Breast Cancer Health Article

Radiation

Once the cancer has been removed, the doctor may recommend radiation to destroy or shrink any remaining breast cancer cells. Radiation stops the cancer cells from dividing. It works especially well on fast-growing tumors. Unfortunately, it also stops some types of healthy cells from dividing. Healthy cells that divide quickly, like those of the skin and hair, are affected the most. This is why radiation can cause fatigue, skin problems, and hair loss.

Chemotherapy

Breast cancer surgery may be followed by chemotherapy in even the earliest stages. Chemotherapy is administered either orally or by injection into a blood vessel. It is usually given in cycles, followed by a period of time for recovery, followed by another course of drugs. Treatment time may range between four to nine months.

There may be significant side effects with some types of chemotherapy, including nausea and vomiting, temporary hair loss, mouth or vaginal sores, fatigue, weakened immune system, and infertility. However, chemotherapy for early breast cancer uses medications that cause fewer side effects.

Hormone therapy

The growth of some breast cancer cells may be slowed by the drug tamoxifen, an anti-estrogen medication. Given each day as a pill, tamoxifen travels throughout the bloodstream, slowing or stopping cancer cell growth. Tamoxifen treatment lasts at least two years, and often as long as five. Research suggests that tamoxifen may lower the chance that a breast cancer can return by between 25% and 35%.

Side effects of tamoxifen may include a slightly higher risk of cancer of the lining of the uterus (endometrial cancer). The risk increases if the drug is taken for more than five years. Other side effects include menopause-like symptoms, such as weight gain, hot flashes, and mood swings.

In rare cases, the surgeon may suggest removal of the ovaries (oophorectomy) in premenopausal women as a way of eliminating the main source of estrogen, which can boost the growth of some breast tumors.

Stem cell treatment

Stem cell treatment is used to treat advanced breast cancer. By first removing a woman's stem cells from her bone marrow or blood, the doctor can use very high doses of chemotherapy or radiation to kill cancer cells. Because this also kills healthy white blood cells, leaving the woman vulnerable to infection, the stem cells are then replaced, where they restore the body's ability to fight infection.

Expected results

The prognosis for breast cancer depends on the type and stage of cancer. Most patients can return to a normal lifestyle within a month or so after surgery. Exercises can help the patient regain strength and flexibility, and avoid building up too much fluid. Arm, shoulder, and chest exercises may aid in the patient's recovery.

It is normal after breast cancer treatment to be depressed or moody, to cry, lose appetite, or feel unworthy or less interested in sex. If these problems last for an extended time, individual counseling is appropriate. Many women have also found that attending a support group of breast cancer survivors to be an invaluable help during this stage.

Prevention

While breast cancer cannot be prevented, it can be diagnosed from a mammogram at an early stage when it is most treatable. Despite recent questions about the effectiveness of mammography in preventing breast cancer, it remains effective in screening for and detecting signs of breast cancer. A baseline mammogram should be done by age 35, so that a normal x ray can be used to compare future mammograms, even when there is no reason to believe there is a lump or cyst. In addition, women should check their own breasts at the same time each month. The American Cancer Society (ACS) publishes guidelines recommending how often and at what ages women should have screening mammograms. The ACS updated its guidelines in 2003 to recommend annual screening mammograms for women beginning at age 40.

In 1998, the National Surgical Adjuvant Breast and Bowel Project (NSABP) released the results of a six-year study called the Breast Cancer Prevention Trial (BCPT) that analyzed the breast cancer prevention qualities of the drug tamoxifen (Novadex). The study concluded that tamoxifen reduced the incidence of breast cancer in women at high risk of developing this disease. Researchers reported a 49% reduction in diagnoses of invasive breast cancer among women who took tamoxifen, and a 50% decrease in diagnoses of noninvasive breast tumors, such as ductal or lobular carcinoma in situ. More recent studies suggest that tamoxifen also helps prevent breast cancer in women over age 60. However, the drug has also been associated with blood clotting problems and an increased risk of uterine cancer in some patients.

A clinical study comparing tamoxifen and raloxifene, an osteoporosis drug, began in 1999. Raloxifene is thought to have breast cancer prevention properties similar to tamoxifen, but with fewer harmful side effects.