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Patient Education (10) ChemoRx

 

 

Systemic Therapy:

CHEMOTHERAPY AND HORMONE THERAPY

Chemotherapy

Chemotherapy is a systemic treatment using cancer-killing drugs that are given intravenously or orally. You may receive as few as two drugs or as many as five in combination. Multiple drug combinations appear to provide the best results.

Chemotherapy may be used in addition to mastectomy or radiation therapy is one of the most promising advances in breast cancer treatment. In adjuvant chemotherapy, the anti-cancer drugs circulate throughout the body and reach areas where the undetected cancer cells may be. Research shows that patients with "positive" lymph nodes (those with cancer cells) and aggressive tumors who receive adjuvant chemotherapy have longer disease-free periods and overall higher survival rates than those treated with mastectomy or radiation therapy alone.

The side effects and the loss of hair associated with some forms of chemotherapy is emotionally difficult for patients. And this is totally warranted, because in our society hair has been identified with beauty and femininity. The hair loss is temporary and will grow back but this does not lessen the anguish you feel when you look in the mirror and see your reflection with no hair. To ease this devastating process it is best to cut your hair as short as possible before it begins to fall out. Also, shop for a wig (which is covered by your insurance company) before you begin chemotherapy, so your hairstylist can match your natural hair as closely as possible. You can also become very creative with scarves, hats and turbans. As difficult as it may seem, you must realize that you are the same person even if you have no hair. You are still able to live, love, and enjoy life.

At the present time, chemotherapy therapy may be recommended for women at high risk of having their cancer return (so called adjuvant chemotherapy). According to recent studies, the National Cancer Institute is now recommending in some instances, post-surgery chemotherapy or hormone therapy for women whose breast cancer has not spread to their lymph nodes.


Hormonal Treatments

The growth of some breast cancer is sensitive or dependent on certain female hormones. By using certain drugs that block the effects of hormones or lower the hormonal levels in the blood, doctors can extend the survival of women whose breast cancer is hormone-dependent.

To identify women, who are most likely to respond to hormone therapy, doctors perform tests on a sample of the tumor that was removed during the biopsy. These tests, called hormone receptor assays or estrogen-progesterone receptor assays, demonstrate that about two-thirds of all women with breast cancer have tumors that contain estrogen receptors (ER), meaning they are estrogen positive (The tumor depended upon estrogen for its growth). These tests also determine if a woman is progesterone positive.

Some drugs, like Tamoxifen changes a woman’s estrogen level and can block the tumor growth and is used in adjuvant hormone therapy. Tamoxifen can reduce the risk of cancer recurring in patients whose tumors have been treated by surgery, radiation therapy, chemotherapy or all three. It is an orally taken anti-cancer drug that has been used in the treatment of breast cancer since the early 1970s. Tamoxifen is the most widely used cancer drug, with more than 3 million breast cancer patients receiving it. It is usually prescribed for a five-year period. Tamoxifen is tolerated well by most patients. However, it may cause short-term side effects related to the lowered levels of estrogen, such as hot flashes and some local effects.

Another criterion that is important in planning adjuvant therapy is a woman’s menopausal status. Studies have shown that the effectiveness of different types of adjuvant therapy for breast cancer depends on whether a woman is premenopausal or postmenopausal. Women who are premenopausal generally respond well to adjuvant chemotherapy. Also, women who are postmenopausal and hormone receptor positive generally respond to adjuvant hormone therapy.

Each anticancer drug produces different reactions in different people; your reaction may vary, even from treatment to treatment. However, most side effects from chemotherapy are temporary and will gradually go away once treatment is completed. How quickly they subside depends on many factors, including your general physical condition and the type of drugs you are receiving. Most doctors and patients believe that the overall benefits achieved by adjuvant therapy for breast cancer outweigh the risk of serious side effects. Each woman and her doctor need to evaluate the known and potential side effects of adjuvant therapy when making decisions about treatment.



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