Surviving Breast Cancer: Better Early Detection and New Treatment Methods Are Helping to Lower the Mortality Rate from the Second Most Deadly Cancer Killer of Women

By Hughes, Carolyn | The Saturday Evening Post, March-April 2002 | Go to article overview

Surviving Breast Cancer: Better Early Detection and New Treatment Methods Are Helping to Lower the Mortality Rate from the Second Most Deadly Cancer Killer of Women


Hughes, Carolyn, The Saturday Evening Post


Part II

Editor's Note: In the first part of this article (February 2002 SEP), Dr. Hughes discussed mammography and early diagnosis, breast-conserving surgery, and radiation and hormonal therapies.

Chemotherapy Adds to Survival

What else can be done to help keep the cancer from coming back? Combinations of chemotherapy drugs can be given to attack any remaining cancer cells that may be lurking in a woman's body.

"Cancer chemotherapy has made a difference," said Dr. A. Marilyn Leitch of the University of Texas, "but the benefits are greater for those with the highest risk of relapse." So if chemotherapy cuts the risk of recurrent cancer by 30 percent, the "bang for the buck" would be a lot more for someone with a 50 percent chance of recurrence (overall 15 fewer in 100 women) than someone with a 10 percent chance of recurrence (overall 3 fewer in 100 women). As a rule, younger women with spreading to the lymph nodes (who are most likely to have the cancer come back) get the most help, with about 12 percent improvement in survival at ten years. Older women see less benefit, with 2 to 6 percent better survival at ten years.

Chemotherapy involves taking four to six monthly cycles of combinations of cancer-fighting drugs. A woman often has a long-term IV catheter implanted under the skin, through which she receives the treatments. Recent studies have shown that treatment combinations which include one of the powerful, but more toxic, anthracycline family of drugs (such as doxorubicin) have given women a slightly better chance of survival over those that did not use this family of drugs, with fewer monthly cycles.

But chemotherapy is no walk in the park. This was the hardest part for Lisa Schmidt, a 45-year-old breast cancer patient.

"I felt so bad for four days after I got the chemotherapy treatments. Later, my hair started to fall out," she says. Hair loss is a common side effect of chemotherapy that women should be prepared for. A custom-dyed wig helped Lisa get through this difficult time: "It really did help me to feel better," she says. She received it from an organization that helps cancer survivors by giving makeup and hair advice (www.lookgoodfeelbetter.org).

Other side effects of chemotherapy include fatigue, nausea or vomiting, and susceptibility to infection. The anthracycline drugs may also lead to heart damage, so the dosage given has to be carefully monitored.

New treatments are being tested for women who have breast cancer that has recurred or is already widespread when it is diagnosed, such as the taxane family of drugs, including Taxol (paclitaxel). Also, stem cell transplants are being tried along with higher doses of combination chemotherapy. Whenever possible, experimental treatments should be used in the setting of a clinical trial, for the sake of future generations of women with breast cancer.

A Personal Decision

Every woman with breast cancer is different. Many things come into play when deciding on a course of treatment, such as her age and health, the appearance of the cancer, the stage, the receptors, and her personal feelings about the treatment and about preserving her breast. Together with her physician, each woman must decide what course of action is right for her.

Actress Suzanne Somers surprised some of her fans when she recently decided to forgo chemotherapy for breast cancer and try an herbal treatment, Iscador. An extract of mistletoe, this substance is toxic to cells and has some activity as a stimulant to the immune system. It hasn't been found to improve survival in breast cancer. As of now, none of the alternative treatments have yet made a convincing case for use in breast cancer. But many drugs that are used originate from plants, like the vinca alkaloids (vincristine and vinblastine) from periwinkle and the taxanes (paclitaxel and docetaxel) from the Pacific yew tree.

Can a Pill Prevent Breast Cancer? …

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