Other Treatments for Breast Cancer
There are several other different types of treatment for breast cancer, for which we will provide a brief overview. These include:
- hormone therapy
Hormone therapy is used to prevent the growth, spread, and recurrence of breast cancer. The female hormone estrogen can increase the growth of breast cancer cells in some women. Hormones are chemicals produced by glands, such as the ovaries and testicles. Hormones help some types of cancer cells to grow, such as breast cancer and prostate cancer. Hormone therapy may be considered for women whose breast cancers test positive for estrogen or progesterone receptors.
A hormone receptor test measures the amount of certain proteins (called hormone receptors) in cancer tissue. Hormones (such as estrogen and progesterone that naturally occur in the body) can attach to these proteins. If the test is positive, it is indicating that the hormone is probably helping the cancer cells to grow. In this case, hormone therapy may be given to block the way the hormone works and help keep the hormone away from the cancer cells (hormone receptors). If the test is negative, the hormone does not affect the growth of the cancer cells, and other effective cancer treatments may be given.
Always discuss the results of the hormone receptor test with your physician.
An antiestrogen drug frequently used, called tamoxifen (Nolvadex®), blocks the effects of estrogen on the growth of malignant cells in breast tissue. However, tamoxifen does not stop the production of estrogen. Side effects that may occur when taking tamoxifen include hot flashes, nausea or vomiting, vaginal spotting, fatigue, headaches, and skin rash.
Taking tamoxifen also increases the risk of endometrial cancer (involves the lining of the uterus) and uterine sarcoma (involves muscular of the uterus), both cancers of the uterus. There is also a small risk of blood clots and stroke.
A second antiestrogen drug under study for breast cancer prevention, called Raloxifene®, is not recommended for women who have already been diagnosed with breast cancer.
Drugs recently approved by the US Food and Drug Administration (FDA), called aromatase inhibitors, are used to prevent the recurrence of breast cancer in postmenopausal women. These drugs, such as anastrozole (Arimidex®) and letrozole (Femara®), prevent estrogen production. Anastrozole is effective only in women who have not had previous hormonal treatment for breast cancer. Letrozole is effective in women who have previously been treated with tamoxifen. Possible side effects of these drugs include osteoporosis or bone fractures.
Another new drug for recurrent breast cancer is fulvestrant (Faslodex®). Also approved by the FDA, this drug eliminates the estrogen receptor rather than blocking it, as is the case with tamoxifen, letrozole, or anastrozole. This drug is used following previous antiestrogen therapy. Side effects for fulvestrant include hot flashes, mild nausea, and fatigue.
Another means of stopping the production of estrogen is the use of surgery to remove the ovaries in women who have not gone through menopause, called an oophorectomy.
- adjuvant therapy
Adjuvant therapy is therapy given after the primary therapy - usually surgery to remove the cancer - to reduce the chance of the cancer spreading or recurring. The adjuvant therapy may be radiation, chemotherapy, or hormone therapy. When a therapy is given before the primary treatment, it is called neoadjuvant therapy.
- biological therapy
Biological therapy uses the body's own materials, or those made in a laboratory, to assist the body in fighting the cancer. It may also be called biological response modifier therapy, or immunotherapy.
Biological therapy treatments are designed to repair, stimulate, or increase the body's natural ability to fight cancer.
The immunotherapy drug used for breast cancer is called trastuzumab (Herceptin®). This monoclonal antibody works against a protein that encourages breast cancer cells to grow. This drug may be combined with chemotherapy and hormonal therapy.
A growth-promoting protein called HER2/neu is present in small amounts on the surface of normal breast cells and most breast cancers. In some breast cancers, this protein is present in higher amounts and these cancers will tend to be more aggressive. Herceptin attaches to this protein and by doing so, slows the growth of the cancer and, in some cases, shrinks tumors.
Herceptin has only been approved for use in women with metastatic breast cancer. However, studies published in 2005 found that use of Herceptin, along with chemotherapy, in early stage breast cancer may cut the chance of recurrence in half. More trials on this use are ongoing.
- bone marrow transplant / autologous stem cell therapy
High doses of chemotherapy or radiation are sometimes used to kill cancer cells, also killing healthy blood-forming stem cells. To combat this, stem cells taken earlier from the patient's bone marrow, or separated from the blood, are later returned to the patient to help restore the body's ability to fight infection.
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