The exact treatment plan for Breast Cancer is devised by a team of specialists — the Cancer Care — comprising health care professionals, oncologist, and oncology nurses, physician assis-tants, pharmacists, Councillors, nutritionists and others. This is the Multidisciplinary team, and together they create a comprehensive plan of treatment for the patient. This treatment may con-sist of a variety of methods and techniques, depending upon the patient’s individual needs. This is because the behavioural patterns of Breast Cancer are often erratic and unique to individual patients. For example, while some tumours grow at a fast pace, others may be big in size but grow at a slower pace.
The final treatment plan often looks into several areas and factors, some of them being:
• The stage that the tumour has progressed to.
• The tumour subtype.
• The patient’s details such as age, health, etc.
• Menopausal state.
• Genomic markers.
• Presence of known mutations in the Breast Cancer Genes.
Based on these factors several means of treatment may be developed such as:
These are treatments which affect the tumour directly and leave the rest of the body untouched, such as a Surgery or Radiation Therapy. These are generally used during the earlier stages of the cancer, and their goal is to get rid of all the visible microscopic cancer cells. To ensure that all the cells are removed, a portion of the breast tissue surrounding the cancer cells is also extracted.
These are treatments that make use of drugs that are either injected directly into the bloodstream or consumed through the mouth, and their purpose is to affect cancer cells wherever they may be in the body. This is generally used for more advanced cancer stages, and include treatments like Chemotherapy, Hormone Therapy and Targeted Therapy.
It is likely that most cancer treatments often combine aspects of both the local and the systemic treatments. Below, you’ll find a more detailed description of the most common treatments used such as Chemotherapy, Radiotherapy and Surgery.
Chemotherapy refers to a treatment via cancer-killing drugs that is either administered intravenously or through the mouth. Its purpose is to travel all through the body via the bloodstream and kill all cancer cells. It treats the entire body of the patient, not just the breast, and thus it’s a ‘Systemic Treatment’ for Cancer. However, Chemotherapy comes with its fair share of side effects. It needs to be prescribed by a Medical Oncologist, that is, a doctor who specialises in cancer and treatments.
As a result of the accompanying side effects of this treatment, it is prescribed under a certain set of circumstances:
As the name suggests this is Chemotherapy prescribed before a Surgery, in order to shrink a large tumour in size. It is thus used for locally advanced cancer. By using Chemo before the surgery, the doctor may also gauge which drugs work best for the patient.
This is the Chemotherapy prescribed after a surgery to reduce risk of recurrence. It can help kill any cancer cells that may have been left behind after the surgery and couldn’t be seen even with imaging tests. These cells have the potential to again mutate and divide, thus leading to a recurrence. Chemotherapy helps prevent that.
Advanced Breast Cancer Treatment:
This is when Chemotherapy is prescribed as the main treatment option when the Cancer has already spread to other parts of the body.
Chemotherapy drugs may be given between gaps of one week, two weeks, three weeks or even four weeks. And the drugs can be given either individually or in combination with other drugs. The latter option, that is, a combination of drugs, is sometimes recommended for Adjuvant Treatment.
Possible side effects of Chemotherapy are — hair loss, mouth sores, nausea, increased chance of Infections, fatigue, diarrhoea, amongst others.
Radiation Therapy refers to the use of high energy x-ray or other radiation particles in order to destroy cancer cells. Radiation therapy may be prescribed by a Radiation Oncologist after an examination of factors such as age, the extent to which the Cancer has spread, and what kind of surgery the patient has had. It is generally prescribed along with other treatments as well.
The major types of Radiation Therapy are:
External Beam Radiation:
As the name suggests this is radiation directed at the patient’s body from an external machine.
This is Radiation therapy by means of a probe in the operating room.
Internal Radiation or Brachytherapy:
This refers to the treatment when a radioactive source is placed inside a tumour for a short period of time.
This treatment is generally prescribed under the following circumstances:
• After a surgery to help destroy any remainder cancer cells and lower the chances of recur-rence.
• Before a surgery to help reduce the size of the tumour.
• Adjuvant Radiation Therapy after a mastectomy if the tumour is larger than 5 centimetres or has spread to the lymph nodes.
Possible side effects of Radiation Therapy are — Swelling of the breast, changes in the skin, burning, redness, fatigue, pneumonitis i.e., a swelling of the lung tissue, amongst others.
This is a prominent Local Treatment wherein the cancer is treated by removing the tumour with a surgical operation prescribed by a Surgical Oncologist. A surgery may also be performed for other reasons such as to find out whether the cancer has spread to the axillary lymph nodes, or to relieve symptoms of advanced cancer.
The two main types of Surgery are:
Also known as Breast-conserving Surgery, this is the treatment whereby only the affected part is removed. During the surgery, even some of the surrounding healthy breast tissues are removed to ensure that there aren’t any cancer cells left that may eventually grow again.
This is when the entire breast along with the surrounding tissues is removed. A double-mastectomy would involve both breasts being removed. However, those who go for Mastectomy at an early stage most likely do not need Radiation Therapy.