Breast Cancer Treatment Options - OmniMedicalSearch.com

Conditions & Diseases: Cancers

Breast Cancer

Treatment Options

The treatment plan can differ from patient to patient, from a breast cancer type to another and from a breast cancer stage to another. The treatment goal for breast cancer in stage I, II and III is to cure the cancer and prevent a recurrence either in the original location of the tumor or anywhere else within the body. The treatment goal for cancer in stage IV is symptom improvement and prolonged survival. Most breast cancer types in the last stage cannot be cured.

Local Therapy
Local therapy is used to treat the tumor without affecting the rest of the body. Surgery and radiation therapy is included in this category.

Surgery: Operation for the treatment of local tumors include 1). breast-conserving surgery and .2) mastectomy.

(1) Breast-conserving surgery includes lumpectomy - a medical procedure that removes only the breast lump and the surrounding margins of normal tissue and partial or segmental mastectomy or quadrantectomy - a procedure that removes more breast tissue than lumpectomy.

(2) Masectomy. There are three types of masectomies:

Simple or total masectomy, when the entire breast including the nipple is removed, but not the axillary lymphatic nodes or muscle tissue from beneath the breast.
Modified radical mastectomy, when the entire breast and some axillary lymph nodes are removed
Radical mastectomy, an extensive procedure when the entire breast, axillary lymph nodes and pectoral (chest wall) muscle under the breast are removed.

Radiation Therapy:
Radition therapy is a treatment type that uses high-energy rays or particles that destroy the cancer cells. There are two types a radiation therapy: 1). external beam radiation and 2). internal radiation.

External beam radiation is an extreme use type of radiation therapy. The radiation is delivered from an external device and focuses on the affected area (usually the whole breast or if the cancer is extended to nearby areas may include the chest wall and underarm area). The main side effects of this therapy are: swelling and heaviness in the breast, sunburn-like skin changes in the treated area, and fatigue.
Internal radiation or brachytherapy is based on the same purpose, to kill the cancer cells. In this case the radiation device is placed inside the body into the breast tissue closer to the cancer.

Systemic Therapy
Systemic therapy involves a treatment received through an oral or IV medication to reach and destroy the cancer cells that may have spread beyond the breast region. Systemic therapy includes: chemotherapy, hormone therapy and immunotherapy.

Chemotherapy
Chemotherapy is a treatment option where cancer-killing drugs are administered intravenously or orally. These drugs move through the bloodstream and are carried into different areas of the body and destroy the cancer cells. Chemotherapy treatment has a specific cycle whereby each treatment period is followed by a recovery period. A typical chemotherapy treatment lasts between 3 to 6 months. Chemotherapy that follows a breast conservation therapy or masectomy is called adjuvant therapy and its role is to reduce the risk of breast cancer recurrence. If the chemotherapy is used as the main treatment option and is administrated before the surgery, it is called neoadjuvant therapy. The advantage of this chemotherapy type is that is shrinks the tumor in small fragments that can later removed through a lumpectomy procedure.

Chemotherapy has several side effects that depend on the type of drug administrated, the drug amount, and the length of treatment. The most frequent side effects of chemotherapy are nausea, vomiting, fatigue, loss of appetite, loss of energy and mouth soreness. The menstrual cycle can be temporarily or permanently affected by chemotherapy. Some other side effects of chemotherapy are damage to the blood-producing cells of the bone marrow, an increased chance of infection, and bleeding or bruising after minor cuts or injuries.

Hormone Therapy
About two thirds of breast cancers containing estrogen or progesterone receptors are caused by the hormone called estrogen. Estrogen is produced by the ovaries until menopause. This hormone will continue to be present in a woman's body after menopause because a testosterone-like hormone produced by the adrenal gland is converted into estrogen mostly into the fat tissues of the body. Hormone therapy is trying to block the estrogen effect and to reduce the estrogen level.

There are several hormone therapy options:

Tamoxifen administration: Tamoxifen is an anti-estrogen drug administrated orally as a pill. Tamoxifen's advantages:

Reduces the chances of cancer recurrence to 50% in early cancer stages for those type of cancers that contain estrogen or progesterone receptors - if administrated after the surgery for a 5 years period.
Is used in the metastasic breast cancer treatment.
Is used to prevent cancer in high risk patients.

The main disadvantages of the Tamoxifen's treatment is the increasing risk of developing cancer of the lining of the uterus and uterine sarcoma, a rare cancer of the connective tissue of the uterus.

This treatment side effects include: vaginal bleeding, blood clots, weight gain, hot flashes, vaginal discharge and mood swings.

Aromatase inhibitors treatment: Aromatase inhibitors are a group of three drugs that stop the estrogen production for postmenopausal women. These three drugs that were approved to be used in early and advanced breast cancer treatment are: (1) letrozole (Femara), (2) anastrozole (Arimidex), and (3) exemestane (Aromasin). The role of these drugs is to block an enzyme that is responsible for producing small amounts of estrogen in postmenopausal women.

Raloxifene administration: Raloxifen is an anti-estrogen drug that blocks the estrogen effect on the breast tissue and breast cancer. This drug is not recommended for women that have already been diagnosed with breast cancer. Clinical trials are currently trying to test if this drug can decrease the risk of breast cancer in women who are most susceptible to breast cancer.

Toremifene administration: Toremifene is another anti-estrogen drug that can be a treatment option for postmenopausal women with breast cancer that has metastasized. Toremifene is also used for treating tumors that are estrogen-receptor positive or whose estrogen receptor status is unknown.

Fulvestrant administration: Fulvestrant is a recent hormone therapy drug used to eliminate the estrogen receptors. It is administrated by injection once a month to female patients that are in menopause and is effective for the treatment of breast cancer that is not no longer responding to tamoxifen treatment. The most common side effects of this treatment are hot flashes, mild nausea, and fatigue.

Ovarian ablation: Ovarian ablation is a procedure that implies estrogen removal. This is another effective treatment option for hormone-responsive breast cancer types. This can be done in two ways: (1) by surgery, when the ovaries are removed, or (2) by drugs like luteinizing hormone-releasing hormone (LHRH) analogs - goserelin or leuprolide. These drugs block the mechanism that cause ovaries to produce estrogen.

Megestrol acetate administration: Megestrol acetate is a hormone therapy option used in treating advanced breast cancer forms. It is also used for those female breast cancer patients that do not respond to other hormone treatments. A most common side effect of this treatment is weight gain and because of this, is sometimes used to reverse a drastic weight loss in patients with advanced forms of cancer.

Androgens administration: A hormone treatment with androgens is administrated for female patients who are in an advanced cancer stage and is considered as a possible treatment option when other hormone treatments were tried and failed. Androgens are male hormones that can cause masculine like side-effects to occur (more body hair and deeper voice).

Article by Alina Morrow, MS
Medical Writer,
OmniMedicalSearch.com

Sources:
http://www.cancer.org
http://www.healthline.com
http://www.breastcancer.org