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Types of therapies available |
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Surgery:2
Surgery is the most usual treatment for breast cancer. Surgery is again of two types, viz,
- Breast sparing surgery
- Mastectomy
Breast sparing surgery:
It is also called as lumpectomy. It is a method to remove the cancer from the breast and not the complete breast.
After lumpectomy, most women receive radiation therapy to the breast. This treatment destroys cancer cells that may remain in the breast.
Mastectomy:
Mastectomy is method in which the complete breast is removed or as much as the breast tissue possible. In most cases, the surgeon also removes lymph nodes under the arm.
Radiation therapy after surgery is a performed, if needed.
Both the methods, sparing surgery and mastectomy can be used for Stage I and Stage II breast cancer.
Radiation Therapy:2
Radiation therapy is a therapy which uses high-energy rays to destroy the cancer cells. Most women receive radiation therapy after lumpectomy . Some women receive radiation therapy after mastectomy.
Treatment depends on the size of the tumor and many other factors. The radiation destroys breast cancer cells that may remain in the area.
Some women have radiation therapy before surgery to destroy cancer cells so that the tumor size decreases. Doctors use this approach when the tumor is large or may be hard to remove.
Two types of radiation therapies are used to treat breast cancer:
- External radiation: The radiation comes from a large machine outside the body. Treatment period is usually 5 days a week for several weeks.
- Implant radiation: Implants that hold a radioactive substance are put directly in the breast. Implants stay in place for several days.
Side effects depend mainly on the dose and type of radiation that is used.
Chemotherapy:2
Chemotherapy for breast cancer is usually the use of drugs for treatment. Chemotherapy is a systemic therapy, because the drugs enter the blood stream and travels through the body.
It is used for multiple purposes; to shrink a tumor prior to surgery, to decrease the chance of recurrence after surgery, to prevent metastasis by killing any cell that may have moved from the original site of the Cancer or to decrease the chances of recurrence following surgery or any combinations of these three.
The drugs used in chemotherapy are cytotoxic- that is, they kill frequently dividing cells, both cancerous and noncancerous. These drugs kill cells by preventing them from dividing . But the bad story about chemotherapy is that, it also destroys other cells as well, like hair and bone marrow cells. Because of this, treatment has to be given in cycles like , the treatment period followed by a recovery period, then another treatment and so on.
Hormone Therapy:
There are certain hormones that can attach to the breast cancer cells and affect their ability to multiply. The purpose of hormone therapy is to add, block, or remove hormones.
The female hormones estrogen and progesterone can promote the growth of some breast cancer cells. So in these patients, hormone therapy is given to block the body's naturally occurring estrogen and fight the cancer's growth.
There are two types of hormone therapy for breast cancer.
- Drugs preventing estrogen and progesterone from promoting breast cancer cell growth.
- Drugs or surgery to stop the production of hormones from the ovaries.
Initially tests are done to determine if the breast cancer cells have estrogen or progesterone receptors. If so, it means that the growth of the cancer can be stimulated with these hormones. If a cancer is found to have these receptors, hormone therapy is recommended as part of the treatment design.
The common example of the drug of this class is Tamoxifen.
Targeted Therapy:
Targeted cancer therapies target specific characteristics of cancer cells. It mainly targets protein that makes the cancer cells to grow in a rapid or abnormal way. Targeted therapies are generally less likely than chemotherapy to harm normal or healthy cells.
Some targeted therapies are called immune targeted therapies. These therapies are antibiotics that works like the antibiotics made naturally by our immune system.
Current Targeted therapies used to treat breast cancer are as follows:
Herceptin
Its chemical name is Trastuzumab. Herceptin works against HER2-positive breast cancers. The mechanism by which it works is by hampering the ability of the cancer cells to receive chemical signals that signifies the cells to grow.
Avastin
Its chemical name is Tevacizumab. Avastin works by blocking the growth of new blood vessels that are essential for the cancer cells to grow and function.
Tykerb
Its chemical name is Lapatinib. Tykerb works against HER2-positive breast cancers. It works by blocking certain proteins that can cause uncontrolled cell growth.
For Complete Drug Information
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Complementary Medicines and Alternative therapies |
Complementary medicine covers a wide range of approaches, which includes various philosophies of healing and many type of therapies. Some therapies are termed as holistic.
Holistic means that good health involves wellbeing of all aspects of a person: physical, mental, spiritual and emotional.
Complementary medicine is used as a supplement along with the traditional medicine. When combined with the standard treatment, these medicines improve the quality of life. But it should be used with the knowledge and permission of the physician involved in standard treatment.
Few examples of complementary medicines include, Aromatherapy, Ayurvedic medicine, Yoga, Massage, Meditation, Reiki, Acupuncture, etc.
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Treatment According to Stages |
Stage 0:
Stage 0 is a is a precancerous condition. It includes two types of cancer:
Lobular carcinoma in situ:
Most women do not need treatment. But it needs frequent checkups as it can lead to invasive form of cancer.
Some treatment options:
- Hormone therapy with tamoxifen to lower the risk of developing cancer.
- Bilateral mastectomy -- the removal of both breasts -- is another option. Some women choose this approach because they are worried about getting cancer.
Ductal carcinoma in situ:
Surgery is a standard method. For small tumors, lumpectomy is chosen and for larger tumors mastectomy is chosen.
Radiation therapy is standard treatment after a lumpectomy.
Hormone therapy with tamoxifen after surgery may also help prevent cancer from developing in the same or opposite breast.
Stage 1:
Stage 1 breast cancers are small and have not invaded the lymph nodes or other parts of the body, the general treatments are breast-conserving surgery such as a partial mastectomy or lumpectomy. The choice of the type of surgery depends on the size and location of the tumor,the size of the breast and what the women feels about preserving her breast. If the stage 1 breast cancer is larger, and/or has spread to nearby lymph nodes, surgery and radiation therapy may be prescribed.
Stage 2:
Women with stage 2 breast cancer receive almost the same treatments as stage 1, however, adjuvant systemic therapy is recommended. Adjuvant systemic therapy may include “hormone therapy, chemotherapy, trastuzumab, or combination of these. Stage 2 patients may require chemotherapy and radiation therapy after surgery.
Stage 3:
Treatment for stage 3 breast cancer includes both local treatment as well as systemic treatment. Local treatment is to remove or destroy the cancer and systemic treatment is to stop the disease from spreading. Local treatment may include surgery or radiation therapy and systemic treatment may include hormonal therapy and chemotherapy or both. The sequence of the treatment may change accordingly.
Stage 4:
Stage 4 breast cancers have spread to other parts of the body. Stage 4 breast cancer is treated with chemotherapy or hormonal therapy to shrink the tumor. Surgery or radiation therapy may also be included to control the cancer in the breast.
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Side Effects16
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Some common side effects of the treatment are as follows:
Anemia:
It is mostly seen in patients treated with chemotherapy. Anemia can lead to fatigue which may affect the person’s quality of life.
Cardiac problems:
Some anticancer drugs can produce cardiac problems. Doxorubicin and Herceptin are two such agents.
Chemo-brain:
Some patients receiving chemotherapy as a part of their cancer therapy, can have trouble remembering names, places or events or may have trouble in concentrating. It is called as chemo-brain.
Fatigue:
Fatigue means extreme tiredness. It is the most common side effect of chemotherapy and radiation therapy.
Alopecia:
Alopecia is hair loss. This is a very common side effect of chemotherapy drugs.
Infections:
As the cancer in the body and the treatment for the same can weaken the immune system of the body, many infections may take lead.
Menopausal symptoms:
Approximately 40% of women with breast cancer develop menopausal symptom due to treatment with hormonal therapy and/or chemotherapy. It is thought to be caused due to decrease in estrogen and other hormones. These symptoms include hot flashes, vaginal dryness, pain during intercourse, insomnia and depression.
Peripheral neuropathy:
It is a side effect of some chemotherapy drugs. Symptoms of peripheral neuropathy are numbness and tingling in hands or feet, difficulty holding a cup or a glass, decreased sensation of hot or cold, muscle weakness, decreased hearing, ringing in ears, etc.
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