Treating Breast cancer
Fighting breast Cancer
Breast Cancer Reconstruction
Following a mastectomy, you have options to help you become comfortable with the changes in your body. They are all options, with benefits to each approach. What is best for you and your body may not be what is best for another woman.
If you are considering breast reconstruction, you should speak with your medical team before the mastectomy, even if you plan to have your reconstruction later on.
There are a few of options for breast reconstruction, and which one you use will depend on your age, body type, and treatment plan.
One possibility is to have breast implants. The breast is filled with silicone sacs of saline or silicone gel.
TRAM Flap, Latissimus Flap, or Gluteal Flap
An alternative solution is to use tissue the surgeon removes from another part of your body, like the belly (TRAM), back (latissimus), or buttocks (gluteal). The surgeon sculpts this tissue into the shape of your breast.
In addition to reconstructing the breast, the surgeon can add a nipple, change the shape or size of the reconstructed breast, and operate on the opposite breast as well for a better match. The plastic surgeon will be able to discuss with you the benefits and risks of each procedure, and help you decide what will make you feel the most natural.
Alternative to Breast Reconstruction
One alternative to breast reconstruction is a removable prosthetic breast that is worn in the bra. This will preserve the shape and look of the breast without the surgical procedures.
What Is Chemo?
Chemotherapy is a treatment method that uses a combination of drugs to either destroy cancer cells or slow down the growth of cancer cells.
- Cytotoxic drugs (meaning “toxic to cells”) are usually given orally or through a vein (intravenously or “through the bloodstream”).
- Chemotherapy is a systemic therapy, meaning that the drugs travel in the bloodstream throughout the entire body.
Chemotherapy for early and locally advanced breast cancer
After breast surgery (adjuvant chemotherapy)
For those with early breast cancer, chemotherapy is usually given after breast surgery (called adjuvant chemotherapy), but before radiation therapy.
Adjuvant chemotherapy helps lower the risk of breast cancer recurrenceby getting rid of cancer cells that might still be in the body.
Before breast surgery (neoadjuvant chemotherapy)
Chemotherapy is sometimes used before surgery (called neoadjuvant or preoperative chemotherapy).
In women with locally advanced breast cancer, neoadjuvant chemotherapy can reduce the size of the tumor in the breast and/or in the lymph nodes, and make it easier to surgically remove the cancer.
How Long The Treatment Lasts?
Chemotherapy usually lasts 3-6 months, but you have days or weeks off between treatments.
Your treatment schedule depends on the combination of drugs given.
And… Side Effects?
The majority of side effects occur during the course of treatment, but usually diminishes upon conclusion. However, there are some types of side effects know to last several months. The worst cases they can last years.
Chemo Side Effects lasts between 3 to 6 Months
Radiation Therapy Focus on trying to kill cancer cells
External Beam Breast
What Are The Side Effects Of Radiation?
Radiation therapy can have side effects, and these vary from person to person.
The most common side-effects are:
- Sunburn-type skin irritation of the targeted area (which may range from mild to intense)
- Red, dry, tender, or itchy skin
- Breast heaviness
- Discoloration, redness, or a bruised appearance
- General fatigue
What should I do about side effects from breast cancer radiation?
If you experience difficulty from side effects, you should discuss them with your doctor, who may be able to suggest ways you can treat side effects and help yourself feel more comfortable. These problems usually go away over a short period of time, but there may be a lasting change in the color of your skin.
Here are some good general tips for dealing with the most common side effects of radiation:
- Bras and tight clothes may rub your skin and cause soreness. You may want to wear loose-fitting cotton clothes during this time.
- Gentle skin care also is important. You should check with your doctor before using any deodorants, lotions, or creams on the treated area.
- You need to be aware that more intense treatment methods will tax your body. During radiation therapy, it is essential to take good care of yourself by getting extra rest and making good nutrition a priority.
- Although resting is important, doctors usually advise patients to try to stay active too, unless it leads to pain or other problems. Routine exercise has been proven to reduce the degree of fatigue patients experience from radiation therapy.
- You may wish to discuss with your doctor the possible long-term effects of radiation therapy. For example, radiation therapy to the chest may harm the lung or heart. Also, it can change the size of your breast and the way it looks. If any of these problems occur, your oncology team can tell you how to manage them.
main Types Of Radiation Therapy:
Whole breast & Partial Breast
Blockers vs Inhibitors
If you have gone through menopause, the options include:
- Aromatase inhibitor: This type of drug prevents the body from making a form of estrogen (estradiol). Examples are anastrazole, exemestane, and letrozole. Common side effects include hot flashes, nausea, vomiting, and painful bones or joints. Serious side effects include thinning bones and an increase in cholesterol. This is also a pill taken daily.
- Tamoxifen: Hormone therapy is given for at least 5 years. Women who have gone through menopause receive tamoxifen for 2 to 5 years. If tamoxifen is given for less than 5 years, then an aromatase inhibitor often is given to complete the 5 years. Some women have hormone therapy for more than 5 years.
More research is underway to determine if there is a benefit in taking hormonal therapy for longer than 5 years. Some research studies have demonstrated that there may be benefits in switching from one hormonal therapy agent to another during the 5 year period. Your oncologist will discuss with you the most appropriate hormonal therapy regimen based on your breast cancer pathology and age. It is very important to take these pills every day as without adhering to the daily schedule and dosage as planned, you may not reap the benefit of these drugs. Overall, hormonal therapy can reduce risk of recurrence by 50%.
These drugs can be expensive. If you need financial help in paying for these medications contact the medical oncology nurse practitioner or social worker to receive assistance how to get the prescription at a discount.
Based on the side effects listed above, sexual dysfunction can occur. If you are experiencing a drop in libido, vaginal dryness resulting in pain during intercourse, make your oncologist aware as there may be some options for decreasing these side effects.
Inhibitors and Blockers Options vary according to
Women's stage of life and age
The risk of developing lymphedema
continues for the rest of your life.
Taking Care Of Yourself During Treatment And Beyond
It’s important for you to take very good care of yourself before, during, and after cancer treatment.
- Taking care of yourself includes eating well and staying as active as you can.
- Do your best to eat the right amount of calories to maintain a good weight.
- Adequate protein can help to keep up your strength.
What if I don’t feel well enough to eat much of anything?
Eating well may actually help you feel better and have more energy. Sometimes, especially during or soon after treatment, you may not feel like eating. Some treatments can leave you feeling tired and uncomfortable. Or you may find that some foods don’t taste as good as they used to.
In addition, the side effects of treatment (such as poor appetite, nausea, vomiting, or mouth blisters) can make it hard to eat well. On the other hand, some women treated for breast cancer may have a problem with weight gain.
Your doctor, a registered dietitian, or another healthcare provider can suggest ways to help you meet your nutrition needs and remain as close to a healthy weight as you can.
Is It Okay To Continue To Exercise During Breast Cancer Treatments?
Yes, as long as your doctor okays your physical activity. Many women find that they feel better when they stay active. Walking, yoga, swimming, and other activities can keep you strong and increase your energy. Exercise may reduce nausea and pain and make treatment easier to handle. It also can help relieve stress. Whatever physical activity you choose, be sure to talk to your doctor before you start.
Also, if your activity causes you pain or other problems, be sure to let your doctor or nurse know.
Mayo clinic Nutrition and Fitness Guides
Nutrition and Physical Fitness are very important factors
on surviving breast cancer
What Happens When My Cancer Treatment Rounds Are Complete?
You’ll need regular check-ups after treatment for breast cancer. Check-ups help ensure that any changes in your health are noted and treated if needed. If you have any new health problems between checkups, you should contact your doctor.
What Happens At Breast Cancer Follow-Up Appointments?
Your doctor will check for return of the breast cancer. Also, check-ups help detect health problems that can result from cancer treatment.
Check-ups usually include an exam of the neck, underarm, chest, and breast areas. Since a new breast cancer may develop, you should continue to have regular mammograms. You probably won’t need a mammogram of a reconstructed breast or if you had a mastectomy without reconstruction. Your doctor may order other imaging procedures or lab tests.
What Kinds Of Problems Need To Be Reported To My Physician During The Breast Cancer Follow-Up Phase?
You should report any changes in the treated area or in your other breast to your doctor right away.
Follow Up Care
Oncologist, Dr. Antonio Wolff, MD
Cancer research UK – Treatments
breastcancer.org – Treatment and Side effects
Cancer.net – Breast Cancer Types Of Treatments
Breast Cancer Care – Going through Breast Cancer Treatment
Maurer Foundation for Breast Health Education – Search: Treatments
American Cancer Society –Treating Breast Cancer
innovation.org – Treatment Approaches
National Health Services UK – Breast Cancer Treatments
Susan G. Komen – Breast Cancer Treatment: Introduction