Reasons To Refuse Treatment
Most people would consider it normal to want to seek treatment for breast cancer the moment you are diagnosed, particularly at a time where survival rates are ever-increasing. But this would also infer that not seeking treatment is abnormal, and thats rarely the case.
There are a plethora of reasons why a woman may not be willing to pursue or continue breast cancer treatment. Some may be transient and fade with time. Others are fully committed and made with a complete understanding of the implications of the refusal.
Among some of the more common reasons for the refusal of breast cancer treatment:
According to research from Canada, the majority of women who refused breast cancer therapy were over 50 , married , and had metastatic disease . Of these, 50% reported using some form of complementary or alternative medicine.
Keytruda Added To Chemotherapy Improves Overall Survival For Metastatic Pd
Dr. Hope Rugo is professor of medicine in the division of hematology and oncology at the University of California San Francisco Helen Diller Family Comprehensive Cancer Center, where she is also the director of breast oncology and clinical trials education. Dr. Rugo is also a member of the Breastcancer.org Professional Advisory Board. She is a principal investigator of a number of clinical trials looking at combining new targeted and immunotherapy medicines with standard treatments for both early-stage and advanced-stage breast cancer and has published hundreds of peer-reviewed papers.
At the European Society for Medical Oncology Congress 2021, Dr. Rugo presented final results from the KEYNOTE-355 trial, which was looking to see if Keytruda and chemotherapy were better than chemotherapy alone as a first treatment for metastatic PD-L1-positive, triple-negative breast cancer. Earlier results found that adding Keytruda to chemotherapy improved progression-free survival how long people lived before the cancer grew for this type of breast cancer. These new results show that adding Keytruda improves overall survival how long people live whether the breast cancer grows or not.
Listen to the podcast to hear Dr. Rugo explain:
Running time: 25:03
What Are Cancer Survival Statistics
A key part of making a prognosis is looking at survival rates. These are numbers researchers collect over many years in people with the same type of cancer. These numbers are based on large groups of people. For breast cancer, there are two main measurements:
Breast cancer survivalrates reflect the percentage of women who are alive 5 years or longer after their diagnosis. This means the numbers are based on women who were found to have breast cancer at least 5 years ago. Advances in diagnosing and treating cancer have led to steadily improving survival rates, so the outlook for women diagnosed today is likely better.
Relative survival rates dont take into account the cause of death. Theyre a measure of the percentage of people with cancer who have lived for a certain time after diagnosis, compared with people who did not have cancer.
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What Is Cam For Cancer
The prevalence of CAM use among cancer patients has been rising over the last few decades. The terms alternative and complementary are used to describe many kinds of products, practices, and treatments.
Alternative therapy refers to non-standard treatment used in place of standard treatment, while complementary therapy usually means methods used along with standard treatment.
Alternative and complementary therapies are often appealing because they use your own body, your own mind, or things that may be found in nature. But sometimes these methods wrongly claim to prevent, diagnose, or treat cancer even when they have not been proven to work through scientific testing.
Some complementary methods have been studied and shown to help people feel better under a doctors care. Examples might include meditation to reduce stress, or acupuncture to reduce pain and nausea.
Breast Cancer Survivors: Life After The Treatments End
The breast cancer treatments are over. Now what? Here’s how to return to your “new normal.”
Life after breast cancer means returning to some familiar things and also making some new choices.
The song says “It ain’t over ’til it’s over,” but when you’ve had breast cancer, you discover that it’s not even over when it’s over.
After a marathon of breast cancer diagnosis and treatment that may last six months to a year, you can hardly wait to get back to a normal life again. But the day of your last radiation treatment or chemotherapy infusion doesn’t mark the end of your journey with breast cancer.
Instead, you’re about to embark on another leg of the trip. This one is all about adjusting to life as a breast cancer survivor. In many ways, it will be a lot like the life you had before, but in other ways, it will be very different. Call it your “new normal.”
From your relationships with your family and your spouse to eating habits and exercise, breast cancer will change your life in ways that last well after treatment ends. How do you fight lingering fatigue? What should you eat to help prevent a breastcancer recurrence? Will you ever have a regular sex life again? These are just a few of the questions that may nag at you as you make the transition from breast cancer treatment to breast cancer survival.
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How Chemotherapy Is Given
Many chemotherapy drugs for breast cancer are given in liquid form, as intravenous infusions or injections, but some are available as pills or tablets.
Some drugs may be given alone, and other drugs are combined to work together. When chemo drugs are given in combination, the treatment is called a regimen.
Some of the common regimens are:
- ACT: Adriamycin and Cytoxan followed by Taxol
- CMF: Cytoxan, methotrexate, and 5-FU
- AC: Adriamycin and Cytoxan
- CAF or FAC: Cytoxan, Adriamycin, and 5-FU
- CEF or FEC: Cytoxan, Ellence , and 5-FU
- TC: Taxotere and Cytoxan
Chemotherapy Is Strong Drug Therapy That Is Designed To Work Quickly To Destroy Fast
Here are just a few modalities that can help boost immunity for both short and long term health:
Vitamin C is vital for healthy cellular growth. C can also help with sleep, nausea and fatigue. In addition to oral supplements, you can also utilize vitamin C IV therapy with the guidance of a trained professional.
Coenzyme Q10 is a powerful antioxidant that can help to lower inflammation, allowing your bodys healing mechanisms to kick in again. In addition, a study at the University of California, Los Angeles found CoQ10 to be protective against anthracycline-induced damage to the cardiovascular system.
Raising body temp can also raise immune system function. In fact, raising body temperature between 104 111 degrees F, such as when you are in an infrared sauna or hot bath, can actually destroy cancer cells.
Other modalities that can help the immune system after chemotherapy include vitamin D/K, iodine, melatonin, modified citrus pectin, bee propolis, curcumin/black pepper, and many others.
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Treatment : Active Surveillance
Active surveillance may be all thats needed for certain types of cancers. Your doctor may recommend this approach if the cancer is at an early stage and is growing slowly or not at all.
For example, doctors often recommend active surveillance for prostate cancer, which tends to grow very slowly. Doctors monitor patients prostate-specific antigen with blood tests and monitor symptoms. If or when symptoms worsen or tests show that the cancer is growing more rapidly, they then begin discussing additional treatments.
Often, patients who are receiving active surveillance have no symptoms and go on living their lives as usual, Batus says.
Surveillance may also be an option for patients who want a break from treatment side effects or for those who have exhausted all other treatment options.
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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.
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Relative Survival Rate By Stage
The survival rates by stage are based on the stage at the time of diagnosis. Youve probably been given a number and letter for your cancer stage. Here, the terms localized, regional, and distant are used instead of numbers and letters. Heres what they mean and the 5-year relative survival rates for each:
- Localized breast cancer is only in the breast. This includes stage IA , some IIA , and some IIB . The 5-year relative survival rate is 99%.
- Regional breast cancer has spread to nearby tissue or lymph nodes. This includes stage IB , some IIA , some IIB , and all stage III . The 5-year relative survival rate is 86%.
- Distant breast cancer has spread to other parts of the body. This includes stage IV, pronounced stage 4). The 5-year relative survival rate is 28%.
Timely Breast Cancer Treatment Improves Survival
- Tags:Early-stage: Stage IA, Early-stage: Stage IB, Early-stage: Stage IIA, Early-stage: Stage IIB, Early-stage: Stage IIIA, Planning/Considering Chemotherapy, and Planning/Considering Surgery
Doctors recommend starting treatment as soon as possible after breast cancer is diagnosed. Timely treatment reduces the risk that the cancer will spread and increases the chances for survival. Still, sometimes women delay treatment for a number of reasons, including cost and scheduling. But if treatment is delayed too long it can affect survival.
Echoing results from earlier research, two studies have found that delaying surgery by 30 days and chemotherapy by 90 days can lead to worse survival.
The studies were published online on Dec. 10, 2015 by JAMA Oncology. Read the abstracts of:
Doctors call treatments given after surgery adjuvant treatments.
In the study looking at when women started chemotherapy, the researchers looked at the records of 24,843 women diagnosed with stage I to stage III breast cancer between 2005 and 2010 who were prescribed chemotherapy after surgery:
- 21% started chemotherapy 30 or fewer days after surgery
- 50% started chemotherapy 31 to 60 days after surgery
- 19.2% started chemotherapy 61 to 90 days after surgery
- 9.8% started chemotherapy 91 or more days after surgery
The researchers considered chemotherapy that started 91 or more days after surgery to be delayed treatment.
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Why Are People Offered Chemotherapy
Chemotherapy is given to reduce the risk of breast cancer coming back in the future. It uses anti-cancer drugs to destroy cancer cells.
It is most commonly given after surgery.
Some people wonder why they need chemotherapy if theyve already had surgery to remove their cancer. Whether someone is offered chemotherapy depends on a number of features of their cancer. These include the size and grade of the cancer whether it has spread to any of the lymph nodes under the arm and whether the cancer is hormone receptor and HER2 positive or negative.
For some people the benefit is clear, but for others its less certain. This is why cancer specialists may use a test, like the one described above, to help estimate the benefit.
Because it affects cells throughout the body, chemotherapy can cause side effects including sickness, hair loss and an increased risk of infection.
Study: More Breast Cancer Patients Can Safely Skip Chemotherapy
A federally funded study has found that many women with the most common type of early stage breast cancer likely do not need chemotherapy after surgery. The study was presented June 3, 2018 at the American Society of Clinical Oncology meeting in Chicago, and simultaneously published in the New England Journal of Medicine. It is likely to change the way many newly diagnosed breast cancer patients are treated.
“With results of this groundbreaking study, we now can safely avoid chemotherapy in about 70% of patients who are diagnosed with the most common form of breast cancer,” said Kathy Albain, MD, a co-author of the study. “For countless women and their doctors, the days of uncertainty are over.”
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Breast Cancer: Types Of Treatment
Have questions about breast cancer? Ask here.
ON THIS PAGE: You will learn about the different types of treatments doctors use for people with breast cancer. Use the menu to see other pages.
This section explains the types of treatments that are the standard of care for early-stage and locally advanced breast cancer. Standard of care means the best treatments known. When making treatment plan decisions, you are strongly encouraged to consider clinical trials as an option. A clinical trial is a research study that tests a new approach to treatment. Doctors want to learn whether the new treatment is safe, effective, and possibly better than the standard treatment. Clinical trials can test a new drug and how often it should be given, a new combination of standard treatments, or new doses of standard drugs or other treatments. Some clinical trials also test giving less treatment than what is usually done as the standard of care. Clinical trials are an option to consider for treatment and care for all stages of cancer. Your doctor can help you consider all your treatment options. Learn more about clinical trials in the About Clinical Trials and Latest Research sections of this guide.
Boosting Immunity After Chemotherapy
You may have heard the statistics when it comes to mortality and chemotherapy. If you havent, they arent good. According to a study conducted by the Northern Sydney Cancer Centre, The overall contribution of curative and adjuvant cytotoxic chemotherapy to 5-year survival in adults was estimated to be 2.3% in Australia and 2.1% in the USA.
A big reason why those who undergo chemotherapy treatment have low survival rates concerns what chemotherapy does to the immune system overall.
After Each Chemo Treatment
If necessary, your blood will be drawn after chemo. If your red counts or neutrophils are low, you may be offered shots to boost those counts. Chemotherapy can greatly affect your blood counts because blood cells divide and multiply quickly and are therefore targeted by the drugs.Staying on top of your blood counts is essential for recovering from chemo with a healthy immune system and avoiding anemia and neutropenia.
Breast Cancer Doctor Discussion Guide
Get our printable guide for your next doctors appointment to help you ask the right questions.
- Nerve damage
- Chemo brain
Your specific chemotherapy drug or regimen may cause other side effects, as well. These effects will subside after youve finished treatment.
Before each treatment, your medical oncologist may want you to take medications to protect against side effects. Be sure to take these on time and as prescribed.
Between chemotherapy appointments, if you have trouble dealing with side effects, dont hesitate to call your clinic and ask for help. If youre dehydrated after a treatment, you can ask for an infusion of saline fluid. Other medications may be given along with the saline to help with nausea and vomiting.
What Is The Chance I Could Die In The Next 5 Years
The average 5-year survival rate for all people with breast cancer is 89%. The 10-year rate is 83%, and the 15-year rate is 78%. If the cancer is located only in the breast , the 5-year survival rate is 99%. More than 70% of breast cancers are diagnosed at an Early Stage.
All survival statistics are primarily based on the stage of breast cancer when diagnosed. Some of the other important factors are also listed below that affect survival.
Stage 0 breast cancer can be also described as a pre-cancer. If you have DCIS you can be quite confident you will do well. DCIS does not spread to other organs. What can be concerning is when an invasive cancer grows back in the area of a prior lumpectomy for DCIS. This type of local recurrence does carry a risk to your life. Luckily, this does not happen frequently. Also, be aware that those who have had DCIS in the past are at a higher risk for developing an entirely new, invasive breast cancer. Take our video lesson on Non-Invasive DCIS to learn more.
Stage I invasive breast cancer has an excellent survival rate. The chance of dying of Stage I breast cancer within five years of diagnosis is 1 to 5% if you pursue recommended treatments.
Stage II breast cancer is also considered an early stage of breast cancer. There is a slightly increased risk to your life versus a Stage I breast cancer. Altogether, the risk of Stage II breast cancer threatening your life in the next 5 years is about 15%.
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