Breast cancer is a malignant disease that largely affects woman as a result of cells that have grown out of control. The breast is composed of lobules that produce milk, thin tubes called ducts that transport milk to the nipple, fat and connective tissue, lymph nodes, and blood vessels. The most common type of breast cancer starts in the cells of the ducts and is known as ductal carcinoma, but the disease can also start in the lobules or other breast tissue.
In the U.S. alone, there are about 230,000 new cases of breast cancer diagnosed annually in women and 2,300 new cases in men every year. Early diagnosis has greatly improved survival rates, and there are numerous treatment options for patients with breast cancer. Local treatment, which includes surgery and radiation therapy, is designed to treat the tumor without affecting the rest of the body; systemic treatment refer to chemotherapy, hormone therapy, targeted therapy, and bone-directed therapy.
Treatment Using Chemotherapy
Chemotherapy is based on the use of cancer-killer drugs either intravenously or orally to destroy cancer cells. The drugs travel through the bloodstream to reach the cancer cells. Among the times chemotherapy can be helpful are after surgery, known as adjuvant therapy, for patients who show no evidence of cancer after surgery chemo is then used to kill any cancer cells that may have been left behind or may have spread but can’t be seen, even on imaging tests.
Neoadjuvant chemotherapy is given before surgery, and it’s used to both shrink the tumor so that it can be removed with less extensive surgery and kill any remaining cancerous cells.
Chemo may also be used as the main treatment for patients with advanced breast cancer, which means it has spread outside the breast and underarm area.
Treatment with chemotherapy usually takes several months and it is administered in cycles followed by rest periods. Among the more common drugs approved by the FDA for chemo in the U.S. include, for early stage breast cancer, Adriamycin or Ellence, or the taxanes Taxol or Taxotere, which may be used in combination with drugs such as fluorouracil, Cytoxan, and carboplatin.
Among the drugs approved for HER2 positive breast cancers, Herceptin is often used with Taxol or Taxotere. Perjet can also be combined with Herceptin and Taxotere for HER2 positive cancers.
For breast cancers that are more advanced, and depending on the patient, oncologists have a wide choice, with chemo drugs such as Taxotere; Taxol; the platinum agents cisplatin or carboplatin; Navelbine; Xeloda; Doxil; Gemzar; mitoxantrone; Ixempra; nab-paclitaxel or Abraxane; and Halaven.
According to the American Cancer Society, “in most cases (especially adjuvant and neoadjuvant treatment), chemo is most effective when combinations of more than one drug are used. Many combinations are being used, and it’s not clear that any single combination is clearly the best.”
Benefits and Risks of Chemotherapy
Chemotherapy is known to be effective in stopping or slowing the growth of cancer cells, being more effective in early stages of the disease. In patients with stage 1 or 2 breast cancer, chemotherapy is more likely to cure cancer, while in stage 3 or 4 breast cancer, the treatment can help shrink the tumors to ease the pain and other symptoms.
Despite the effectiveness of chemo in the treatment of breast cancer, there are also many side effects and risks which should be considered. The most common side effects include hair loss and nail changes, mouth sores, loss of appetite or increased appetite, nausea and vomiting, and low blood cell counts. When chemo affects the blood-forming cells of the bone marrow, patients may also experience increased chance of infections related to low white blood cell counts, easy bruising or bleeding related to low blood platelet counts, and fatigue from low red blood cell counts.
Less common side effects may also occur when specific drugs are used, including menstrual alterations; a problem characterized by damage in the nerves outside of the brain and spinal cord called neuropathy; heart problems; hand-foot syndrome; slight decreased mental function known as chemo brain; increased risk of leukemia; and feeling unwell or tired.
According to the National Cancer Institute at the National Institutes of Health, “You cannot tell if chemotherapy is working based on its side effects. Some people think that severe side effects mean that chemotherapy is working well, or that no side effects mean that chemotherapy is not working. The truth is that side effects have nothing to do with how well chemotherapy is fighting your cancer.”
Note: Breast Cancer News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.