|
There are various treatment options available for different types and stages of breast cancer. Treatment options explained here are broken down into external therapy
and systemic therapy. Your physician will determine the most appropriate therapy for you.
Surgery
Your physician will determine which surgical option is best for you depending on the size and stage of the tumor. Types of surgery include:
| • |
Lumpectomy—only cancerous tissue and a small amount of surrounding tissue are removed |
| • |
Partial mastectomy (wide excision)—more of the tissue surrounding the tumor is removed than in
a lumpectomy |
| • |
Quadrantectomy—one fourth of the breast is removed |
| • |
Mastectomy—removal of the entire breast and some surrounding tissue |
| • |
Lymph node surgery—this surgery is the only way to determine if the cancer has spread to the
lymph nodes and possibly to other parts of the body: |
| |
— |
Sentinel lymph node dissection (SLND)—a dye is injected into the cancer site during surgery and traced to locate
the first axillary lymph node that receives drainage from the breast. This lymph node is removed and examined for cancerous
cells. If cancerous cells are not present, the cancer probably has not spread to other tissues |
| |
— |
Axillary lymph node dissection (ALND)—if it is likely that the cancer has spread to the lymph nodes, an ALND
will be performed to remove all or some of the lymph nodes in the armpit |
After surgery, the surgery site will be bandaged, and you may have drainage tubes from the surgery site to remove any fluid that collects as you heal. Your doctor
can give you specific instructions about caring for the wound and managing your pain following surgery.
Radiation therapy
Radiation therapy utilizes radioactive
energy to destroy or shrink tumor cells. Radiation may be used to shrink tumor size before surgery, but it is more commonly used following breast cancer surgery to eliminate
any cancer cells that may have escaped removal. Radiation treatments are generally administered 5 days a week for about 6 weeks, depending on the area of the body being radiated
and the goal of the radiation treatments.
Because advances in radiation therapy allow for more accurate targeting of the tumor site, the incidence of side effects has been greatly reduced. Over time, patients
receiving radiation therapy sometimes feel more tired, particularly late in the day. Patients may also notice a darkening, thickening, or increased sensitivity of the skin in
the area receiving therapeutic doses of radiation.
Systemic therapy—including chemotherapy and hormone
therapy—refers to any therapy that is taken orally or intravenously and travels through your entire body. Systemic therapy is generally given after surgery
(adjuvant therapy) to help destroy any remaining cancer cells in the body.
Chemotherapy
Chemotherapy refers to certain cancer drugs that may be given intravenously or orally
and are carried throughout the body via the bloodstream. Chemotherapy drugs work by either preventing the cancer cell from dividing or “starving” the cell to death.
Because chemotherapy drugs work in different ways, physicians commonly use them in combination to help attack the cancer cells from different angles. Chemotherapy drugs are usually
given for 1 or more days every 3 to 4 weeks with intervals for recovery. Generally, chemotherapy treatment may continue for 3 to 6 months.
Although chemotherapy drugs are very effective in killing cancer cells in the body, they may also damage normal cells. Certain cells in the body are more sensitive
to the damaging effects of chemotherapy drugs. This may lead to some of the common side effects associated with chemotherapy, including nausea, vomiting, fatigue, mouth sores,
and hair loss.
Hormone therapy
The hormone estrogen can promote
the growth of some breast cancers. Many types of breast cancer cells are dependent on estrogen to grow and divide and are referred to as estrogen-receptor positive (ER positive).
Breast cancer cells that are not sensitive to estrogen are referred to as estrogen-receptor negative (ER negative). Once estrogen is bound to the estrogen receptor,
a chemical signal is sent to the breast cancer cell telling the cell to divide, leading to growth of the cancer.
(Fig. 1)
The goal of hormone therapy in breast cancer is to stop or slow down cancer growth by reducing the amount of estrogen in the blood or preventing it from binding
to the cellular estrogen receptor.
SERMs
Selective estrogen receptor modulators (SERMs), such as Nolvadex® (tamoxifen
citrate) and FARESTON® (toremifene citrate), are drugs that act as antiestrogens in the breast. Because
they bind to the estrogen receptors, they effectively block estrogen from binding (Fig 2). This prevents cancer cells from growing and dividing and results in tumor shrinkage.
Side effects of SERM therapy include hot flashes, vaginal discharge, and sweating.
Although tamoxifen has demonstrated benefits in treating women with breast cancer, it has been shown to increase the risk of endometrial cancer. For women who are
currently taking or have previously taken tamoxifen, it is particularly important to report any unusual vaginal bleeding to your doctor.
Oophorectomy
Because the ovaries are a woman’s main source of estrogen, removal of the ovaries—or oophorectomy—reduces
the overall amount of estrogen in the body. This treatment is limited to premenopausal women whose ovaries are still producing estrogen.
Aromatase inhibitors
In postmenopausal women, androgens are produced by the adrenal glands and the ovaries. Aromatase
inhibitors work by blocking the enzyme, aromatase, which is responsible for producing estrogen from androgens in peripheral tissues such as adipose tissue (fat).
Currently, there are 3 aromatase inhibitors approved for marketing in the United States—Femara® (letrozole), Arimidex® (anastrozole), and Aromasin®
(exemestane). Because aromatase inhibitors reduce estrogen production and levels in the body, this may lead to osteoporosis (loss of bone density) and bone fractures. Other
side effects may include hot flashes, fatigue, nausea, and pain.
LH-RH agonists
Luteinizing hormone-releasing hormone (LH-RH) agonist drugs are synthetic forms of a hormone. They turn off estrogen production
by the ovaries in premenopausal women. LH-RH agonists are given in addition to surgery and other treatments, such as chemotherapy or radiotherapy, and may lower estrogen levels
to those of postmenopausal women. Zoladex® (goserelin acetate) is an example of such a drug. The most commonly reported side effects with Zoladex include hot flashes,
sweating, headache, mood changes, and loss of sex drive.
Arimidex® (anastrozole), Nolvadex® (tamoxifen citrate), and Zoladex® (goserelin acetate) are registered trademarks of the AstraZeneca group of companies.
Aromasin® (exemestane) is a registered trademark of Pharmacia Corporation.
Femara® (letrozole) is a registered trademark of Novartis Pharmaceuticals.
Prescribing Information
Important Safety Information
Online Privacy Policy
Home • About FARESTON® • Living
With Breast Cancer • Support Groups • Contact Us
FARESTON® is a registered trademark in the U.S. of GTx, Inc.
© 2006 GTx, Inc. Memphis, TN 38163
While GTx, Inc. makes reasonable efforts to include accurate, up-to-date information on this site, GTx, Inc. makes no warranties or representations as to its accuracy. GTx, Inc. assumes no liability for any errors or omissions in the content of this site.
|
