Handling and Treatment of Breast Cancer

Handling and treatment of breast cancer depends on the type and stage experienced by patients. Generally the new person known to have breast cancer after stepping up stadiums are quite severe, this is due to a lack of knowledge or a sense of shame so too late for medicine was examined for abnormalities that it faces.

Here's an example, 
• The size and location of the tumor? 
• Whether the cancer has spread?
• The health condition of the patient as a whole.?

In general, doctors will work with patients to determine the treatment plan Although the treatment of each patient will be adjusted by the doctor. But here are the general steps undertaken in the treatment of breast cancer:

• The main purpose of early-stage cancer treatment is to remove the tumor and tissue surrounding the tumor. So doctors will recommend surgery to remove the tumor. Generally, radiation therapy will then be performed on the remaining breast tissue. For certain circumstances (eg, patients with serious medical problems) radiation can be postponed.



• The following steps in dealing with early stage cancer is to reduce the risk cancer will recur and discard the remaining cancer cells. When the tumor is large lymph nodes or channels have been stricken with cancer as well, the doctor will recommend additional therapy, among others: Radiation Therapy, Chemotherapy, and / or hormone therapy. As for the recurrence of cancer, treated with a variety of ways. 

 When planning treatment, doctors will consider several factors:
• Stage and grade of cancer 
• status of the tumor hormone receptor (ER, PR) and HER2/neu status
• Age of patients and the general health
• Patients have gone through menopause or not 
• The presence of gene mutations of breast cancer biology breast cancer condition an effect on the behavior of the cancer and its treatment. Some tumors are small in size but growing in size fast or big but slow growth.Treatment with surgery;
In general, the smaller the tumor, it is recommended to operasi.Berikut is type-type operation:

• Lumpectomy (Partial mastectomy / Segmental mastectomy), remove the tumor and tissue around the tumor clean. For DCIS and invasive cancer, usually radiation therapy to the affected area given tumor.

Total mastectomy, removes the entire breast, but not including the lymph nodes under the armpit

• Modified radical mastectomy, removing the breast and lymph nodes under the armpit.
• Axillary node limph, raised dots underarm lymph nodes, cancer cells and then examined by a pathologist.

• Sentinel lymp node biopsy, a procedure where the surgeon will seek out and then lift the main lymph node armpit pad (sentinel lymph node) is directly related to the breast. Pathologist will then examine the cancer cells. To identify the sentinel lymp node surgeon will inject a liquid and / or radioactive tracer into the area around the nipple. Fluid or tracer were going to point-point flow of lymph nodes, the first will get to the sentinel lymp nodes. Surgeons will find the points on the KGB (lymph nodes) a different color (if used fluid) or radiation (when using a tracer). This method will typically have a lower risk of lymphedema (swelling of the arm) than the axillary lymp node dissection. If the sentinel node is free, but the result of the spread of cancer, then no further operations to the KGB. If otherwise, then followed the surgical removal of the KGB.

 
Women who have performed mastectomy could then consider doing a breast reconstruction surgeon will make the new breast. Reconstruction can be done by taking tissue from other body parts. Or with a synthetic implant. This can be done directly at the time of mastectomy may well afterwards.

 

Adjuvant therapy.  

Treatment is given as an adjunct treatment after surgery. The goal is to reduce cancer risk for relapse. But every cancer treatment no one would be rid of cancer (only God knows, the human endeavor alone). Adjuvant Therapy include: Radiation Therapy, Chemotherapy, Hormone therapy and Targeted Therapy. Below is an outline of adjuvant therapy:

 

1. RADIATION THERAPY. This therapy uses X-ray high berenergy or other particles to kill cancer cells. This therapy is given regularly per week. Usually 5 days a week. (Monday - Friday) for 6-7 weeks. The goal is: kill cancer cells that may still exist / teetinggal area around the tumor that was inoperable, shrink the size of the tumor before surgery, to make it easier at the time of appointment. My experience, when metastatic cancer ketulang back, in as much as 10x radiation to relieve pain. Danuntuk shrink the tumor before surgery in as many as 38 times more radiation. Radiation process is not painful to the process is not long. Not until four minutes, there is no any effect. Only the areas in the radiation should not be exposed to water because it can blister. When I radiation in the armpit, is somewhat scuffed. Because usually underarm sweating. Can be treated with a bandage wounds, after a somewhat dry the wound can spread with cream / ointment for abrasions due to radiation.

2. Chemotherapy. Chemotherapy is the use of a drug whose function is to kill cancer cells. Systemic chemotherapy, Chemo drugs are channeled through the blood vessels, the target is the entire cancer cell in the body. Side effects of chemotherapy drugs are very individualized, depending on each patient is also given dosisi usually the doctor will calculate the area of ​​the body through the patient's weight. At the time I did a year ago and now chemotherapy side effects can say there is no / can be ignored. What I feel is hair loss, when leukocytes begin to come down to feel very tired. Others do not exist. (To minimize the side effects will be discussed separately). Side effects are generally perceived patient is:

1. Hair loss2. Possible risk of infection (basanya thrush in the mouth, throat, difficulty swallowing due to a fungal infection)3. Blackened nails and skin, sometimes dry skin4. Nausea & vomiting5. Bones ache6. Loss of appetite7. Diarrhea or even constipation8. Stomach acid rises 

The symptoms will usually disappear when treatment is completed. Chemotherapy can be administered orally (drink) and intravenous (infused). Beseri given (for the oral is usually taken for 2 weeks, rest 1 week. When infused 6 times a Chemo, the distance is 3 weeks for a full dose). Usually do not have to stay in hospital, where one hour after the Chemo does not have any effect. If the nausea a little bit it's okay to be away from home usually directly rest / sleep.

Chemotherapy, can be given as neoadjuvant therapy (given before surgery is held, the goal is to shrink large tumors, cancer heal wounds that have been broken due to cancer), or adjuvant therapy (given after surgery, to reduce the recurrence).

In which case if cancer recurrence (cancer reccurence). Patients are typically offered to use new drugs or combinations of existing drugs. Different drugs, are useful for different cancers. And research shows that the combination of certain drugs would be more effective than individual drugs. Drug - a drug commonly used chemotherapy for breast cancer are:

• Cyclophosphamide (Cytoxan, Neosar)• Methotrexate (many brands)• Fluorouracil (5-Fu, Adrucil)• Doxorubicin (Adriamycin, Rubex)• Paclitaxel (Taxol)• Docetaxel (Taxotere)• Vinorelbine (Navelbine)• Capecitabine (Xeloda)• Proteins bound paclitaxel (Abraxane)• Gemcitabine (Gemzar)• There is also a new drug made by Brysto Myers Squib and the Ixempra (but not yet circulated in Indonesia, because it is still very new)• Etc.

Examples of drug combinations:
• CMF (cyclophosphamide, methotrexate, and 5-FU) 
• FAC (5-Fu, Doxorubicin, cyclophosmide)• TAC (docetaxel, doxorubicin, and cyclophosphamide)
• GT (gemcitabine and paclitaxel) 
• Etc. 

Some of these drugs can also be combined with trastuzumab (Herceptine), a drug belonging to the targeted therapy. In the treatment of cancer will always be evaluated by team doctors also better if patients actively involved.

3. HORMONE THERAPY. Hormone therapy is useful for patients who biopsynya results showed positive results for estrogen receptor (ER +) and Progesterone receptors (PR +) means that this type of cancer is influenced by hormone-growth hormone so that the necessary drugs to block hormone to limit / halttumor growth. Can use alone or in conjunction with chemotherapy drugs. Examples of hormone therapy as adjuvant therapy is tamoxifen, anastrozole (Arimidex), letrozole (Femara) and exemestane (aromasin).
 

A. estrogen receptor
B. estrogen
C. Estrogen helper protein
D. Cell nucleus
E. DNA (genetic material) inside the cell nucleus

 

Cell with estrogen receptors blocked by tamoxifen and helper proteins:
A. estrogen receptor
B. tamoxifen
C. Estrogen helper protein
D. Tamoxifen helper protein
E. Cell nucleus
F. DNA (genetic material) inside the cell nucleus

4.TARGETED THERAPYis including new drugs work to halt / stop the action of an abnormal protein (HER2/neu) that causes the cancer cells grow and divide terkontrol.Monoclonal no antibodies targete protein normally present in large amounts in cancer cells.
• Trastuzumab (Herceptin) is used as a cure for breast cancer that contains too much protein HER2/neu.

• Bevacizumab (Avastin) is antiangiogenic. (Still in clinical trials). This agent Antiagiogenesis blocking angiogenesis (formation of new blood vessels) are needed to develop  tumors and metastases.

Posted in: Breast Cancer,Cancer