- Treatments for Breast Cancer
- Surgical Operations Options
- Radiation Therapy
- Hormone Blocking Therapy
- Biological Therapy (Targeted Drugs)
Treatments for Breast Cancer
When it comes to treating breast cancer, a multidisciplinary team of specialists is necessary. There may be an oncologist, radiologist, highly specialized cancer surgeon, specialized nurse, pathologist, radiographer and reconstructive surgeon involved. Besides, occupation therapist, psychologist, dietitian and physical therapist may also be a part of the team. Of course, while deciding on what treatment a patient is to be provided with, the team will consider several things.
They are as follows:
- The type of breast cancer you’re dealing with.
- The stage and grade of the breast cancer as well. This implies understanding of how big the tumor is and whether it has affected any other organs inside your organism. If cancer has invaded any other areas, it’s important to know which ones exactly.
- They’ll need to know if cancer cells are sensitive to hormones.
- Your overall health condition.
- Your age so that to figure out if menopause is already over.
- The preferences of the patient.
Below you can see a list of possible breast cancer treatment procedures:
- Surgical operation.
- Hormone therapy.
- Targeted drug therapy.
Surgical Operations Options
- Lumpectomy – an operation when the tumor is removed together with a small area of healthy tissue that’s around it. This surgery is often referred to as breast-sparing. In case the tumor is not big and the surgeon assumes that it’s not hard to separate from the surrounding tissue, this is exactly this surgery that’s carried out.
- Mastectomy – implies that the breast will be removed. There are two types of this operation. Simple mastectomy is when the lobules, ducts, fatty tissue, nipple, areola and some skin as well are removed. Radical mastectomy involves the removal of chest wall muscle and the lymph nodes located in the armpit.
- Sentinel node biopsy – is a surgical operation during which only lymph node is removed. The crux of the matter is that if breast cancer has had impact on a lymph node, from there it can get to other areas of your body.
- Axillary lymph node dissection – is performed if cancer cells have been detected in the sentinel node. Apart from it, the surgeon may find it necessary to remove some lymph nodes in the armpit.
- Breast reconstruction surgery – includes several surgical procedures carried out with the view of recreating a breast thus making it look more alike the other breast. Moreover, this procedure is possible to carry out together with mastectomy. The surgeon is likely to use either a breast implant or tissue from another part of the patient’s body.
This is how it works – there are certain doses of radiation that aim at destroying cancer cells inside the tumor. As a rule, you start undergoing this procedure once the operation has been carried out. The same can be said about chemotherapy. The main goal of these two procedures is to get rid of any cancer cells that may still be alive inside your organism. Usually, a patient is recommended radiation therapy a month after the surgical operation or chemotherapy. There may be a necessity for a patient to undergo a three to six week course that implies three to five sessions per week. Keep in mind that the procedure is not that long, only several minutes.
While deciding on the type of radiation a patient needs, the doctors consider his or her breast cancer type. There are cases when there is no necessity for radiation at all.
Radiation types involve:
- Breast radiation therapy – a procedure that’s administered to the breast tissue left after lumpectomy.
- Chest wall radiation therapy is recommended to undergo after mastectomy.
- Breast boost implies that there will be a high-dose of radiation targeted at the area where the tumor was previously located. Note that the way your breast looks may change. This is especially true for those women who have large breasts.
- Lymph nodes radiation therapy means that radiation is directed to the armpit and its surrounding area. This way the cancer cells that have already managed to get to the lymph nodes are killed.
- Breast brachytherapy is a 5-day course that is recommended only after a patient has undergone lumpectomy. According to some researches, it may be advantageous to patients that deal with the early stage of breast cancer when the cancer hasn’t yet invaded the milk ducts. This therapy is carried out with the help of a strut-based applicator. Besides, the results of the researches prove that having undergone the therapy women then have lower risks of the disease reoccurrence as well as less and lighter side effects.
As for the side effects the therapy can cause, there may be fatigue, lymphedema, breast skin being irritated and darker than before.
These type of procedures involving cytotoxic drugs are used to destroy the cancer cells. A patient may be recommended them in case there exists a high risk of the disease reoccurrence or the cancer may invade other areas of your organism. There is a particular term – “adjuvant therapy” for it.
In case you’re dealing with big-size tumors, chemotherapy may be carried out even before the surgical operation. The main goal here is to make the tumor smaller so that it’s less difficult to remove it. Such like procedures are referred to as neo-adjuvant chemotherapy.
Doctors prescribe chemotherapy in case there occur metastases. This means that cancer has attacked other parts of your organism as well. Chemotherapy is beneficial if the aim is to make cancer symptoms lighter.
Besides, chemotherapy is advantageous if there is a need to stop the production of estrogen. The fact is that estrogen may contribute to the growth and development of some breast cancers.
There is a number of side effects chemotherapy may cause. The list of them includes nausea and vomiting, loss of appetite, feeling weak and tired, sore mouth, loss of hair and being a bit more susceptible to various infections. You can keep the majority of the mentioned side effects by using the necessary drugs your doctor is to prescribe. If a woman is over 40, one of the side effects may be menopause starting early.
Since it’s quite important for a woman to be able to get pregnant, scientists have found a way of treatment that has a lighter effect on the ovaries. Here, the cancer is subject to an aggressive attack using arsenic-based chemo drugs. There is a belief that the method will be quite successful in both – treating the cancer and keeping female patients fertile.
Hormone Blocking Therapy
This type of therapy is used only if breast cancer is sensitive to hormones. Doctors call such like cancers ER positive (meaning estrogen receptor positive) and PR positive (progesterone receptor positive). By making use of the drugs the doctors strive for preventing the recurrence of the disease. Keep in mind that in the majority of cases this therapy is to be undergone after surgery. However, there are case when it’s recommended to undergo before the surgical operation so that to make the tumor smaller.
If a patient has some health problems due to which it’s impossible to carry out a surgical operation or undergo radiation therapy and chemotherapy, hormone therapy treatment may still be received. Actually, hormone therapy will have no effect if the cancer is not susceptible to hormones it’s based on. A patient usually receives this therapy for up to 5 years after the surgical operation is carried out.
Below you’ll find a list of drugs used in hormone therapy and their descriptions:
- Tamoxifen – the main aim of this drug is to interrupt the binding of estrogen to ER positive cancer cells. As a result of taking the drug you may gain weight and your head may ache. There may be nausea, vomiting, hot flashes, weakness, ache in joints and changes in your periods.
- Aromatase inhibitors are usually prescribed to women who have had menopause. The drug blocks aromatase – a certain hormone that contributes to the production of estrogen once there has been a menopause. Before menopause, ovaries are responsible for the production of estrogen. Letrozole, exemestane and anastrozole all refer to the group of aromatase inhibitors. As for side effects, there may occur vomiting, nausea, weakness, rash on skin, headache, painful sensations in bones and joints, loss of libido, sweating and hot flashes.
- Ovarian ablation or suppression. At pre-menopausal stage, estrogen is being produced in the ovaries. If ovarian suppression occurs, the ovaries can no longer produce it. Ablation may either be done by carrying out a surgical operation or when undergoing radiotherapy. As a result, it’s impossible to make the ovaries function again and menopause occurs.
- – LHRHa or luteinizing hormone-releasing hormone agonist. Here a certain drug called Goserelin will put an end to the work of the ovaries. For a period of treatment, a patient will have no periods but, once it’ll be finished, they will start again. A woman just needs to stop taking the drug. If a woman is close to 50 years old, which is considered to be menopausal age, she’s likely to never have periods again. The most usual side effects involve change of mood, sleep disorder, sweating and hot flashes.
Biological Therapy (Targeted Drugs)
- Trastuzumab or Herceptin. These antibody targets kill cancer cells that are positive to HER2. It’s quite beneficial since there is a number of cancers that start the production of excess HER2 (growth factor receptor 2) inside your organism. Herceptin attacks the protein. However, there may be rash on your skin, head ache and even a slight damage to your heart.
- Lapatinib or Tykerb is the drug that doesn’t only attack the HER2 protein, but helps even in cases of advanced breast cancer as well. Tykerb is used only if there was no response on Herceptin. As for the side effects, there may be pain in hands and feet, rash on skin, sore mouth, feeling very tired, diarrhea, vomiting and nausea.
- Bevacizumab or Avastin. The drug that aims to stop the cells from invading new blood vessels. As a result, the drug is very good at depriving the tumor of nutrients and oxygen. The list of side effects includes congestive heart failure, high blood pressure, kidney and heart damage, blood clots, headache and sore mouth. Even though FDA doesn’t approve of it, the doctors may prescribe it to you off-label. However, there is still no exact answer on whether the drug is truly successful in fighting the disease. FDA claimed that taking Avastin will not only be useless in case of breast cancer, but it can also be quite dangerous.
- Low dose aspirin. According to the results of the research and tests on mice, taking low-doses of aspirin may stop the growth and invasion of breast cancer into other areas of your organism. However, you should know that even though the results give some perspective for future, it’s yet in the very beginning and, therefore, it’s too early for stating that it’s 100% effective.