Breast Cancer Treatment Options: Hormonal and Chemotherapy

Hormonal therapy

Hormonal therapy keeps cancer cells from getting the hormones they need to grow. It is used to treat women with cancers that are fed by estrogen. You will know if your cancer is fed by estrogen by asking if your tumor is estrogen receptor positive.

Estrogen-receptor-positive cancer means that estrogen or progesterone might encourage the growth of breast cancer cells in your body. Normally, estrogen and progesterone bind to certain sites in your breast and in other parts of your body. But with this treatment, a hormonal medication binds to these sites instead and prevents estrogen from reaching them. This may help destroy cancer cells that have spread or reduce the chances that your cancer will recur. Like chemotherapy, hormonal therapy can affect cancer cells throughout the body. However, with hormonal therapy, your hair will not fall out, and you will not get sick. But there is an increased chance of getting blood clots in your legs, and you may experience menopausal symptoms. Clinical trials are ongoing to see if a new type of hormonal therapy called aromatase inhibitors might be better in starving ER+ cancer cells than tamoxifen.

Chemotherapy

Chemotherapy uses drugs to destroy cancer cells. Chemotherapy may be recommended following surgery to kill any cancer cells that may have spread outside your breast. Chemotherapy for breast cancer is usually a combination of two or more drugs. The drugs enter the bloodstream and travel throughout the body. You may have between four and eight treatments spread over three to six months. The benefit that you will be expected to derive from taking chemotherapy will vary based on your age, tumor size and lymph node status. To calculate the estimated benefit of chemotherapy in your particular case, click here.

In some cases, your physician may suggest neoadjuvant therapy, which means taking chemotherapy drugs before surgery to shrink a breast tumor before an operation. This may make it possible for you to have a lumpectomy rather than a mastectomy to remove the cancer, with the same survival rate as if you were to have chemotherapy after breast surgery. In this situation, your surgeon may opt to do sentinel lymph node biopsy before chemotherapy.

Chemotherapy side effects may include hair loss, nausea, vomiting and fatigue. These occur because in addition to attacking cancerous cells, chemotherapy affects healthy cells - especially fast-growing cells in your digestive tract, hair and bone marrow. Not everyone has side effects; today there are better ways to control them if you do.

Many new drugs can help prevent or greatly reduce nausea. Relaxation techniques, including guided imagery, meditation and deep breathing also may help. In addition, exercise has been shown to be effective in reducing fatigue caused by chemotherapy. Clinical trials are ongoing to determine the relationship between stress and response to chemotherapy