Cancer is one of major threats today and a huge population succumbs under its grasp everyday globally. Cancer in most cases is fatal and the treatment involves an extensive plan which also takes a toll on the health. But, in the recent past years several the number of cancer survivors have increased drastically igniting the ray of hope for all those fighting this dreadful disease.
Breast cancer is one of the most common cancers that occurs in the breast area and generally makes women its victim. Breast cancer is a malignant tumour which should be treated as early as possible to prevent the disease from spreading to other parts of the body. Breast Cancer Treatment depends on number of factors such as:
- Stage of the breast cancer
- Type of the breast cancer
- Patient health, age and preference
- Reactivity to hormones
Depending on the stage of the cancer and keeping other important factors in mind the entire treatment plan is devised. The most prominent breast cancer treatment includes:
- Radiation Therapy
- Hormone Therapy
- Biological Therapy
It is important to understand each type of treatment in detail to understand why and how it is incorporated in the treatment process.
Surgery is done on the patient to remove the breast cancer causing tumour from the body. There are various types of surgeries for removing tumour like:
- Lumpectomy (for eliminating breast cancer): This surgery is recommended to patients who have smaller tumours. The process involves eliminating the tumour and a small margin of healthy tissue around it to prevent the spread of the cancer. This surgery is not recommended for patients who have larger tumours.
- Mastectomy (eliminating the entire breast): This surgery involves removing the entire breast tissue. This includes removing the ducts, lobules, nipple, fatty tissue, areola, and some skin. Nipple-sparing mastectomy and skin-sparing mastectomy are mostly practiced operation for the breast cancer.
- Sentinel node biopsy (eliminating a limited number of lymph nodes): It is a surgical procedure to detect whether the tumour has spread beyond a primary tumour to the lymphatic system. If the breast cancer extends to a lymph node then the breast cancer can spread further. Therefore, eliminating the required lymph node can restrict the cancer from spreading,
- Axillary lymph node dissection (eliminating several lymph nodes): If there are cancer cells found in the sentinel lymph nodes, then the surgeon may recommend removal of several lymph nodes in the armpit to stop the spread of cancer.
- Reconstruction: In this surgery the surgeon can perform a breast surgery to reform the breast so that it looks similar to the other one. It can be done at the same time while performing a mastectomy, or at a later date. Breast implantation may be used, or tissue from another part of the patient’s body can also be used. Some patients with cancer in one breast may also choose to remove the other breast due to higher risk of cancer because of genetic predisposition.
Radiation therapy is practiced by using high powered beams of energy such as protons and X-rays to destroy cancer cells. A specific machine is used that focuses the energy rays at the body (external beam radiation). There are other methods in which radiation can be performed by placing radioactive material inside the body.
For chemotherapy, the doctor may prescribe anti-cancer drug that may be injected to the vein or prescribed to be inhaled. The drug mixes into the bloodstream to kill cancer cell. It is not recommended to everyone suffering from breast cancer. Chemo can also be advised in a lot of situations like after surgery (adjuvant chemotherapy), before surgery (neo adjuvant chemotherapy) or for advanced breast cancer. Chemotherapy comes with several side effects such as vomiting, nausea, fatigue, loss of appetite, sore mouth and many more.
Hormone Blocking Therapy
Doctors refer to hormone blocking therapy to treat the breast cancer either for blocking the production of the hormones or for blocking the hormones from working to prevent recurrence or spread of the disease. This therapy is suggested for patients whose tumours are positive for either progesterone (PR) receptor or estrogen (ER).It is mostly prescribed after surgery(adjuvant therapy) to reduce the risk of the cancer from coming back. This can also be performed prior to surgery to shrink the size of the cancer in the breast.
Medicines that are used to block hormones can be divided into the following two categories:
- Selective Estrogen Receptor Modulators (SERMs)
- Estrogen Receptor Downregulators (ERDs)
Ovarian suppression can be done through surgery (Oophorectomy) or by medications. Medications are used to supress the ovaries from producing estrogen. The medication temporarily stops the hormone production of the ovaries.
Immunotherapy uses the immune system to fight cancer. It is suggested to patients who have triple negative breast cancer i.e., the cancer cells does not have receptors for progesterone or HER2 and estrogen. For treating triple negative breast cancer, immunotherapy is combined with chemotherapy.
Targeted drugs treatment can kill specific abnormalities within cancer cells. It focuses on a protein that the breast cancer cell over produce called epidermal growth factor receptor 2(HER2). This protein helps the breast cancer cells to grow and survive. Hence, to damage the targeted cancer cell which produces too much HER2 targeted therapy drugs is recommended by the doctor.
Treatments for breast can have severe adverse effects. Such as infertility, hair loss, darkening of the breast skin, fatigue, nausea etc. Therefore, when deciding on a treatment, the patient should go for a detailed discussion beforehand with a doctor so that the patients knows the risks involved in the treatment and how to minimize the negative effects.