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A Comparison of Different Treatments for Breast Cancer

Introduction

Cancer is a growth (tumor) usually having its origin form the epithelium1. However, the tumor can either be benign or malignant. Benign tumors can be removed and do not have a tendency to grow back and neither do they spread to the body. On the other hand, malignant tumors can be detached but are known to be recurring. Breast cancer is cancer that affects the breasts. According to the NCI (2009), Breast cancer is reputed to be the most common cancerous ailment among women in the United States, a part form skin cancer. There is an annual record of 190,000 women being diagnosed with the disease. Nevertheless, breast cancer can also affect men. There is a tentative figure of 2,000 men being under the attack annually in the USA.

Breast cancer usually begins from the cells2. Normal cells usually die and get replaced by new ones. However, sometimes the process goes wrong, where new cells start emerging when existing ones re not yet dead, or damaged cells don’t die as they are supposed to. Consequently, there occurs the build up of extra lumps that lead to the tumor growth.

Factors to consider before choosing a type breast cancer treatment

Before one contemplates to undergo a breast cancer treatment (after diagnosis), there are several determinant factors that the patient should look at (ACS & NCCN, 2006):

  • First, the magnitude of the breast cancer and whether or not one has more than one tumor.
  • Secondly, the grade of cancer and its histology3
  • Thirdly, whether or not one has lymph nodes4 with the cancer (nodal status)
  • Fourth, the cancer stage5
  • Whether or not the cancer contains hormone receptors6 and the implications
  • Whether or not the cancer is positive for HER- 27 and the implications that come along with it.
  • Whether or not there are any side effects
  • Whether or not there are any clinical trials that one can opt to go for.

Albeit breast cancer is a killer disease, it can be successfully treated. Treatment is also more importantly based on the stage, which could be 1, 2, 3 or 4 (Cancer Research UK, 2009). Nevertheless, treatment should be done by experienced professionals. Usually, the professionals should include a pathologist, radiologist, surgeon, oncology nurse, radiation oncologist, social worker and the like. Regardless, the patient’s preferences and specific medical situation must be considered.

Types of treatments for breast cancer

The modus operandi for breast cancer treatment for breast cancer is usually reached to after diagnosis followed by a biopsy8. According to the NCI (2009), albeit treatment is dependant on the stage of the cancer, different patients usually require different treatment options. A patient can have a type of treatment that is best for her but at the same time fail to be the best option for another patient. The known options for breast cancer treatment are surgery, hormone therapy, radiation therapy, chemotherapy, and targeted therapy. Nevertheless, there are enough cases where a patient gets two or more types of the breast cancer treatments.

Surgery

As explained by the healthinfotranslations (2008), surgery is usually done with the intension of getting rid of as much level of cancer as the doctor can possibly manage. Surgery for breast cancer treatment can be done in two different options: Mastectomy9 or Lumpectomy10. Nevertheless, both mastectomy and lumpectomy do not give a clear guarantee that all the breast cancer is terminated. There is always a tendency for cancerous cells that are too small to notice, to remain after completion of the surgical process.

Mastectomy, which involves the removal of the whole breast, is usually followed by the surgical removal of the under-arm lymph nodes; in most cases is usually a cautionary measure against the spreading of the cancer (Lindel, 2010). Nevertheless, mastectomy can either be partial (only surrounding are removed), or simple (entire breast removal). On the other hand, a lumpectomy is strictly not an option for large or deeply penetrating tumors. This is because the major intent of doing lumpectomy is usually to save the most part of the breast as well as removing the tumor and preventing its spread.

In addition to mastectomy and lumpectomy, there is also another kind of surgery that usually comes after either of the two; reconstructive surgery. In this case, the patient may decide to have her breasts operated on with an intention of giving it the “breast appearance” back. This kind of surgery is also called breast reconstruction and can either be done at the same time11 with mastectomy or after12. In reconstructive surgery, either saline- filled implants or tissue taken from another part of the body is used (ACS & NCCN, 2006).

Chemotherapy

Chemotherapy refers to the treatment of the breast cancer using either chemical agents or medical drugs. The drugs or chemical agents are either delivered to the bloodstream by pill or intravenous13. The other flexibility about thus mode of breast cancer treatment is that one can choose to undertake it at home, in an outpatient hospital section or at the doctor’s office. Nevertheless, depending on the stage of the breast cancer, there are those patients who will be required to stay in the hospital for purposes of close supervision.

The taking of drugs, be it through veins, pill or both, may lead to side effects depending on the type of drug and the quantity. Although chemotherapy is intended to be killing cancerous cells that are fast growing, there may be an unexpected tragedy where normal cells that tend to divide rapidly are harmed. Such normal cells include blood cells, cells at the roots of hair and cells that make the digestive tract alignment. In this case, chemotherapy can have weakness or bleeding easily, loss of hair and reduced appetite as side effects. Additionally, depending on the drug, one’s heat may be weakened or even cause leukemia. In this case, chemotherapy will require tests especially for the heart, before, during an after treatment (NCI, 2009).

Targeted therapy

Targeted therapy is usually done with the intension of hindering the progression of breast cancer cells. This kind of therapy is usually administered using drugs (pills or through veins). Taking the case of the protein HER2, which is a stimulant for the development of breast cancer cells, drugs may be administered to block their actions so as to limit the progression of the breast cancer. As discussed earlier, in such a case a patient will have to go for initial tests so as to determine whether her breast cancer is HER2 related or not.

There are two types of drugs that are commonly administered in this kind of breast cancer treatment. First, there is the Trastuzumab or Herceptin drug , which is usually delivered through a vein either alone or alongside chemotherapy. Trastuzumab is usually accompanied by side effects especially during the first treatment that may include chills, fever, weakness, rashes, headaches, breathing difficulties and vomiting. The drug may also affect the lungs and hearts and it is therefore important for the doctor to check the condition of the lungs and heart before, during and after treatments.

Lapatinib on the other hand is usually a tablet swallowed and has to be administered alongside chemotherapy. It shares the same side effects as Trastuzumab in addition to affecting the heart, liver and lung. It is therefore recommended that doctor observes these organs before commencing, during and after treatment.

Radiation therapy

According to Heron (2010), radiation is directly targeted to the tumor, unlike chemotherapy. Helathifotranslations (2008), explain that radiation is usually done so as to heal the entire breast and in most cases it commences within a range of 4 to 6 weeks after surgery. Radiation is usually done with concentrated beams of radiation that are directly focused to the tumor in the breast. It is usually done to either damage or destroys the cancerous cells. In some cases, doctors use radiation complemented by chemotherapy as a powerful tool to fight breast cancers that are aggressive (Heron, 2010).

According to the Susan G. Komen for the cure (2007), there have been recent developments on further developing radiation and making it more effective with the introduction of brachytherapy14. Brachytherapy, also referred to as interstitial radiation or internal radiation involves the positioning of the radioactive seeds at the same spot or near where the tumor had been before surgery. In addition, the seeds may also be positioned in the lumpectomy15 site so as to make the radiation treatment more effective as an addition to beam radiation therapy.

Complementary and alternative therapies

Stoddart (2009) explains that in addition to the type of therapy used, there are medical treatments that can be done to balance the physical, emotional and mental well being of the patients. Such may include special supplements, massage, acupuncture, herbs and the like. The ANC and NCCN (2006) explain that complementary medicines are those used in the place of regular medical care.

Conclusion

Studies have shown the different ways of cancer treatment. Nevertheless, there exist two major factors as far as the flexibility of options to be taken by the patient is concerned. First, there is the stage of cancer and secondly there are the patient’s preferences. For an early stage of cancer, there are many options that can be taken; lumpectomy, chemotherapy, radiotherapy or targeted therapies are all options. Nevertheless, there seem to be only one option for a deeply progressed breast cancer; mastectomy. However, in such serious cases, other breast cancer treatment ways especially radiotherapy can be incorporated so as to make the treatment more effective.

There is really no question of which treatment method is more effective than the other. Nonetheless, there seem to be a lot of side effects associated with chemotherapy that can cause serious complications. Chemotherapy therefore needs a closer supervision by the doctor. Nevertheless, there has been a recent rising trend in the use of complementary and alternative therapies that are primarily used to make whichever kind of breast cancer treatment, to be easier to administer and also more effective.

Reference List

American Cancer Society & National Comprehensive Cancer Network. (2006). Breast cancer treatment guidelines for patients. Web.

Cancer Research UK. (2009). Number stages of breast cancer. Web.

Healthinfotranslations. (2008). Breast Cancer. Web.

Heron, F., S. (2009). Aggressive Breast Cancer Treatment. Web.

Lindell, J. (2010). Treatments for breast cancer. Web.

National Cancer Institute. (2009). What You Need To Know About Breast Cancer. Web.

Stoddart, L., S. (2009). Treatment Alternatives for Breast Cancer. Web.

Susan G. (2010). Komen For the Cure: The state of breast cancer. Web.

Footnotes

  1. The tissue that covers the breasts,. It performs secretory, transporting and regulatory tasks.
  2. Cells make the single most building blocks of the human body, in this case, the breast.
  3. The appearance of the cancer cells when observed under the microscope.
  4. Minute bean- shaped immune tissues found in the lymphatic vessels. Remove waste and fluid from lymph.
  5. The size and location of the cancer in relation to the tumor, lymph nodes and involvement of organs.
  6. Proteins located either on the surface or cytoplasm of the cell that binds to a hormone. Tumors tested for hormone receptors can be treated either with hormones or antihormones depending on the tests.
  7. A gene which produces a receptor that assists in growth of cells. Have a tendency to be fast growing and can be treated using a monoclonal antibody (tratuzumab).
  8. Extracting cells for examination, done by a pathologist. The calls can either be observed under the microscope or have other tests done on them. Biopsy can be icisional; only a sample is removed. Excisional; the whole lump or suspected area is removed or needle; sample fluid is extracted by needle.
  9. Breast cancer surgery that involves the removal of the whole breast.
  10. Breast cancer surgery that involves the removal of only the breast lump and tissue around the breast tissue.
  11. Usually referred to as immediate construction.
  12. Usually referred to as delayed reconstruction.
  13. Delivered in to the bloodstream by vein.
  14. An internal kind of radiation that uses radioactive pellets placed close to the tumor.
  15. Surgical removal of the breast cancer tumor with minimal amount of tissue surrounding it.