How To Treat Breast Cancer?
How To Treat Breast Cancer? There are several factors that become a doctor’s consideration before deciding the best treatment, namely the stage and the rate of cancer development, the overall health condition of the patient and the menopause.
Breast cancer is detected through routine examination is usually in the early stages. Primary breast cancer (the first cancer cell begins with breast cells and not the spread of cancer cells from other organs) can generally heal totally if diagnosed and treated early.
While the cancer is detected due to physical symptoms that appear may already be in a more advanced stage. If detected at an advanced stage and after spreading to other parts of the body, then breast cancer can not be cured. The type of treatment to be recommended is also different and aims to ease the burden for the sufferer.
The first type of breast cancer treatment is usually surgery. The type of surgery varies depending on the type of breast cancer you are suffering from. The surgical process is usually followed up with chemotherapy, radiotherapy, or biological treatments for certain cases. Chemotherapy or hormone therapy can sometimes be the first treatment step.
If detected at an advanced stage after spreading to other parts of the body, breast cancer can not be cured. The type of treatment to be recommended is also different and aims to ease the burden for the sufferer.
Surgery for breast cancer is divided into two, ie surgery that only removes the tumor and surgery that raises the breasts thoroughly (mastectomy). Plastic surgery reconstruction can usually be done immediately after a mastectomy.
To deal with early-stage breast cancer, studies have shown that surgical combination of tumor removal and radiotherapy have the same success rate as total mastectomy.
- Lumpectomy (surgical removal of the tumor)
In lumpectomy, the shape of the breast will be left as completely as possible. This operation is generally recommended for small tumors and includes removal of the tumor along with a bit of healthy tissue around it. Considerations in determining the amount of breast tissue to be removed include the quantity of tissue around the tumor that needs to be removed, the type, size, location of the tumor, and the size of the breast.
- Mastectomy (removal of the breast)
This surgical process is the removal of the entire breast tissue, including the nipple. Patients may undergo mastectomy along with sentinel lymph node biopsy if there is no indication of cancer spread in the lymph nodes. Conversely, patients are advised to undergo the process of removal of lymph nodes in the armpits if the cancer has spread to that part.
- Plastic surgery reconstruction
This is the process of surgery to make the new breasts as closely as possible with the other breasts. Reconstructive plastic surgery can be done in two ways, namely a direct reconstruction operation simultaneously with a mastectomy, and a periodic reconstruction surgery done some time after a mastectomy. This new breast-making operation can be performed by using breast implants or tissues from other body parts.
Chemotherapy is generally there are two types, namely chemotherapy after surgery to destroy cancer cells and before a useful operation shrink tumors. The types and combinations of anticancer drugs used will be determined by the physician based on the type of cancer and its extent.
The side effects of chemotherapy will generally affect healthy cells. Therefore, the prevention or control of some side effects will be treated with other medicines by doctors. Some of the side effects of chemotherapy include loss of appetite, nausea, vomiting, mouth ulcers or a sore sensation in the mouth, susceptible to infection, fatigue, and hair loss.
Chemotherapy can also inhibit the production of the body’s hormone estrogen. Patients who have not experienced menopause will experience menstruation that stops during chemotherapy. This cycle should return after treatment is completed. However, early menopause may also occur in women over the age of 40 as they approach the average age of menopause.
If other body parts have been affected by the spread of breast cancer, chemotherapy will not be able to cure cancer. But chemotherapy can shrink tumors, relieve symptoms, and prolong life.
Radiotherapy is a therapeutic process to destroy the remnants of cancer cells with controlled doses of radiation. This process is usually given about a month after surgery and chemotherapy to condition the body can recover first. But not all breast cancer patients need it.
Just like chemotherapy, this procedure also has side effects, namely irritation so that the breast skin is sore, red, and watery, the skin color of the breast becomes darker, excessive fatigue and lymphedema (excess fluid that arises in the arm due to blockage of lymph nodes in the armpits).
Hormone Therapy To Overcome Breast Cancer
Especially for breast cancer whose growth is triggered by estrogen or natural progesterone (hormone-positive hormone receptor), hormone therapy is used to lower the level of cancer or inhibit the effects of these hormones. This step is also sometimes performed before surgery to shrink the tumor to be easily removed, but is generally applied after surgery and chemotherapy.
If the condition is not healthy, the patient will not be able to undergo surgery, chemotherapy, or radiotherapy. Therefore, hormone therapy can be an alternative as a single treatment process.
The duration of hormone therapy that is generally recommended is a maximum of five years after surgery. The type of therapy that will be lived depends on the age, whether you have menopause or not, the rate of cancer development, the type of hormone that triggers cancer, and other types of treatment that is lived.
Tamoxifen and aromatase enzyme inhibitors are two types of drugs commonly used in hormone therapy. Tamoxifen serves to inhibit estrogen from binding to cancer cells.
While the inhibitor of aromatase enzyme is recommended for patients who have experienced menopause. Its function is to inhibit the performance of aromatase, a substance that helps estrogen production in the body after menopause. Examples of these drugs in the form of tablets available and taken every day are letrozol, eksemestan, and anastrozol.
Tamoxifen and aromatase enzyme inhibitors may cause several similar side effects, including headache, nausea, vomiting and heat sensation, sweating, and hot flushes. However, tamoxifen has a special side effect, which can cause changes in menstrual cycle in breast cancer patients.
Step Ablation Or Ovarian Suppression
Ovarian ablation or suppression will stop the ovaries from producing estrogen.
Ablation itself can be done with surgery or radiotherapy. Ovarian ablation will permanently stop the performance of the ovaries and trigger early menopause.
Ovarian suppression utilizes luteinising hormone-releasing hormone (aLHRH) agonist called goserelin. Use of this drug will stop menstruation for a while. Menstruation will return to normal after the use process is complete. For people aged close to the age of menopause or about 45 years, their periods may stop permanently even if goserelin is over.
Goserelin injections are given once a month. The side effects of these drugs resemble those of menopause such as emotional feeling, difficulty sleeping and thermal sensations accompanied by heart palpitations.
Biological Therapy With Trastuzumab
The growth of some types of breast cancer triggered by the HER2 protein (human epidermal growth factor receptor 2) is called HER2 positive. In addition to stopping the HER2 effect, biological therapy also helps the immune system to fight cancer cells. If your HER2 protein level is high and you are able to undergo biological therapy, trastuzumab may be recommended by your doctor for you after chemotherapy.
Antibodies serve to destroy harmful cells such as viruses and bacteria. These proteins are produced naturally by the immune system. Trastuzumab is a type of biological therapy known as monoclonal antibody. This drug will inhibit HER2 so that cancer cells will die.
This therapy is not suitable for patients with heart disease such as angina, hypertension, or heart valve disease. If it is required to use trastuzumab, patients should undergo regular cardiac examination. Other side effects of trastuzumab are nausea, headache, diarrhea, shortness of breath, chills, fever, and pain.