delaying the chemotherapy for six weeks,
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eight weeks, till after surgery and then giving chemotherapy.
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Take our video lesson on neoadjuvant chemotherapy to learn more about this but a few of the situations that it might apply.
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If you have a larger tumor, very important.
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Inflammatory breast cancer, very important.
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HER2 positive and triple negative breast cancers even if it's not a large tumor or involving your lymph nodes,
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there is likely some distinct benefits possibly to you.
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So that's where you've got to engage your breast surgeon
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and your larger breast cancer treatment team that they work with to determine whether
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or not you may or may not benefit from neoadjuvant chemotherapy.
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The decision as to whether or not you will or will not benefit from breast cancer chemotherapy
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is very simple in some situations and incredibly difficult in others.
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The Breast Cancer School for Patients recommends that you really know chemotherapy basics.
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Know your tumor receptors, know genomic assays, know about chemotherapy before surgery,
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how cancer in your lymph nodes can affect the decision whether or not you will or will not benefit from chemotherapy.
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closely and engage your medical oncologist, breast surgeon, and their entire multidisciplinary team.
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That way you will make the very best treatment decisions for yourself.
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To learn more about will I need chemotherapy for breast cancer, visit the Breast Cancer School for Patients,
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where we actually teach you everything you need to know.
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We're here to help you get the best possible breast cancer care in your community.
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Register on our website to get our list of questions to prepare you for your next doctor visit.
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אוצר מילים והערות הגייה לשיעור הזה
שיעור הדיבור הזה ברמה C1 מבוסס על הסרטון “Will I need Chemotherapy for My Breast Cancer?”. המילים שחוזרות הכי הרבה: cancer, chemotherapy, breast, receptor, tumor. בסרטון הזה יש 165 משפטים ו-2221 מילים לתרגול Shadowing. הדיבור נמשך 14:44. הדובר מדבר בקצב טבעי של כ-151 מילים בדקה, קרוב לשיחה יומיומית. רק 81% מהמילים נמצאות בין 3,000 המילים הנפוצות ביותר באנגלית, כך שאוצר המילים מאתגר.
אוצר מילים מרכזי בסרטון הזה
14 המילים המתקדמות ביותר בסרטון, עם ההגייה והמשמעות שלהן:
| מילה | הגייה | משמעות |
|---|---|---|
| lymph שם עצם | /lɪmf/ | לימפה |
| estrogen שם עצם | /ˈɛstɹəd͡ʒən/ | אסטרוגן |
| indication שם עצם | /ɪndɪˈkeɪʃən/ | סימן, עות |
| biopsy שם עצם | /ˈbaɪɑpsi/ | בִּיּוֹפְּסְיָה |
| tolerate פועל | /ˈtɑ.lə.ɹeɪt/ | סָבַל |
| diagnose פועל | /ˈdaɪ.əɡˌnoʊs/ | אבחן |
| enlarge פועל | /ɪnˈlɑɹd͡ʒ/ | הִגְדִּיל |
| ultrasound שם עצם | /ʌl.tɹə.saʊnd/ | אולטרה סאונד |
| subset שם עצם | /ˈsʌbˌsɛt/ | תת קבוצה |
| favourable שם תואר | /ˈfeɪv(ə)ɹəbəl/ | אָהוּד |
| threaten פועל | /ˈθɹɛt.n̩/ | איים |
| leap פועל | /ˈliːp/ | קפץ |
| needle שם עצם | /ˈniː.dəl/ | מַחַט |
| pill שם עצם | /pɪl/ | כַּדּוּר, גְּלוּלָה |
Phrasal verbs שתשמעו
| מילה | משמעות |
|---|---|
| come back פועל | שָׁב |
| figure out פועל | הֵבִין, מצא תשובה |
משפטים שכדאי לחזור עליהם
משפטים קצרים ושלמים מהסרטון שאפשר להשתמש בהם בשיחה יומיומית:
- Will I lose my hair?
- What if they find cancer in my lymph nodes?
- Will I need chemotherapy?
דקדוק בסרטון הזה
המבנים שהדובר משתמש בהם הכי הרבה, עם המילים המדויקות מהסרטון:
| מבנה | בסרטון |
|---|---|
| סביל (Passive voice) be + past participle — הדגש הוא על מה שקורה, לא על מי שעושה את הפעולה | are diagnosed · be assured · may be found |
| הווה מושלם (Present perfect) have/has + past participle — פעולה שקרתה בעבר ועדיין יש לה חשיבות או השפעה עכשיו | have already spread · has gone · has not spread |
| משפטי זיקה (Relative clauses) who / which + clause — מידע נוסף על אדם או דבר | therapy which is · one that has |
הגייה ששווה לשים לב אליה
הדובר משתמש ב-33 קיצורים וצורות מקוצרות, כמו I'm, you're, they're. אמרו אותם בצורה הקצרה, כפי שאתם שומעים אותם.
- הצלילים של “th”: chemotherapy /ˌkiːməʊˈθɛɹəpi/, underneath /ˌʌndɚˈniθ/, threaten /ˈθɹɛt.n̩/, altogether /ɔl.tuˈɡɛð.ɚ/
- הצלילים של “sh” ו-“zh”: indication /ɪndɪˈkeɪʃən/, infusion /ɪnˈfjuːʒən/, outpatient /ˈaʊtˌpeɪʃ(ə)nt/, reassure /ˌɹi.əˈʃʊɹ/, assure /əˈʃʊɹ/
- מילים ארוכות — שימו לב להטעמה: chemotherapy /ˌkiːməʊˈθɛɹəpi/, oncologist /ɒŋˈkɒləd͡ʒɪst/, progesterone /pɹoʊˈd͡ʒɛstəˌɹoʊn/, indication /ɪndɪˈkeɪʃən/, axillary /ˈæksɪlɛɹi/
צלילים שדוברי עברית מתקשים בהם:
- /æ/ — פתוח יותר מה-“אֶ” העברית, לא כמו “a” ב-“cup”: assay /ˈæseɪ/, axillary /ˈæksɪlɛɹi/, inflammatory /ɪnˈflæmət(ə)ɹi/, lymphatic /lɪmˈfæ.tɪk/, metastatic /mɛtəˈstætɪk/
- /r/ — הלשון לא נוגעת בשום מקום, לא ה-“ר” הגרונית: chemotherapy /ˌkiːməʊˈθɛɹəpi/, receptor /ɹɪˈsɛp.tə/, tumor /tuː.məɹ/, estrogen /ˈɛstɹəd͡ʒən/, progesterone /pɹoʊˈd͡ʒɛstəˌɹoʊn/
- עיצור קולי בסוף מילה — /b/, /d/, /g/, /z/, /v/ בלי להפוך אותם לאטומים: node /noʊd/, enlarge /ɪnˈlɑɹd͡ʒ/, ultrasound /ʌl.tɹə.saʊnd/, definitive /dɪˈfɪn.ɪ.tɪv/, straightforward /ˌstɹeɪtˈfɔː(ɹ)wə(ɹ)d/
איך לתרגל עם הסרטון הזה
- הקשיבו לכל הסרטון פעם אחת בלי לדבר, ורשמו את המילים שאתם לא מכירים.
- התחילו במהירות 0.75×, תרגלו Shadowing משפט אחר משפט, וחזרו למהירות רגילה כשזה מרגיש קל.
- הקליטו את עצמכם והשוו למקור, תוך תשומת לב למילים כמו lymph, estrogen, indication.
מהי טכניקת השאדואינג?
שאדואינג היא טכניקת למידת שפה מבוססת מדע שפותחה במקור להכשרת מתורגמנים מקצועיים ופופולרית על ידי הפוליגלוט ד"ר אלכסנדר ארגואלס. השיטה פשוטה אך עוצמתית: אתה מקשיב לאודיו באנגלית ילידית וחוזר עליו בקול רם מיד — כמו צל העוקב אחרי הדובר עם עיכוב של 1–2 שניות בלבד. בניגוד להאזנה פסיבית או תרגילי דקדוק, שאדואינג מכריח את המוח והשרירים בפה לעבד ולשחזר דפוסי דיבור אמיתיים בו זמנית. מחקרים מראים שזה משפר משמעותית את דיוק ההגייה, האינטונציה, הקצב, הדיבור המחובר, הבנת השמיעה ושטף הדיבור — מה שהופך אותו לאחת השיטות היעילות ביותר להכנה לIELTS Speaking ולתקשורת באנגלית בעולם האמיתי.