Next question is what is your treatment. Before I get into the specifics, I thought I ought to explain a few things.
1. Standard Treatment - surgery, chemo, radiation, and other standard treatment drugs.
2. Clinical Trials - experimental drugs, what they are and the trials I am eligible for.
3. My plan of treatment (this is still to be decided, so I will leave this for last)
This blog will be about the "standard treatment".
Every surgeon and oncologist will tell you there are 2 steps to cancer treatment.
First there is localized treatment. Cancer is generally located in one place, sometimes more if it's spread (metastasized). How do you "treat" the tumors? You remove them. This means surgery. In breast cancer, this translates to lumpetomy (removal of just the lump) or mastectomy (removal of all of the breast tissue). Mastectomies are broken into unilateral (one breast) and bilateral (both breasts). Surgery and recommendations are based on the type of cancer, how large the tumor is, and if the patient has a genetic mutation/family history that makes them more likely to develop cancer in both breasts.
The 2nd half of treatment for any cancer is "systemic". So surgery removes the cancer, but there is the belief that even after you remove the cancer, there are tiny cancer cells roving around your body that could turn into cancer elsewhere (metastisis). This is where chemo and radiation are introduced.
In very simple terms, chemo drugs are drugs that attack rapidly dividing cells. As cancer is made up of this type of fast cell division, it stops the growth of cancer and can kill it. This is also why chemo causes hair loss and sores in the mouth. The fastest dividing cells in a healthy adult are hair, fingernails and in the mouth. Chemo attacks those healthy cells along with the cancer cells. So the hair falls out, the fingernails slow growth and some patients experiance mouth sores.
The order in which these treatments are applied are currently being researched. There is Neoadjuvant therapy, which means chemo prior to surgery. In the case of larger tumors, chemo can help shrink the tumor to make it more operable. There is also Adjuvant therapy, which means the drugs after surgery. In cases with my small tumor, this is usually the direction suggested.
There currently is no set scientific studies that has determined which order of treatment is best, although this is being studied right now.
So those are the forms of treatment that are most commonly used currently, chemo and surgery. Radiation is applicable depending on what type of surgery you choose. If I were to stop at a lumpectomy, I would also get radiation to help treat the remaining breast tissue, kill any cancer cells the surgery missed, and decrease chances of recurrance. As I plan on removing all the breast tissue (mastectomy), I would not get radiation.
These two treatment types are currently used in almost all cancer treatment. And I say almost because there are always exceptions to every rule.
Beyond chemo and radiation, there are other drugs that are now used in longer term treatment of cancer, but these are specific to the TYPE of cancer you are diagnosed with. If you have hormone positive cancer, you get hormone blockers like Tamoxifen. If you have HER2+ cancer, you take Herceptin to block production of the protein that feeds that cancer. The only other somewhat commonly prescribed treatment currently for breast cancer are drugs called bisphosphonates. These are drugs that help to build up the bone and strengthen the bone to help stop the spread/recurrance of cancer into the bones.
This covers the commonly used and fully tested drugs that are used to treat breast cancer: chemo, radiation, hormone blockers, Herceptin, and bisphosponates.
Next blog will discuss clinical trials, the exciting new drugs that are being tested currently and what trials I am eligible for personally.