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Breast-Cancer Articles


Lower Your Risk For Breast Cancer Heart Disease

(category: Breast-Cancer, Word count: 739)
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Many postmenopausal women are looking for alternatives to hormone therapy, especially in light of the recent Women's Health Initiative research findings concerning the risks of combined estrogen and progestin therapy. Of particular interest are phytoestrogens, which have been gaining popularity due to their "natural" status, alleged health claims, and availability in a wide range of foods and supplements.

What are Phytoestrogens?

Phytoestrogens are naturally occurring plant compounds that have some similarities to estradiol, the most potent naturally occurring estrogen. However, phytoestrogens tend to have weaker effects than most estrogens, are not stored in the body, and can be easily broken down and eliminated.

Observational studies have found a lower prevalence of breast cancer, heart disease and hip fracture rates among people living in places like Southeast Asia, where diets are typically high in phytoestrogens. In North America, knowledge of these reported health effects has stimulated great interest in the health benefits of phytoestrogens. According to the Food and Drug Administration, the sale of soy foods, a major source of phytoestrogens, has increased dramatically in the past decade.

Dietary Sources of Phytoestrogens

Phytoestrogens consist of more than 20 compounds and can be found in more than 300 plants, such as herbs, grains and fruits. The three main classes of dietary phytoestrogens are isoflavones, lignans and coumestans:

1. Isoflavones (genistein, daidzein, glycitein and equol) are primarily found in soy beans and soy products, chickpeas and other legumes.

2. Lignans (enterolactone and enterodiol) are found in seeds (primarily flaxseed), cereal bran, legumes, and alcohol (beer and bourbon).

3. Coumestans (coumestrol) can be found in alfalfa and clover. Most food sources containing these compounds typically include more than one class of phytoestrogens.

The Skeletal Effects of Phytoestrogens

Much of the evidence concerning the potential role of phytoestrogens in bone health is based on animal studies. In fact, soybean protein, soy isoflavones, genistein, daidzein and coumestrol have all been shown to have a protective effect on bone in animals who had their ovaries surgically removed.

In humans, however, the evidence is conflicting. Compared to Caucasian populations, documented hip fracture rates are lower in countries such as Hong Kong, China and Japan where dietary phytoestrogen intakes are high. Yet reports suggest that Japanese women have a greater risk of sustaining a vertebral fracture than Caucasian women.

Several studies have explored the effects of soy isoflavones on bone health, but results have been mixed, ranging from a modest impact to no effect. Most of these studies have serious limitations, including their short duration and small sample size, making it difficult to fully evaluate the impact of these compounds on bone health.

Ipriflavone Supplements

Ipriflavone, a synthetic isoflavone, has shown some promise in its ability to conserve bone in postmenopausal women. Ipriflavone has also been shown to have a protective effect on bone density in pre-menopausal women taking gonadotropin-releasing hormone (GnRH), a treatment for endometriosis that triggers bone loss.

However, a definitive three-year study of more than 400 postmenopausal women concluded that ipriflavone did not prevent bone loss. Additionally, the compound was linked to lymphocytopenia (a reduction in lymphocytes) in a significant number of study participants. Lymphocytes are a type of white blood cell that helps the body fight infection.

Risks and Benefits Are Unclear

Some studies suggest that, unlike estrogen, phytoestrogens do not appear to target breast or uterine tissue. This suggests that they may act more like SERMS (selective estrogen receptor modulators such as raloxifene and tamoxifen) than actual estrogens. However, in other studies high isoflavone levels have been linked to an increased risk of breast cancer.

Clearly, additional research is needed to further evaluate the effects of phytoestrogens before judgments regarding their safety and usefulness can be made.

Key Points

Based on information available at this time, it is reasonable to make the following conclusions concerning phytoestrogens and bone health in postmenopausal women:

1. Moderate amounts of foods containing phytoestrogens can be safely included in the diet but do not expect it to help build bone. Keep to the basic rule - eat the least processed forms.

2. Due to a lack of evidence and concerns about safety, supplementation with synthetic isoflavones (ipriflavone) is in question.

3. Postmenopausal women are encouraged to view evidence concerning phytoestrogens and bone health as conflicting and incomplete. For women who are estrogen dominant increasing their phytoestrogen intake may not improve their bone position.

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Prostate Cancer Treatment

(category: Breast-Cancer, Word count: 581)
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Cancer that grows in the prostate gland is called prostate cancer. Prostate cancer is the second leading cause of cancer deaths among men in the U.S. About one man in six will be diagnosed with prostate cancer during his lifetime, but only one man in 34 will die of the disease.

In the early stages, surgery and radiation may be used to remove or attempt to kill the cancer cells or shrink the tumor. Doctors will usually advice you to undergo a surgical operation. You will then be given some medications to take. Many studies have shown that this combination reduces the pains experienced by men to a great extent especially if the prostate cancer has spread to the bones. The cancer will not totally disappear nor will you live longer. Seek medical advice too and you would be in a better position to decide according to your own health and your personal values. Medications can have many side effects, including hot flashes and loss of sexual desire. Urinary incontinence can be a possible complication of surgery.

Also a form of treatment used for early stage cancer is high intensity focused ultrasound (HIFU). This procedure is carried out under anesthesia (or using a local spinal anesthetic) and a probe is placed into the prostate gland through the rectum. A beam of high intensity focused ultrasound is them used to raise the temperature in the area of focus and thus to kill the cancer cells

Another prostate cancer treatment option is radiation therapy. This prostate cancer treatment includes the use of radiation of high energy from protons, neutrons, gamma rays and x-rays, as well as other sources to kill the cancerous cells and to shrink any existing tumors. There are two ways that radiation therapy can be administered as prostate cancer treatment. The first is from a machine that is located outside your body called external beam radiation therapy, or you may have material that is radioactive that is placed in your body near where the cancer is located. This is referred to as internal radiation therapy.

A relatively new technique, which is still being evaluated, is known as cryosurgery. During cryosurgery, which is carried out under anesthesia, cooling probes are guided into the prostate using ultrasound and the cancer cells are killed by freezing them.

The form of treatment used for early stage cancer is high intensity focused ultrasound (HIFU). This procedure is carried out under anesthesia (or using a local spinal anesthetic) and a probe is placed into the prostate gland through the rectum. A beam of high intensity focused ultrasound is them used to raise the temperature in the area of focus and thus to kill the cancer cells

For late stage prostate cancer hormone therapy is used and this is designed not to attack the cancer itself but to target the male hormones (in particular testosterone), which the cancer cells need to grow. In cases where hormone therapy proves ineffective, systematic radiation therapy or chemotherapy may be recommended.

The outcome of prostate cancer varies greatly; mostly because the disease is found in older men who may have a variety of other complicating diseases or conditions, such as cardiac or respiratory disease, or disabilities that immobilize or greatly decrease their activities. Whatever the stage of your cancer it is important to consider all of the options carefully and weigh the advantages, disadvantages and risks of each carefully before choosing the treatment that is best for you.

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What You Need To Know If Your Mother Had Breast Cancer

(category: Breast-Cancer, Word count: 362)
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If your mother had breast cancer, you have an increased chance of developing it yourself. Knowing your family history, understanding your personal risk, getting appropriate screening tests and making lifestyle choices are important steps toward good breast health, according to the Susan G. Komen Breast Cancer Foundation.

"If breast cancer runs in your family, understanding your risk and how to approach your breast health is important to both your physical and emotional well-being," says Cheryl Perkins, M.D., senior clinical advisor for the Komen Foundation.

Family History and

Increased Risk

If your mother, sister or daughter has breast cancer, your risk of developing the disease is two to three times greater than a woman without this family history. However, being at increased risk for breast cancer does not guarantee you will develop the disease. Talk to your provider to discuss your personal risk and his/her recommendations for regular screening. Regular screening usually includes mammography, clinical breast exams and breast self-exam. Additional screening may be recommended depending on your personal risk.

Gene Mutations and

Genetic Testing

Only 5 to 10 percent of all breast cancer is due to heredity. Genetic testing can determine if you inherited the mutated BRCA1 or BRCA2 genes, which are key in the development of some breast cancers. However, having a mutated gene does not guarantee that you will get breast cancer. If you have concerns about your family history and personal risk, talk with your doctor about whether genetic testing is right for you.

Taking Preventive Steps-Making Healthy Lifestyle Choices

Many factors can increase a woman's chance of getting breast cancer. While some risks, such as being a woman and getting older, are out of your control, others can be managed. For example, risk factors such as consuming alcohol, lack of exercise and being overweight are all factors that you can modify.

Helping Your Mother Through Breast Cancer

If your mother is diagnosed with breast cancer, she needs your support. From diagnosis through treatment and beyond, your mother's co-survivor network of family and friends will be a vital part of her support system.

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Breast Cancer And You Risk Factors And Safety Precautions

(category: Breast-Cancer, Word count: 651)
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Today's woman is more knowledgeable and conscientious than ever about the risks of breast cancer. This is especially true for women over 40 years of age, who have crossed the threshold of increased risk of breast cancer.

Age is so important to the development of breast cancer that about 76% of women who develop it have no other risk factors other than age. However, all women, regardless of age or race, need to acknowledge the risk of developing it. All women are at risk.

Risk Factors

Women who have never smoked a day in their entire lives can develop breast cancer. Women who have been always been health conscious can also develop it. In fact, nearly one woman out of eleven will experience breast cancer. A staggering statistic by anybody's standards!

An estimated 211,000 new cases of breast cancer was diagnosed this past year. Even with the increased awareness programs, early detection through annual mammography screening and instruction for self-examination, breast cancer remains a leading cause of death for women.

Breast cancer, like other forms of cancer, is a disease of the cells. In all, there are about fifteen different types of breast cancer. Some are more serious than others, but the one common factor each shares is that neither the cause nor the cure has been found.

There are four recognized developmental stages of breast cancer:

(1.) State 0: Cancer cells are present in either the lining of the milk glands (lobules), or in the tubes (ducts) that link the milk glands to the nipple. No cancer cells have spread to the nearby fatty tissue.

(2.) Stage 1: Cancer has spread to nearby fatty tissue in the breast. Tumor size is about 1? or under; no cancer cells are present in surrounding lymph nodes.

(3.) Stage 2: Size of tumor is 1? to 2? in diameter; cancer cells may have also spread to nearby lymph nodes.

(4.) Stage 3: Cancer is locally advanced. Tumors are approximately 2? or larger in diameter, or tumors of any size have spread to lymph nodes under the arm or in the chest (above or below the collarbone).

(5.) Stage 4: Metastatic, advanced breast cancer. The cancer has spread from the breast and lymph nodes to other parts of the body.

Early detection of breast cancer remains a woman's best chance of survival, and women of all ages should take advantage of all the resources available.

Every woman should:

1.) Become educated about the risk factors associated with breast cancer.

2.) Become knowledgeable about the types, stages, and symptoms of breast cancer.

3.) Learn the correct procedure for self-examination tests, and perform them routinely.

Long-term use of oral contraceptives, early menstruation, late first full-term pregnancy, exposure to high doses of radiation - puberty through childbearing years, and inherited genetic mutation can all increase a woman's risk of acquiring breast cancer.

Women 40 years of age and older should also:

1.) Have an annual mammography screening.

2.) Become educated about increased age-related risks associated with breast cancer.

Recent studies confirm that risk of breast cancer in midlife increases with regular consumption of alcohol, hormone replacement therapy, weight, and body mass distribution.

During self-examination, look for a lump or thickening in the breast, a discharge from the nipple, scaliness on the skin or around the nipple, a change in shape, color, or texture, and dimpling or puckering.

If you detect a lump, don't panic. About 85-percent of all lumps turn out to be nonmalignant. Make an appointment with your doctor for a more thorough examination, and tests.

Treatment for breast cancer today is often less radical than in years past, and chances for survival much better when the tumor is discovered early.

Author's note: The third Friday in October is National Mammography Day. This year, that day will be celebrated October 20, 2006.

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Is Tamoxifen Effective In Curing Breast Cancer

(category: Breast-Cancer, Word count: 434)
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Tamoxifen, known in the trade as Nolvadex, is usually prescribed by specialists in breast cancer and is taken in pill form. A patient will stay on the drug for about five years.

Often the woman's cancer will be tested to see if it is sensitive to the amount of oestrogen in the system. If the cancer is oestrogen sensitive, tamoxifen will be given.

Because tamoxifen is such a weak estrogen, its estrogen signals don't stimulate very much cell growth. And because it has stolen the place away from more powerful estrogen, it blocks estrogen-stimulated cancer cell growth. In this way, tamoxifen acts like an "anti-estrogen."

Tamoxifen may also take the place of natural estrogen in the receptors of healthy breast cells. In that way it holds down growth activity, and possibly stops abnormal growth and the development of a totally new breast cancer. By blocking natural estrogen from getting to the receptors, tamoxifen is helpful in reducing the risk of breast cancer in women at high risk who have never had breast cancer. It also can help women who have already had breast cancer in one breast by lowering the risk of a new breast cancer forming in the other breast.

One study found that radiation plus tamoxifen was much better than tamoxifen alone at reducing the risk of breast cancer coming back after a lumpectomy in women with hormone-receptor-positive breast cancer. This was true even for women with very small cancers.

For pre-menopausal women, tamoxifen is the best hormonal therapy. But tamoxifen is no longer the first choice for post-menopausal women. If you've been on tamoxifen for two to three years and now you're in menopause, your doctor may recommend that you switch to an aromatase inhibitor to finish your five years of hormonal therapy. However, you can still get a lot of benefit if you take tamoxifen for up to five years and then switch to an aromatase inhibitor.

Tamoxifen was first used to fight breast cancer at the Christie Hospital in Manchester, England, in 1969. It has since proved its worth as means of stopping the spread or recurrence of the disease in women who have already been treated for it.

But, it was noticed back in the early 1980s that some women who were receiving the drug for cancer in one breast did not develop any tumorous growth in the other. This prompted the suggestion that Tamoxifen might have another preventative role for those women who are at risk of getting breast cancer but have yet to develop any signs of the disease.

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Breast Cancer Treatment Conventional Treatment Methods

(category: Breast-Cancer, Word count: 161)
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Your team of doctors will make treatment recommendations based on the stage of your cancer. Your standard treatment options may include surgery, chemotherapy, radiation, and hormone therapy. If you have been diagnosed with DCIS or LCIS, your stage is the lowest and the road you will travel will be easier. For DCIS, your options may include breast-conserving surgery or mastectomy with or without radiation and hormone therapy.

LCIS treatments options are a bit different. They include observation to determine changes, hormone therapy to prevent cancer from developing, or bilateral prophylactic (preventive) mastectomies.

Things get more complicated when your cancer spreads beyond the ducts or lobes/lobules. Once your cancer has been staged, you can visit www.cancer.gov to determine your treatment options. They will typically include: surgery, chemotherapy, radiation, and/or hormone therapy. For IBC, treatment options are similar to the other types of breast cancer, but they will always include chemotherapy because of its aggressiveness.

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Breast Cancer Its Causes

(category: Breast-Cancer, Word count: 323)
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Breast cancer is a malignant tumor developed from cells of the breast, and it is one of the most common cancers affecting females, at time has not been established what is the exact cause of this one, but last researches clearly pointing that there are several risks factors;

These are the most probably breast cancer risk factors;

-Last researches have established that in the age group above 50 years there is a high incidence; on the other hand, in the age group below 25 years the incidence is very low. It is very important to say that this disease is very aggressive in patient 25-50 years old.

-Menstrual cycle is other factor that should be considered; common in the ladies who have a longer menstrual life, i.e. the onset of menarche is earlier and cessation of menstruation is late.

-The women that smoke and drink alcohol increase the risk of developing breast cancer.

-Breast cancer is developed more frequently in spinsters and married woman that have not given birth to children, or if given birth then have not breast fed their offspring.

-The women that have had a breast cancer on one side have greater risk to develop cancer on the opposite side, and if there are antecedents of breast cancer in their families (mother, sisters and daughters), there are greatest risks too.

-Breast cancer is linked with obesity and higher intake of saturated fatty acids

-Breast cancer is linked too, with the continuous or sequential uses of combined oestrogen plus progestin hormone therapy (CHT)

-Women that have been using oral anti contraceptives for more than ten years are more vulnerable to the development of this disease.

On the other hand, women doing 4-5 hours of exercises per week reduce their risk of developing breast cancer.

In short, these facts derive from the statistical analysis; they should not be taken as causative or predisposing factors.

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Alternative Breast Cancer Natural Herbal Treatment

(category: Breast-Cancer, Word count: 1356)
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In recent years, there's been an explosion of life-saving treatment in an alternative way with natural and herbal medicine advances against breast cancer, bringing new hope and excitement. Instead of only one or two options, today there's an overwhelming menu of treatment choices that fight the complex mix of cells in each individual cancer.

Let me ask you a question before you start reading this article:

If I could show you a natural cancer fighting strategy that when used alone or when coupled with conventional treatments could kill your cancer - would you be willing to spend 15 minutes reading and listenting to the audio of the patients. This potentially is a life changing report?

If you answered NO, then I wish you the best of luck with your doctor.

If you answered YES, then go ahead and read this report. Do not simply skim over it or skip around from section to section - but read it word for word. There is some cancer fighting information here. You won't want to miss a thing.

Finding out that you or a loved one has breast cancer can be absolutely terrifying. However, once you understand the causes of breast cancer and learn how to reverse those causes, you or your loved one can have more than a fighting chance of beating breast cancer. Unfortunately, these strategies can't help everyone survive, but if the person using these strategies has enough time left so that they can start to work, quite often they reverse their cancer.

Now, because you chose to read this report in its entirety - this tells me two things about you.

1. You want an aggressive no-holds barred approach to skyrocket your chances of survival beyond the ordinary.

2. You realize conventional treatments may not do the trick alone, and can potentially batter your body, destroy your health and possibly ruin you financially.

A Breast Cancer Survivor says that "We fight cancer everyday...and we never give up."

We know you are fighting for your life. At Cancer Treatment Centers and our mission is to arm you with every choice and offer you every chance.

Aggressive research, innovative new therapies, and highly-trained, experienced cancer practitioner of conventional treatment work to provide each patient with a personalized treatment plan, based on his or her unique medical condition, needs and desires.

Breast Cancer Treatment

There is hope. Some about treatment options available to you.

Alternative Cancer Treatments

Alternative cancer treatments that counter the underlying causes of cancer, help relieve pain, reduce side effects and help the immune system to more effectively fight cancer.

Let me be in brief about the things

What this cancer exactly is?

Cancer cells are always being created in the body. It's an ongoing process that has gone on for eons. In fact, the immune system developed components whose job it is to seek out and destroy cancer cells.

Cancer is not a mysterious disease that suddenly attacks you out of the blue, something that you can't do anything about. It has definite causes that you can correct if your body has enough time, and if you take action to change the internal environment to one that creates health, not cancer, while at the same time attacking cancerous cells and tumors by exploiting their weaknesses.

How we came across this disease?

Cancer has been around as long as mankind, but only in the second half of the 20th century did the number of cancer cases explodes. Contributing to this explosion are the huge amounts of toxins and pollutants we are exposed to, high stress lifestyles that zap the immune system, poor quality junk food that's full of pesticides, irradiated and now genetically modified, pathogens, electromagnetic stress, lights and just about anything that wasn't around 200 years ago. All these weaken the immune system, and alter the internal environment in the body to an environment that promotes the growth of cancer.

Cancer tumors begin when more cancerous cells are being created than an overworked, depleted immune system can destroy.

Constant exposure to tens of thousands of manmade chemicals from birth onward, chlorinated and fluoridated water, electromagnetic radiation, pesticides and other toxins, leads to the creation of too many free radicals and excessive numbers of cancerous cells.

Alone this would be enough to raise cancer levels, but combined with an immune system weakened by a diet of refined and over processed food, mineral depleted soils, and too much exposure to artificial light at night, the immune system at some point no longer is able to keep cancer in check and it starts to grow in your body.

Did you know about this?

Research shows that the immune system needy 9 1/2 hours of sleep in total darkness to recharge completely. When was the last time you had enough sleep?

As a result of all this stress on our bodies and the overload of toxins, what you get is a malfunctioning immune system and a body that is not capable of destroying the excessive numbers of cancerous cells that develop. Some, sooner or later, survive and multiply. And then you have cancer.

Overcoming cancer is a process of reversing the conditions that allowed the cancer to develop, and going after and killing cancerous cells.

The exact causes don't have to be known, though certainly the more varied the approaches taken to correct those conditions, the more likely you are going to hit on what works best in a particular case. What needs to be done is to strongly and dramatically interrupt and reverse these cancer-causing conditions so that the body becomes healthier, and no longer capable of breeding cancer.

The more cancer there is, the more serious the condition - meaning much has to be done - fast. In your personal situation it may be too late, or it may not. No one knows where that cutoff point is as even advanced cases can turn around.

This report acts like a suggestor to you. The most important things you can do for your health is to eat five servings of fruits and vegetables a day. But much, much more potent.

One of the basics of fighting cancer is going on a fairly low carbohydrate diet, especially sugars and refined carbohydrates, because they digest extremely fast and flood the body. Your body must then produce a lot of insulin to get the sugar into cells fast, and this feeds the cancer cells just what they like to eat.

10 Strategies to focus on when fighting cancer...

1.Kill Them Naturally And Safely Without Harming Your Body

2.Increasing Oxygen Levels In Your Body And Cells Can Literally Kill Cancerous Cells

3.Normalizing pH Levels which Can Stop Cancer In Its Tracks

4.Getting Methylgyloxal Back Into Cells Puts The Brakes On Cancer Cell Growth

5.A Strong Immune System Seeks Out And Destroys Cancer Cells

6.Eliminating Candida And Fungal Infections Vital For Getting Rid Of Cancer

7.Reducing Toxic Overload Vital For Successfully Fighting Cancer

8.Free Radical Scavengers Protect Cells From Damage

9.Increasing Enzyme Levels Can Wipe Out Cancer

10.Raising The Vibratory Level In The Body Disrupts Cancer Growth

11.Resolving Issues And Reducing Stress May Be Vital For Success Against Cancer

A natural and herbal approach to cancer is based on making the body healthier. This alternative cancer strategy is to strengthen a depleted, worn out, under energized immune system that is not capable of killing cancer cells as fast as they are multiplying.

This is part of changing the body's internal environment so cancer cells can't survive and so you will experience greater health in every way. You accomplish this by supporting the body's fight against cancer, by changing the body's internal environment to one that does not support the growth of cancer, and by directly attacking cancer cells.

You will learn about safe and effective supplements that deal with each cancer weakness mentioned in the web site. Products that can defeat cancer as they get at the underlying causes of cancer. That work on any and every cancer. Let's get started with the last one first...

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Breast Cancer Information Is Important

(category: Breast-Cancer, Word count: 578)
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Breast cancer usually happens when certain cells located in the breast start to grow out of control, taking over nearby tissue and spreading throughout the body. Large collections of this infected tissue are called "tumors". Some tumors are not even considered to be cancer because they cannot spread throughout the body or threaten a person's life. These types of tumors are called "benign tumors".

The types of tumors that do spread throughout the body and invade the tissues around the breast are considered to be cancer and have been given the name "malignant tumors". It is said that any type of tissue in the breast can form some type of cancer, but it mostly comes from either ducts or glands.

It can take months or even years for a tumor to get big enough for someone to actually feel it in their breast, so they are encouraged to be screened for tumors by a mammogram. Mammograms are designed to detect any type of disease before a person even begins to feel it.

Breast cancer is the most common "malignancy" that affects women in America and throughout Europe. Every single woman is at risk of getting breast cancer and almost 200,000 cases of were said to be diagnosed in the United States in 2001. It is the second highest cause, behind lung cancer, of cancer deaths among women in North America.

The types of risk factors for breast cancer are divided into two types, those you can't change and those you can change. The factors associated with increasing your risk of breast cancer that your can't change include: just being a woman, getting older, or having some type of family history or a relative with breast cancer. Other risk factors are having your menopause late, having children past the age of thirty, or contracting a genetic mutation that would somehow increase your risk.

Certain types of risk factors that you can change are:

- not taking hormone replacement therapy (HRT), which means that long term uses of estrogens for menopause symptoms does in fact slightly increase your risk.

- stopping the use of birth control pills, because it is noted that ten years following the cessation of The Pill, a woman's risk of breast cancer reverts to what it would have been if she had not used this form of birth control.

However, neither of these risks are as significant as the ones that are associated with your gender, age, and family history.

All the factors are based on probabilities, and that means that a person without any of those mentioned is still subject to developing breast cancer and the best way to be sure is to get the proper screening and detection for breast cancer development.

There are preventative measures that can be taken, up to a point. It is noted that a drug called Tamoxifen is not used widely as a prevention, but it has been proved to be helpful in some cases. There is also a limited amount of data that suggests that Vitamin A may be useful in the prevention of breast cancer, but further research is needed to prove this.

The most important step for a woman to prevent breast cancer is to schedule regular checkups, screenings and mammograms, learn how to perform her own exams, and also to acquire all the information she can about the subject.

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