What are the most common treatments for breast cancer?
What are the most common treatments for breast cancer?All women with breast cancer should consult with a medical oncologist to determine their specific treatment needs. There are two main types of breast cancer treatment: local and systemic. Surgery and radiation therapy are local treatments. Chemotherapy and hormone therapy are systemic therapies. Local and systemic treatments are usually used together to provide the best chance of recovery.
What are the different types of surgery?There are two main types of surgeries for breast cancer: breast conserving surgery and mastectomy. With breast conserving surgeries, the surgeon tries to spare and preserve as much of the breast tissue as possible. The surgeon will remove the breast cancer, some normal tissue around it and usually some of the lymph nodes in the underarm. With a mastectomy, the entire breast is removed.
Which surgery is best for you?Ask your surgeon which surgery options are best for you and why. You may want to consider a second opinion if you have several surgical options. Think about what treatments you are willing to undergo. For example, if you do not want radiation therapy, then breast conserving surgery may not be the best option for you. Research has shown lumpectomy with radiation therapy and mastectomy to be equally effective treatments for early stage breast cancer.
After a mastectomy, can I have my breast reconstructed?Breast reconstruction can help restore the look and feel of the breast that was removed during a total mastectomy. Done by a plastic surgeon, breast reconstruction can be completed during the total mastectomy surgery or some time after the surgery. When a woman decides to have reconstruction depends on her wishes and the specifics of her situation. She should discuss her options with her surgeons, medical and radiation oncologists.
What is radiation therapy?Radiation therapy (also called radiotherapy) is the use of high-energy rays, usually X-rays, to kill cancer cells. Radiation is very effective in killing fast growing cells like breast cancer. Some healthy cells are also damaged during radiation therapy, but these can recover. Sometimes radiation is given before surgery to shrink tumor cells. But most often it's given after surgery to stop the growth of any cancer cells that may remain.
What are the side effects associated with radiation therapy?Radiation therapy may involve several side effects, but there are things that an individual can do to relieve these side effects. Common side effects include skin irritation and redness, breast changes or swelling, fatigue, dry cough or difficulty swallowing and lymphedema. Remember, your doctors, nurses, family and friends can help you cope with the different types of side effects.
What is chemotherapy?Chemotherapy is the use of anti-cancer drugs to treat cancer. It can be used to treat cancer by stopping the growth of cancer by killing cancer cells that have spread to other parts of the body. Chemotherapy is given after surgery (called adjuvant chemotherapy) or before surgery (known as neoadjuvant chemotherapy) to reduce the risk of breast cancer returning.
What are the side effects associated with chemotherapy?Side effects from chemotherapy depend on what drug or combination of drugs is used. The severity of these side effects will vary from person to person. Some of the most common side effects include nausea and vomiting, hair loss, early menopause and fatigue. Other possible side effects include infections, mouth and throat sores and weight gain. Remember, chemotherapy can greatly reduce the chances of breast cancer returning. The side effects are temporary and the management of these side effects has greatly improved in recent years.
What is hormone therapy?When a woman is diagnosed with breast cancer, tests are done to determine if the cancer is positive for estrogen and progesterone receptors. These receptors are the parts of a cancer cell that attract estrogen or progesterone. If a cancer is found to have these receptors, hormone therapy is recommended as an adjuvant therapy to help prevent the spread or recurrence of breast cancer.
There are several types of hormone therapy. The first type involves the use of prescription drugs, such as tamoxifen. These drugs attach to the estrogen receptor inside the breast cancer cells and prevent your natural hormones from stimulating cancer cell growth. Another type of hormone therapy involves stopping the ovaries from producing estrogen, the hormone that may promote breast cancer growth. If the ovaries are removed, or their function turned off with a hormonal treatment, then these hormones cannot be produced. A third class is the aromatase inhibitors which prevent fat and muscle cells from producing estrogen in postmenopausal women.
What is tamoxifen?Tamoxifen (brand name, Nolvadex) is a drug used to treat breast cancers that rely on estrogen for growth. Some breast cancers need estrogen to grow. Estrogen enters the breast cancer cells and promotes growth. When tamoxifen is used, it also enters the cancer cells and blocks estrogen's ability to promote tumor growth. Tamoxifen is prescribed for women who have estrogen or progesterone receptor positive breast cancer and for women who are at risk of developing breast cancer. Tamoxifen has been used as a treatment for breast cancer for over 20 years, but the FDA has approved it for use by women at higher risk.
What are the side effects of tamoxifen?The very common side effects of tamoxifen include hot flashes and common side effects include abnormal vaginal discharge. Uncommon side effects include fatigue, nausea, depression and loss of sex drive and rare side effects include headache, bloating and vaginal bleeding.
Tamoxifen also has four established long-term side effects. It slightly increases the chance of developing endometrial cancer (cancer of the uterus), blood clots in the large veins (deep venous thrombosis), blood clots in the lungs (pulmonary emboli), and cataracts (Fisher et al, 1998; NHRMC, 1996). While the prospect of such side effects can be frightening to some women, the risk of experiencing any one of them is very small and is far outweighed by the benefits of treating the cancer.
What are the benefits of tamoxifen?In addition to its effectiveness in treating breast cancer, tamoxifen also has other health benefits. Tamoxifen can:
What are aromatase inhibitors?Aromatase inhibitors like anastrozole (Arimidex), exemestane (Aromasin) and letrozole (Femara) are used in postmenopausal women to stop the conversion of certain hormones into estrogen. In doing so, these drugs lower the amount of estrogen that is in the body and available to a hormone-receptor positive tumor. Aromatase inhibitors are currently used for the treatment of metastatic breast cancer and are being studied for the treatment of early breast cancer.
How do I find a doctor/breast surgeon?Finding a good doctor to work with you is the best way to decide what treatments are right for you. Most insurance plans will provide you with a list of doctors to choose from. All women with breast cancer should talk with a medical oncologist to determine their specific treatment needs
How can I receive financial assistance for breast cancer treatment?Financial assistance for the treatment of breast cancer can come from several places. The U.S. government has several programs which help patients pay for medical treatment, including Aid to Families with Dependent Children, Medicare, Medicaid and the Hill-Burton Program. Also, local Komen Affiliates, the American Cancer Society and your local hospital, community organization, and/or cancer support organization may be able to provide some financial assistance.
Where can I find a breast cancer support group?Ask your doctor, oncology nurse or hospital social worker about breast cancer support groups within your community. Also, contact your local chapter of the American Cancer Society or a major hospital/cancer center and ask about support groups in your area.
How can I help my friend/family member who has cancer?Helping a friend or family member who has cancer can be as easy as writing a letter of support, cooking a meal for them or offering to drive them to the doctor. Let that friend or family member know that you are ready and willing to help them by asking that person how they would like you to help. Simply asking, "What can I do for you today?" may be the best way you can help and support a friend or family member with cancer.
What are clinical trials?Clinical trials are carefully controlled research studies conducted with actual patients. These studies test the safety and potential benefits of new treatments and the effectiveness of new ways to diagnose or prevent disease, and identify risks of a specific drug or treatment that may not yet be known.
Why are clinical trials conducted?Clinical trials produce scientific advances in breast cancer prevention, detection, treatment and care. Clinical trials advance care beyond the best that is currently available. Clinical trials have been responsible for many advances in breast cancer treatment, such as lumpectomy, the use of tamoxifen and screening mammography.
What are the different phases of clinical trials?There are three phases of clinical trials:
Phase I: Tests to see if a treatment is safe for humans and looks for early signs of effectiveness
Phase II: Tests to see if the treatment works against breast cancer
Phase III: Compares the effectiveness of the new treatment against a standard treatment
What is informed consent?This form describes all the facts about the study including details about the treatment and tests you may receive and the possible risks and benefits. It is important that you read this form carefully and ask either the doctor or nurse if you have any questions or concerns. Remember, you can leave the study at any time if you feel it is no longer in your best interest to participate. Before you decide to take part in a clinical trial, you should know as much as possible. Ask your medical doctor for more details on the trial, such as: