Breast cancer treatment and hospitals

The mainstay of breast cancer treatment is Surgery. Adjuvant Hormonal therapy (with tamoxifen or an aromatase inhibitor) is given when the tumor expresses estrogen receptors or progesterone receptors. Chemotherapy is given for more advanced stages of disease. Monoclonal antibodies are sometimes used, especially for HER2-positive tumors. Radiotherapy is given after Surgery to the region of the tumor bed, to destroy microscopic tumors that may have escaped Surgery. Treatments are constantly being evaluated in randomized, controlled trials, to evaluate and compare individual drugs, combinations of drugs, and surgical and radiation techniques. The latest research is reported annually at scientific meetings such as that of theAmerican Society of Clinical Oncology and St. Gallen, Switzerland. These studies are reviewed by professional societies and other organizations, and formulated into guidelines for specific treatment groups and risk category.

In planning treatment, doctors can also use PCR tests like Oncotype DX or microarray tests that predict breast cancer recurrence risk based on gene expression. In February 2007, the first breast cancer predictor test won formal approval from theFood and Drug Administration . This is a new gene test to help predict whether women with early-stage breast cancer will relapse in 5 or 10 years, this could help influence how aggressively the initial tumor is treated.

Radiation therapy is also used to help destroy cancer cells that may breast cancerlinger after Surgery. Radiation can reduce the risk of recurrence by 50-66% (1/2 – 2/3rds reduction of risk) when delivered in the correct dose.

Planning Your Treatment

After a breast cancer diagnosis, you and your doctors will put together a treatment plan specific to your situation, based on your pathology report. Your treatment plan will be made up of one or more specific treatments that are intended to target the cancer cells in different ways and reduce the risk of future breast cancer recurrence. You and your doctor will base your treatment decisions on YOUR unique situation, including consideration of your overall medical condition and your personal style of making decisions. You may have to re-evaluate your decisions periodically. Your medical team will be your guide.

Surgery

Surgery is usually the first line of attack against breast cancer. This section explains the different types of breast cancer Surgery.

Decisions about Surgery depend on many factors. You and your doctor will determine the kind of Surgery that’s most appropriate for you based on the stage of the cancer, the “personality” of the cancer, and what is acceptable to you in terms of your long-term peace of mind.

Chemotherapy

Chemotherapy is a systemic therapy; this means it affects the whole body by going through the bloodstream. The purpose of Chemotherapy and other systemic treatments is to get rid of any cancer cells that may have spread from where the cancer started to another part of the body.

Chemotherapy is effective against cancer cells because the drugs love to interfere with rapidly dividing cells. The side effects of Chemotherapy come about because cancer cells aren’t the only rapidly dividing cells in your body. The cells in your blood, mouth, intestinal tract, nose, nails, vagina, and hair are also undergoing constant, rapid division. This means that the Chemotherapy is going to affect them, too.

Still, Chemotherapy is much easier to tolerate today than even a few years ago. And for many women it’s an important “insurance policy” against cancer recurrence. It’s also important to remember that organs in which the cells do not divide rapidly, such as the liver and kidneys, are rarely affected by Chemotherapy. And doctors and nurses will keep close track of side effects and can treat most of them to improve the way you feel.

Radiation therapy

Radiation therapy — also called radiotherapy — is a highly targeted, highly effective way to destroy cancer cells in the breast that may stick around after Surgery. Radiation can reduce the risk of breast cancer recurrence by about 70%. Despite what many people fear, Radiation therapy is relatively easy to tolerate and its side effects are limited to the treated area.

Your radiation treatments will be overseen by a radiation oncologist, a cancer doctor who specializes in Radiation therapy.

Hormonal Therapy

Hormonal therapy medicines treat hormone-receptor-positive breast cancers in two ways:

  • by lowering the amount of the hormone estrogen in the body
  • by blocking the action of estrogen in the body

Most of the estrogen in women’s bodies is made by the ovaries. Estrogen makes hormone-receptor-positive breast cancers grow. So reducing the amount of estrogen or blocking its action can help shrink hormone-receptor-positive breast cancers and reduce the risk of hormone-receptor-positive breast cancers coming back (recurring).

Hormonal therapy medicines are NOT effective against hormone-receptor-negative breast cancers.

There are several types of Hormonal therapy medicines, including aromatase inhibitors, selective estrogen receptor modulators, and estrogen receptor downregulators.

In some cases, the ovaries and fallopian tubes may be surgically removed to treat hormone-receptor-positive breast cancer or as a preventive measure for women at very high risk of breast cancer. The ovaries also may be shut down temporarily using medication.

It’s important to know that Hormonal therapy IS NOT hormone replacement therapy (HRT). HRT isn’t used to treat breast cancer. HRT is taken by some women to treat troublesome menopausal side effects such as hot flashes and mood swings.

Targeted Therapies

Targeted cancer therapies are treatments that target specific characteristics of cancer cells, such as a protein that allows the cancer cells to grow in a rapid or abnormal way. Targeted therapies are generally less likely than Chemotherapy to harm normal, healthy cells. Some targeted therapies are antibodies that work like the antibodies made naturally by our immune systems. These types of targeted therapies are sometimes called immune targeted therapies.

There are currently 3 targeted therapies doctors use to treat breast cancer:

Herceptin

Herceptin (chemical name: trastuzumab) works against HER2-positive breast cancers by blocking the ability of the cancer cells to receive chemical signals that tell the cells to grow.

Tykerb

Tykerb (chemical name: lapatinib) works against HER2-positive breast cancers by blocking certain proteins that can cause uncontrolled cell growth.

Avastin

Avastin (chemical name: bevacizumab) works by blocking the growth of new blood vessels that cancer cells depend on to grow and function.

Complementary & Holistic Medicine

The goal of complementary medicine is to balance the whole person — physically, mentally, and emotionally — while conventional medicine does its work. For many people diagnosed with breast cancer, complementary medicine has helped to:

  • relieve symptoms
  • ease treatment side effects
  • improve quality of life

Researchers are working to better understand the value and benefit of complementary medicine in breast cancer.

In this section, you can read:

What Is Complementary Medicine?

Learn about how complementary medicine works, points to consider, and costs associated with complementary techniques.

Types of Complementary Techniques

Explore a wide range of complementary therapy techniques — from acupuncture and yoga to prayer, music therapy, and massage.

The Healing Benefits

Discover how complementary therapies can help you manage the physical and emotional symptoms of breast cancer.

Is Complementary Medicine Safe and Effective?

Learn about the treatment standards, safety testing, and potential side effects associated with complementary medicine.

Finding a Practitioner

How do you tell if a complementary medicine practitioner is reputable? Learn how to find a skilled practitioner and what questions to ask before starting treatment.

Talking to Your Doctor

Learn how to discuss complementary medicine with your doctors and nurses.

What Doctors and Patients Say About Complementary Medicine

Hear from women who have used complementary therapies and doctors who recommend them.

Resource Guide

Get a list of trusted websites and books where you can learn more about complementary medicine and a list of places to find a skilled complementary medicine practitioner.

Clinical Trials

Clinical trials are research studies in which people agree to try new therapies (under careful supervision) in order to help doctors identify the best treatments with the fewest side effects. These studies help improve the overall standard of care.

Today, fewer than 5% of breast cancer patients receive treatment for their disease in a clinical trial. Why? One factor is that information about current trials and how to enroll in a trial are often not well understood. In this section, you can learn more about what clinical trials involve and how to join one.

Breast cancer hospitals – Breast cancer Centers

www.breastcancer.org