All breast cancer treatments are focused on two main goals which are to eliminate cancer from the body as much as possible and also prevent it from coming back. Amongst all the treatment options available for breast cancer, which one to opt for is basically governed by three major factors:
- Size of tumor and how much it has spread
- If there are “receptors” for HER2, protein, estrogen or progesterone present in the tumor or not
Other factors such as age, whether the person has gone through menopause or not, other health conditions and personal preferences also play a very important role in deciding which treatment method to opt for.
What are the various types of Breast Cancer Treatment?
- Surgery: This includes either removing the whole breast called Mastectomy or just eliminating the tumor and the tissues around it which is called Lumpectomy or Breast-Conserving Surgery.
- Radiation Therapy: In this method, cancerous cells are eliminated through high energy beams.
- Chemotherapy: Highly potent medication is used to kill the cancer cells present. Major side effects include nausea, hair loss, early menopause and fatigue.
- Hormone Therapy: Hormones like estrogen which can easily trigger the growth of tumor cells is prevented through various medications. Medicines include Tamoxifen, aromatase inhibitors like anastrozole (Arimidex), exemestane (Aromasin) and letrozole (Femara). Fulvestrant (Faslodex) is an injection used to stop estrogen from attaching to cancer cells.
- Targeted Therapy: This includes prompting the body’s immune system to destroy cancerous cells. The breast cancer cells which have high levels of HER2 protein are targeted by this treatment method.
Chemotherapy, Hormone Therapy or Targeted Therapy is used along with surgery or radiation therapy to remove the presence of cancer cells as much as possible.
Treating Cancer with Chemotherapy:
Chemotherapy helps in removing tumor cells in three ways:
- Shrinking the size of the tumor to be later removed by surgery is known as neoadjuvant therapy.
- Eliminating the whole group of cancerous cells from other parts of the body.
- Preventing cancer from occurring again after surgery and radiation therapy. When used in this manner it is termed as adjuvant therapy.
Drugs used in chemotherapy can be broadly classified into major categories:
- Anthracyclines: this includes doxorubicin (Adriamycin) and epirubicin (Ellence).
- Taxanes: this includes docetaxel (Taxotere) and paclitaxel (Taxol).
Chemotherapy is either given in the form of pills or injected into the veins of an individual. There could be a single drug used for this or a combination of them. Major side effects of this method are nausea or vomiting, loss of appetite, hair loss, weight gain, and fatigue.
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High beam radiation is targeted at cancer cells to prevent them from growing or spreading to other parts of the body. The best part about this method is that it causes less damage to the healthy cells as only cancerous cells are targeted.
Different types of radiation therapy used are:
- External Beam Radiation: it is the most commonly used method in which a machine radiating a defined radiation beam is projected on the affected part of the body.
- Proton Therapy: Energy from Protons is radiated in the form of the external beam to destroy the DNA of the cancer cells to prevent them from dividing and growing.
- Brachytherapy: highly targeted radiation is delivered to the tumor through something implanted in your body.
Major side effects of radiation therapy are hair loss, sensitive and red skin, swollen breast, fatigue, changes in the appearance or texture of treated area and less sweating from the treated area.
Also called biological therapy, this therapy is intended at utilizing the body’s immune system or hormonal system. It prompts the immune system to destroy the cancerous cells by either killing these cells or prevent them from spreading. Antibiotics are used for this purpose, originally they are made by white blood cells but can be manufactured in the lab and given as a medicine.
A protein called Human Epidermal Growth Factor Receptor 2 (HER2), found in the long arm of the human chromosome, promotes the growth of cancer cells. In most cases of breast cancer, the gene mutation of cancer cells produces excessive of HER2 protein and thus breast cancer is termed as “HER2-positive”.
- Transtuzumab (Herceptin) is a commonly used medication to treat this type of breast cancer. It is a lab manufactured antibody and helps in curing cancer by either triggering the immune system to destroy the cancer cells or sticking to the tumor and stopping it from growing.
- Pertuzumab is another kind of antibody used to treat HER2 positive breast cancer. It can be harmful to the fetus so it is not prescribed to pregnant women.
- Lapatinib is a small molecule drug used along with chemotherapy to treat advanced and more peculiar cases of HER2 positive breast cancer.
If your breast cancer is “HER2 negative”, then different treatments are used in which medicine prescribed is everolimus (Afinitor) with exemestane (Aromasin).
Possible side effects of Biological therapy include dizziness, weakness, allergic reactions, rashes, diarrhea, and fever.
What are the different treatment options available for various stages of Breast Cancer?
- Stage 0 Breast Cancer: If the abnormal cells are present in the breast ducts (i.e. Ductal Carcinoma In Situ), then it can be treated by surgery (either lumpectomy or mastectomy) followed by radiation therapy or hormone therapy to lower the risk of reoccurrence of cancer.If the tumor appears only in the lobes of breasts( i.e. Lobular Carcinoma In Situ), it is treated by a double mastectomy and hormone therapy to prevent cancer from being invasive.
- Stage 1 Breast Cancer: Surgery is the standard approach to cure this stage of cancer followed by radiation therapy to eliminate the cells that were missed. A chemotherapy procedure can also follow to reduce the chances of cancer coming back.
- Stage 2 Breast Cancer: Surgery followed by radiation therapy and chemotherapy is the medication method used for this stage of cancer. At times, chemotherapy is done before the surgery to reduce the size of the tumor and then lumpectomy is preferred.
- Stage 3 Breast Cancer: At this stage, the tumor has already spread to nearby lymph nodes of the breast and chemotherapy is the common treatment used to reduce the spread of cancer cells and then surgery is conducted to remove the tumor and the affected lymph nodes as well.
- Stage 4 Breast Cancer: Chemotherapy in combination with hormone therapy is used to control the growth of cancerous cells.
Can The Cancer Once Treated Recur?
Recurrence of cancer is possible in three ways:
- Local Recurrence: if it appears at the original site.
- Regional Recurrence: if cancer occurs again in nearby areas such as the chest.
- Distant Recurrence: also called metastasis, tumor, in this case, has spread to different parts of the body such as bone marrow, lungs or other lymph nodes.
Studies show the recurrence of breast cancer is more prominent in women who had cancer in lymph nodes of underarms, a large tumor or aggressive type of tumor.
Tests conducted in case of recurrence start with biopsy followed by additional tests which include X-rays, CT scan, blood test, PET scan, and an MRI. Treatment is dependent on whether the tumor which has reappeared is local, regional or distant.
Tags: Breast Cancer Treatment Radiation, Options For Breast Cancer Treatment, Breast Cancer Treatment For Stage 1, Breast Cancer Treatment For Stage 2
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