Chemotherapy is a treatment used by oncologists whereby a combination of drugs that can destroy cancer cells are delivered through the bloodstream. Injected intravenously or taken orally, these drugs are often used in addition to surgery, radiation or to treat cancer that has recurred. Some common side effects are nausea, vomiting, temporary hair loss, low blood counts and early menopause. Not everyone suffers all of these side effects and researchers are finding many ways to counter these. Some of the current clinical trials are specifically targeting the "quality of life" issues of cancer patients.
In the 80's, oncologists started using a method called "fractionated drip infusion" where patients received small repeated doses instead of one large injection. This method is more effective at against the cancer and is also less toxic to the patient. Treatments usually last three to six months.
There are drugs that your oncologist can prescribe to reduce side effects such as nausea, vomiting and low blood counts. Since some herbal remedies may interfere with the effectiveness of chemo treatments, you should always discuss these with your oncologist.
Combinations of drugs have proven to be more effective against cancer cells. Two commonly used combination are:
The Physician's desk reference (PDR) is a good source to find out more about any drug that is prescribed by your doctor. You may also get information from your local pharmacy. Every drug comes with a drug information sheet that cites the usage, dosage, possible side effects and drug interaction facts.
The BC Cancer Agency has a section on their website that provides drug information. BC stands for British Columbia, so this list may not be comprehensive of chemotherapuetic drugs used in the U.S. www.bccancer.bc.ca/cdm/patients/cid/contents.shtml
Doctors can prescribe drugs to reduce side effects. Zofran is an effective drug that can stop vomiting. There are some indications that Zofran may reduce vomiting but not reduce nausea. There is an upcoming study by Gary Morrow of the University of Rochester Medical School which is designed to check the efficacy of Zofran and its cousins for treatment of nausea.
Hormone therapy is the treatment of cancer by removing, blocking or adding hormones.
Tamoxifen® (Novalex) is one form of chemotherapy that has been used successfully for the past twenty years to reduce tumors prior to surgical removal. Some cancer growths are promoted by estrogen and Tamoxifen blocks the effects of the hormone estrogen. Tamoxifen is most effective in stopping the growth of tumors that test positive for an estrogen receptor. (65% to 80% of breast cancers in postmenopausal women and 45% to 60% in premenopausal women test positive for an estrogen receptor.
There is a relatively new market for this drug as a preventative treatment (to prevent the recurrence of breast cancer). There has been a lot of controversy, however, over its effectiveness. Side effects include mild nausea, weight gain, vaginal dryness or discharge, early onset of menopause (hot flashes, mood swings), depression and a slight increase in the incidence of endometrial cancer. (Endometrial cancer is easily diagnosed and treated in post-menopausal women since one of its early symptoms is vaginal bleeding.) There is concern that Tamoxifen resistence occurs with prolong use. To read more on this drug, visit CancerBACUP
Read an exerpt of an article by Sherrill Sellman about Tamoxifen.
A new clinical trial, STAR (Study of Tamoxifen and Raloxifene) is presently studying the effects of Tamoxifen against Raloxifene (Evista). Raloxifene has traditionally been used to prevent postmenopausal osteoporosis. Raloxifene blocks estrogen in a similar way to Tamoxifen, but does not increase the chances of endometrial cancer. See article Raloxifene (Evista®) Osteoporosis Trials Show Reductions in Breast Cancer Incidence 05/18/98
There are other forms of hormone therapy. Megestrol acetate (Megace), Anastrozole (Arimidex), Formestane (Lentaron), Goserelin (Zoladex), Letrozole (Femara), Medroxyprogesterone acetate (Provera, MPA or Farlutal), Toremifene (Fareston) a modified form of Tamoxifen (Novalex) and a new agent Exemestane a derivative of androstenedione. To read more on these drugs, visit CancerBACUP
Years ago, it was customary in the U.S. to remove the ovaries from women who had breast cancer. This surgery eliminated the body's main source of estrogen.
Anti-HER2 Humanized Monoclonal Antibody
Herceptin® (trastuzumab) is a drug used to treat breast cancer that has spread to other parts of the body. Herceptin® is a monoclonal antibody designed to block a protein receptor called HER2 that is produced in excess amounts in some women with breast cancer (about 25 percent to 30 percent). These women have too many copies of Her-2/nue, a gene that triggers the production of a protein that may help cancer cells reproduce. Herceptin® is a genetically engineered copy of this antibody that can block the action of the protein.
Genentech, a biotechnology company, developed the drug. More about Herceptin. Learn about the history of Herceptin
Source: National Cancer Institute and NBC. "The drug is almost nontoxic, with none of the common debilitating side effects of chemotherapy."
Radiation may be used before surgery to decrease the size of the tumor or after surgery to decrease the chances of recurrence.
Treatments of radiation therapy after a lumpectomy reduces the rate of breast cancer recurrence the same as treatment with a total mastectomy. The procedure is relatively painless, however, dryness, itching, slight swelling and fatigue may occur after treatments. Today, radiation treatments are delivered with computer-assisted precision to the site of the tissue. Brachytherapy, or interstitial radiation therapy, places the source of radiation directly into the tumor. .
Whole body hyperthermia involves a very sophisticated hot tub device, general anesthesia and medical supervision. Regional hyperthermia can involve either a miniature water-bed like device applied to the tumor or focused microwaves. Ultrasound and radio frequency waves are methods that can also be found but are less popular.
Most experts believe that hyperthermia by itself is not all that effective.
Treatments given in conjunction with radiation, mistletoe or chemotherapy
enhances the results of these treatments and can reduce the side effects
by allowing for lower doses.
Biological therapies attempt to focus the immune system into a more vigorous attack on the cancer. Lymphokines are produced by the immune system to kill invading cells, such as cancer. Lymphokine activated killer cells taken from the patient's blood are incubated in the laboratory in the presence of a stimulator (interleukin-2) and then injected back into the cancer patient's body for an improved immune response.
Interferon, interleukin, monoclonal antibodies and tumor necrosis factor are among the leading contenders as biological therapies against cancer. The downside of biological therapies is that most forms have extremely toxic side effects, and none can be used legally in the U.S. unless the patient has been considered untreatable by three other conventional means. The National Cancer Institute is beginning to place more emphasis on researching biological therapies.
Note: In June, 1999 The Breast & Cervical Cancer Treatment Act was passed. This act provides federal funds to the state to care for patients of these diseases who are not insured or who are under insured. More on the The Breast & Cervical Cancer Treatment Act
(I found this information at: http://web2.airmail.net/lorac1/Mammogram.html)