Time To Treatment With Metastatic Breast Cancer
There is little research looking at the optimal time until treatment for metastatic breast cancer, though it appears that waiting more than 12 weeks has been linked with lower survival. In general, however, the goal of treatment with MBC is different than early stage disease. For most people, treatment for early-stage disease is aggressive, with the goal to reduce the risk of recurrence. With MBC, the goal is often to use the least amount of treatment necessary to control the disease.
Cancers Linked To Radiation Treatment
Lung cancer:;The risk of lung cancer is higher in women who had radiation therapy after a mastectomy as part of their treatment. The risk is even higher in women who smoke. The risk does not seem to be increased in women who have radiation therapy to the breast after a lumpectomy.
Sarcoma: Radiation therapy to the breast also increases the risk of sarcomas of blood vessels , bone , and other connective tissues in areas that were treated. Overall, this risk is low.
Certain blood cancers: Breast radiation is linked to a higher risk of leukemia and myelodysplastic syndrome . Overall, though, this risk is low.
Neoadjuvant And Adjuvant Systemic Therapy
For women who have a hormone receptor-positive breast cancer, most doctors will recommend hormone therapy as an adjuvant treatment, no matter how small the tumor is. Women with tumors larger than 0.5 cm across may be more likely to benefit from it. Hormone therapy is typically given for at least 5 years.
If the tumor is larger than 1 cm across, chemo after surgery is sometimes recommended. A woman’s age when she is diagnosed;may help in deciding if chemo should be offered or not. Some doctors may suggest chemo for smaller tumors as well, especially if they have any unfavorable features .
After surgery, some women with HER2-positive cancers will be treated with trastuzumab for up to 1 year.
Many women with HER2-positive cancers will be treated with trastuzumab followed by surgery and more trastuzumab for up to 1 year. If after neoadjuvant therapy, residual cancer is found during surgery, trastuzumab may be changed to a different drug, called ado-trastuzumab emtansine, which is given every 3 weeks for 14 doses. If hormone receptor-positive cancer is found in the lymph nodes, your doctor might recommend one year of trastuzumab followed by additional treatment with an oral drug called neratinib for 1 year.
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Increased Risk Of Leukemia
Very rarely, certain chemo drugs can cause diseases of the bone marrow, such as myelodysplastic syndromes;or even acute myeloid leukemia, a cancer of white blood cells. If this happens, it is usually within 10 years after treatment. For most women, the benefits of chemo in helping prevent breast cancer from coming back or in extending life are far likely to exceed the risk of this rare but serious complication.
Sex Contraception And Pregnancy
You can still have sex during treatment. Its thought that chemotherapy drugs cant pass into vaginal fluids or semen, but this cant be completely ruled out as chemotherapy drugs can pass into the blood and some other body fluids. Most treatment teams will advise using barrier methods of contraception, such as condoms during treatment, and for a few days after chemotherapy is given.;
If you havent been through the menopause, its important to use contraception because chemotherapy drugs can harm a developing baby in the first three months of pregnancy. Its still possible to become pregnant even if your periods become irregular or stop completely.
Your specialist will usually recommend barrier methods of contraception, such as condoms. The contraceptive pill is not usually recommended because it contains hormones. Emergency contraception such as the morning after pill can still be used.
An interuterine device can be used as long as its not the type that releases hormones. If you have a coil in place that does release hormones, such as the Mirena or Jaydess, when youre diagnosed, you may be advised to have this removed.
Find out more about how breast cancer and its treatment can affect;sex and intimacy;and read our;tips on how to manage these changes.
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What Is Neoadjuvant Therapy
Neoadjuvant therapy is a treatment approach which focuses on this type of reverse order. The idea is to first shrink the tumor with chemotherapy before any next steps, specifically surgery.
This approach not only can improve surgical options, but also allows for a better assessment of the patients response to the chemotherapy, Dr. Moore says. It can also inform better recommendations for follow-up treatments after surgery. The approach doesnt work for everyone, but its certainly worth discussing with your doctor to find out if youre a candidate.
Take Steps To Improve Your Overall Health
Because chemotherapy can affect fast-growing healthy cells, such as your white blood cells, platelets and red blood cells, it helps to be as healthy as possible before you begin treatment, to minimize its side effects. Your doctor may recommend that you take the following steps to optimize your overall health:
- Get plenty of rest.
- Eat a balanced diet rich in fruits, vegetables and whole grains.
- Minimize stress.
- Avoid infections, such as the common cold and the flu. Talk to your doctor about recommended vaccinations, including annual flu vaccines.
- See your dentist for any signs of infection in your teeth or gums.
- Undergo blood tests to check your liver function and tests to check your heart. If there are any problems, your doctor may delay your treatment or select a chemotherapy drug and dosage that are safer for you.
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Possible Side Effects Of Chemo For Breast Cancer
Chemo drugs can cause side effects. These depend on the type and dose of drugs given, and the length of treatment. Some of the most common possible side effects include:
- Hair loss
Chemo can also affect the blood-forming cells of the bone marrow, which can lead to:
- Increased chance of infections
- Easy bruising or bleeding
- Fatigue
These side effects usually go away after treatment is finished. There are often ways to lessen these side effects. For example, drugs can be given to help prevent or reduce nausea and vomiting.
Other side effects are also possible. Some of these are more common with certain chemo drugs. Ask your cancer care team about the possible side effects of the specific drugs you are getting.
Reasons To Wait A Short While
While information suggests having surgery within a few weeks and chemotherapy within a month is ideal, there are some very good reasons why you may wish to wait a few days or a few weeks to begin treatment.
Most surgeons and oncologists will reassure you that you have some time, though there are always exceptions to that general rule . Advantages of taking some time include:
Breast Cancer Doctor Discussion Guide
Get our printable guide for your next doctor’s appointment to help you ask the right questions.
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External Beam Breast Cancer Radiation
External beam radiation is the most common kind of radiation treatment for breast cancer. Its a painless treatment, like getting an X-ray. A doctor will place a machine on the outside of your body and aim the radiation beams at the area of the cancer. Your doctor will figure out where to aim the rays and how much radiation to use before each treatment. They will mark the area with temporary or permanent ink.
Each treatment only lasts a few minutes. The session setup will take longer. External radiation treatment happens five days a week for about five to seven weeks. Its the longest type of radiation treatment available.
Short-term side effects of external radiation include:
- fatigue
- swelling and pain in the arm or chest
- weakened and fractured ribs
- future cancer in the inner lining of your blood vessels
External radiation does not leave radiation in your body. You will not be radioactive during or after treatment.
Could Low Dose Chemo Be An Option For You
If you have been on a Healthy Breast journey for a while, then it should be no secret to you that cancer cells feed on glucose. Armed with this knowledge, you know that you must AVOID SUGARY FOODS at all costs if you want to prevent and heal cancer. If you are currently on a healing path and are considering options, you may also be able to use cancers needs for extra glucose to your advantage. Insulin Potentiated Therapy, or IPT, takes advantage of cancers obsession with sugar to strategically use the best of both conventional treatment and natural healing.
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Targeted Therapy Vs Chemotherapy
Chemotherapy is a type of cancer treatment that works by killing fast-growing cells in your body to help prevent the growth and spread of cancer cells. It can be given as an oral medication or administered through an IV.
But because chemotherapy can kill both healthy and cancerous cells in your body, it can cause many side effects.
On the other hand, targeted therapy is a treatment that attacks cancer cells specifically by interfering with certain pathways that control their growth.
Unlike chemotherapy, targeted therapy is designed to only affect cancer cells, meaning that its less likely to harm the normal, healthy cells in your body. But targeted therapy pills do have side effects as well.
Furthermore, while chemotherapy kills off cancer cells that have already been produced, targeted therapy also works by preventing cancer cells from multiplying and spreading.
Targeted therapy can be administered orally or through an IV for the treatment of breast cancer. Its often used alone or in combination with other cancer treatments, including chemotherapy.
Outlook For People With Stage 3 Breast Cancer
Its natural to want to know your outlook, but statistics dont tell the whole story. Your breast cancer type, overall health, and many more factors beyond your control may affect treatment outcomes.
Establishing open communication with your treatment team can help you best assess where you are in your cancer journey.
Support groups can be a great source of comfort as you navigate your diagnosis through your treatment and beyond. Your doctors office or hospital can offer some suggestions and resources in your area.
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Second Cancers After Breast Cancer
Breast cancer survivors can be affected by a number of health problems, but often a major concern is facing cancer again. Cancer that comes back after treatment is called a recurrence. But some cancer survivors develop a new, unrelated cancer later. This is called a second cancer.
Women whove had breast cancer can still get other cancers. Although most breast cancer survivors dont get cancer again, they are at higher risk for getting some types of cancer, including:
- A second breast cancer
- Salivary gland cancer
- Melanoma of the skin
- Acute myeloid leukemia
The most common second cancer in breast cancer survivors is another breast cancer. The new cancer can occur in the opposite breast, or in the same breast for women who were treated with breast-conserving surgery .
Are Some Therapies More Effective Based On Stage
The type of radiation treatment you get depends on the stage of breast cancer. People with early to stage 3 breast cancer will benefit most from radiation treatment. Radiation can also help ease side effects in people with advanced breast cancer.
External whole breast radiation works best:
- for early stage to stage 3 breast cancer
- for tumors that are an inch or smaller
- if the cancer is in one spot
- if you had breast-saving surgery or a mastectomy
External beam radiation can also help treat side effects of advanced breast cancer.
Internal radiation works best:
- for early stage breast cancer
- if the cancer is in one spot
- if you had breast-saving surgery or a mastectomy
Sometimes, a person with advanced breast cancer will have internal radiation.
Intraoperative radiation works best:
- during early stage breast cancer
- when the tumor is too close to healthy tissue for external radiation to be possible
Not everyone can have intraoperative radiation or internal beam radiation. Whether you can have these procedures depends on:
- size and location of the tumor
- size of your breast
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Who Needs Breast Cancer Chemotherapy
Chemotherapy is offered to most patients based on several factors including:
- Type of receptors and status
- Number of lymph nodes involved and degree of involvement
- The risk for cancer to spread elsewhere in the body
Your medical team will work to select the right blend of chemotherapy drugs to suppress each stage of the cancer cells growth.
Adjuvant And Neoadjuvant Drugs
- Ixabepilone
- Eribulin
Although drug combinations are often used to treat early breast cancer, advanced breast cancer more often is treated with single chemo drugs. Still, some combinations, such as;paclitaxel plus gemcitabine, are commonly used to treat advanced breast cancer.
For cancers that are HER2-positive, one or more drugs that target HER2 may be used with chemo.
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When You Might Have Chemotherapy
Whether you have chemotherapy as part of your treatment depends on what;type of cancer you have, how big it is;and whether it has spread or not.
Doctors use chemotherapy because it circulates throughout the body in the bloodstream. So it can treat cancer almost anywhere in the body. Chemotherapy is a systemic treatment.
Surgery only removes the cancer from the area it is in the body. And radiotherapy only treats the area of the body it is aimed at.;
You might have chemotherapy:
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How Does Chemotherapy Work
Chemotherapy works by attacking fast-growing cells in your body, including cancer cells. There are many different types of chemotherapy; your medical oncologist will talk to you about whats most suitable for you. Sometimes more than one type of treatment may be effective for you, and you may be asked to decide which one to have. Your medical oncologist can tell you about the pros and cons of each.
Some questions you might like to ask include:
- What are the possible side effects of each treatment?
- How long is the course of each treatment?
- How will the treatment fit in with my lifestyle and personal circumstances?
Some chemotherapy drugs are given in tablet form, however, most are administered intravenously . As a result, it is useful to drink plenty of fluids, relax and keep your hands and arms warm, as this can help the nurse or doctor find your veins.
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Will I Be Able To Work While I Am Having Treatment
Most women are able to continue working during chemotherapy if they wish to. If you plan to keep working, it helps to have a supportive work place that gives you flexible work hours. You may need to have a few days off after each cycle of chemotherapy and when you get back to work you may find it difficult to work long hours. Your doctor can provide a medical certificate for time off; this can be just a few days or a few months depending on your individual situation.
Feeling Unwell Or Tired
Many women do not feel as healthy after chemo as they did before. There is often a residual feeling of body pain or achiness and a mild loss of physical functioning. These changes may be very subtle and happen slowly over time.
Fatigue is another common problem for women who have received chemo. This may last a few months up to several years. It can often be helped, so its important to let your doctor or nurse know about it. Exercise, naps, and conserving energy may be recommended. If you have sleep problems, they can be treated. Sometimes fatigue can be a sign;of depression, which may be helped by counseling and/or medicines.
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Personal Stories About Choosing Chemotherapy For Breast Cancer
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
I was diagnosed with breast cancer 3 years ago. It was quite a shock. Even though my breast cancer was small and I did not have any cancer cells in my lymph nodes, I decided to take chemotherapy. My doctor said that even though it would not guarantee that the cancer would not come back, it would improve my chances for a cure. I was really worried about the side effects, but they were not that bad. I just wanted to do everything in my power to beat this breast cancer. My checkups have been fine so far, so I think I made the right choice.
Laurel, age 43
I was diagnosed with breast cancer about 3 years after I went through menopause. My breast cancer was small, and I did not have any cancer in my lymph nodes. I stopped taking my menopause hormones, had surgery and radiation, and have been taking tamoxifen ever since. I see my doctor a couple of times a year and so far have been okay. I’m going to ask my doctor if I’m a good candidate for switching to something like Arimidex. I hear that it’s a smart choice for some women.
Brenda, age 57
Paula, age 61
Treatment Of Breast Cancer Stages I
The stage of your breast cancer is an important factor in making decisions about your treatment.;
Most women with breast cancer in stages I, II, or III are treated with surgery, often followed by radiation therapy. Many women also get some kind of drug therapy. In general, the more the breast cancer has spread, the more treatment you will likely need.;But your treatment options are affected by your personal preferences and other information about your breast cancer, such as:
- If the cancer cells contain hormone receptors. That is, if the cancer is estrogen receptor -positive or progesterone receptor -positive.
- If the cancer cells have large amounts of the HER2 protein
- How fast the cancer is growing
- Your overall health
- If you have gone through menopause or not
Talk with your doctor about how these factors can affect your treatment options.
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