Will My Breast Cancer Come Back? Reducing the Risk of Breast Cancer Recurrence After Surgery
More than 215,000 women are diagnosed with breast cancer every year. For many of them, surgery to remove the tumor is just the first step in the battle against the disease, often followed by radiation and/or chemotherapy. After that, these women may need to decide with their doctor whether to have “adjuvant therapy”-medication to help prevent their cancer from coming back.
When a woman’s breast cancer does come back or spreads to other parts of the body, she may be at greater risk of dying from the disease. Women whose breast cancer is detected in the nearby lymph nodes at diagnosis and those who receive chemotherapy after surgery are considered to be at increased risk for breast cancer recurrence.
Postmenopausal women whose early-stage breast cancer is hormone-sensitive have a new option as their first hormone therapy following surgery. The U.S. Food and Drug Administration recently approved Femara® (letrozole tablets) on December 28, 2005 for this type of use. This approval was based on a median of 24 months of treatment. The study is still ongoing to determine the long-term safety and efficacy of Femara. Already a leading breast cancer treatment, Femara is now the only medicine in a group called aromatase inhibitors that is approved for use both immediately following surgery and after five years of tamoxifen. The FDA granted Femara a priority review, a distinction reserved for medications that could potentially offer a significant improvement compared to products currently on the market.
A panel from the American Society of Clinical Oncology, the country’s leading group of oncologists, recommends aromatase inhibitors, such as Femara, be part of the optimal adjuvant treatment for this group of women.
“One of the greatest fears confronted by women who have been treated for early breast cancer is that their cancer will come back. With Femara, we now have an option that can help address that fear early on, even in patients who we know face the greatest risk of recurrence,” said Matthew Ellis, MD, PhD, FRCP, director of the Breast Cancer Program at Washington University in St. Louis.
In a large clinical study of post-surgery breast cancer treatment, researchers compared the effectiveness of Femara and tamoxifen, another drug prescribed after surgery. An analysis performed after 26 months showed that Femara reduced the risk of breast cancer coming back by 21% over the reduction offered by tamoxifen. Patients taking Femara also showed a 27 percent reduction in the risk of the cancer spreading to distant parts of the body.
In this study, women at increased risk of recurrence experienced the greatest benefit from Femara. Femara lowered this risk by 29 percent in women whose breast cancer had already spread to the lymph nodes at the time of diagnosis and by 30 percent in women who had prior chemotherapy. The results also showed that in these high-risk women, Femara reduced the risk of cancer spreading to distant parts of the body by 33 percent and 31 percent, respectively.
In this study, Femara was generally well tolerated with the most common side effects including hot flashes, joint pain, night sweats, weight gain and nausea.
Tips for Living Healthy
Discuss postsurgery treatment options with an oncologist. Whether you’re one, five or 10 years beyond your diagnosis, taking care of your overall health and well-being can also reduce your risk of cancer coming back and give you the energy to do the things in life that you love.
• Practice good nutrition
• Exercise regularly
• Tap into a support network
• Take time out for yourself
Editors Note: Important safety information
Femara® (letrozole tablets) is approved for the adjuvant (following surgery) treatment of postmenopausal women with hormone receptor−positive early breast cancer. The benefits of Femara in clinical trials are based on 24 months of treatment. Further follow-up will be needed to determine long-term results, safety and effectiveness.
Talk to your doctor if you’re allergic to Femara or any of its ingredients. You should not take Femara if you are pregnant as it may cause fetal harm. You must be postmenopausal to take Femara. Some women reported fatigue and dizziness with Femara. Until you know how it affects you, use caution before driving or operating machinery. There was an increase in cholesterol in patients on Femara versus tamoxifen (5.4% vs. 1.2%).
In the adjuvant setting, commonly reported side effects were generally mild to moderate. Side effects seen in Femara versus tamoxifen included hot flashes (33.7% vs. 38%), joint pain (21.2% vs. 13.5%), night sweats (14.1% vs. 13.5%), weight gain (10.7% vs. 12.9%) and nausea (9.5% vs. 10.4%). Other side effects seen were bone fractures and osteoporosis.
What You Need To Know If Your Mother Had Breast Cancer
If your mother had breast cancer, you have an increased chance of developing it yourself. Knowing your family history, understanding your personal risk, getting appropriate screening tests and making lifestyle choices are important steps toward good breast health, according to the Susan G. Komen Breast Cancer Foundation.
“If breast cancer runs in your family, understanding your risk and how to approach your breast health is important to both your physical and emotional well-being,” says Cheryl Perkins, M.D., senior clinical advisor for the Komen Foundation.
Family History and
Increased Risk
If your mother, sister or daughter has breast cancer, your risk of developing the disease is two to three times greater than a woman without this family history. However, being at increased risk for breast cancer does not guarantee you will develop the disease. Talk to your provider to discuss your personal risk and his/her recommendations for regular screening. Regular screening usually includes mammography, clinical breast exams and breast self-exam. Additional screening may be recommended depending on your personal risk.
Gene Mutations and
Genetic Testing
Only 5 to 10 percent of all breast cancer is due to heredity. Genetic testing can determine if you inherited the mutated BRCA1 or BRCA2 genes, which are key in the development of some breast cancers. However, having a mutated gene does not guarantee that you will get breast cancer. If you have concerns about your family history and personal risk, talk with your doctor about whether genetic testing is right for you.
Taking Preventive Steps-Making Healthy Lifestyle Choices
Many factors can increase a woman’s chance of getting breast cancer. While some risks, such as being a woman and getting older, are out of your control, others can be managed. For example, risk factors such as consuming alcohol, lack of exercise and being overweight are all factors that you can modify.
Helping Your Mother Through Breast Cancer
If your mother is diagnosed with breast cancer, she needs your support. From diagnosis through treatment and beyond, your mother’s co-survivor network of family and friends will be a vital part of her support system.
Solution To Breast Cancer!
How long should a patient take tamoxifen for the treatment of breast cancer?
Patients with advanced breast cancer may take tamoxifen for varying lengths of time, depending on their response to this treatment and other factors. When used as adjuvant therapy for early stage breast cancer, tamoxifen is generally prescribed for 5 years. However, the ideal length of treatment with tamoxifen is not known.
How Often Should I Take Tamoxifen?
Two studies have confirmed the benefit of taking adjuvant tamoxifen daily for 5 years. These studies compared 5 years of treatment with tamoxifen with 10 years of treatment. When taken for 5 years, the drug reduces the risk of recurrence of the original breast cancer and also reduces the risk of developing a second primary cancer in the other breast. Taking tamoxifen for longer than 5 years is not more effective than 5 years of therapy.
What is Tamoxifen
Tamoxifen is an oral selective estrogen receptor modulator which is used in breast cancer treatment, and is currently the world’s largest selling breast cancer treatment. It is used for the treatment of early and advanced breast cancer in pre- and post-menopausal women. It is also approved by the FDA for the reduction of the incidence of breast cancer in women at high risk of developing the disease. It has been further approved for the reduction of contralateral (in the opposite breast) breast cancer.
Tamoxifen and Cancer
Tamoxifen is used to reduce the risk of breast cancer for women who:
1. are at high risk of breast cancer but have no personal history of the disease
2. have non-invasive, hormone-receptor-positive breast cancer, or DCIS (ductal carcinoma in situ)
3. have hormone-receptor-positive invasive breast cancer at any stage.
Tamoxifen is sometimes used to treat gynecomastia in men. Tamoxifen is also used by bodybuilders in a steroid cycle to try and prevent or reduce drug-induced gynecomastia caused by steroids that are used in the same cycle.
Tamoxifen is also used to treat infertility in women with anovulatory disorders. A dose of 10-40 mg per day is administered in days 3-7 of a woman’s cycle.
Reduce Breast Cancer By 45%!
A US study of 13,000 patients showed Tamoxifen reduced the rate of expected cancers from one in 130 to one in 236 – a cut of about 45%. The American researchers ended their trial early when they said the drug’s benefits became overwhelmingly obvious.
Other studies found that tamoxifen AND chemotherapy improved survival improved survival rates by about 40–50% compared to taking one treatment or the other.
Should women taking tamoxifen avoid pregnancy?
Yes. Tamoxifen may make premenopausal women more fertile, but doctors advise women on tamoxifen to avoid pregnancy because animal studies have suggested that the use of tamoxifen in pregnancy can cause fetal harm. Women who have questions about fertility, birth control, or pregnancy should discuss their concerns with their doctor.
Does tamoxifen cause a woman to begin menopause?
Tamoxifen does not cause a woman to begin menopause, although it can cause some symptoms that are similar to those that may occur during menopause. In most premenopausal women taking tamoxifen, the ovaries continue to act normally and produce estrogen in the same or slightly increased amounts.
Do the benefits of tamoxifen in treating breast cancer outweigh its risks?
The benefits of tamoxifen as a treatment for breast cancer are firmly established and far outweigh the potential risks. Patients who are concerned about the risks and benefits of tamoxifen or any other medications are encouraged to discuss these concerns with their doctor.
Tamoxifen ( ta-MOX-i-fen) is a medicine that blocks the effects of the estrogen hormone in the body. It is used to treat breast cancer in women or men. It may also be used to treat other kinds of cancer, as determined by your doctor.
Tamoxifen also may be used to reduce the risk of developing breast cancer in women who have a high risk of developing breast cancer. Women at high risk for developing breast cancer are at least 35 years of age and have a combination of risk factors that make their chance of developing breast cancer 1.67% or more over the next 5 years. Your doctor will help to determine your risk of developing breast cancer.
Prostate Cancer Treatment
Cancer that grows in the prostate gland is called prostate cancer. Prostate cancer is the second leading cause of cancer deaths among men in the U.S. About one man in six will be diagnosed with prostate cancer during his lifetime, but only one man in 34 will die of the disease.
In the early stages, surgery and radiation may be used to remove or attempt to kill the cancer cells or shrink the tumor. Doctors will usually advice you to undergo a surgical operation. You will then be given some medications to take. Many studies have shown that this combination reduces the pains experienced by men to a great extent especially if the prostate cancer has spread to the bones. The cancer will not totally disappear nor will you live longer. Seek medical advice too and you would be in a better position to decide according to your own health and your personal values. Medications can have many side effects, including hot flashes and loss of sexual desire. Urinary incontinence can be a possible complication of surgery.
Also a form of treatment used for early stage cancer is high intensity focused ultrasound (HIFU). This procedure is carried out under anesthesia (or using a local spinal anesthetic) and a probe is placed into the prostate gland through the rectum. A beam of high intensity focused ultrasound is them used to raise the temperature in the area of focus and thus to kill the cancer cells
Another prostate cancer treatment option is radiation therapy. This prostate cancer treatment includes the use of radiation of high energy from protons, neutrons, gamma rays and x-rays, as well as other sources to kill the cancerous cells and to shrink any existing tumors. There are two ways that radiation therapy can be administered as prostate cancer treatment. The first is from a machine that is located outside your body called external beam radiation therapy, or you may have material that is radioactive that is placed in your body near where the cancer is located. This is referred to as internal radiation therapy.
A relatively new technique, which is still being evaluated, is known as cryosurgery. During cryosurgery, which is carried out under anesthesia, cooling probes are guided into the prostate using ultrasound and the cancer cells are killed by freezing them.
The form of treatment used for early stage cancer is high intensity focused ultrasound (HIFU). This procedure is carried out under anesthesia (or using a local spinal anesthetic) and a probe is placed into the prostate gland through the rectum. A beam of high intensity focused ultrasound is them used to raise the temperature in the area of focus and thus to kill the cancer cells
For late stage prostate cancer hormone therapy is used and this is designed not to attack the cancer itself but to target the male hormones (in particular testosterone), which the cancer cells need to grow. In cases where hormone therapy proves ineffective, systematic radiation therapy or chemotherapy may be recommended.
The outcome of prostate cancer varies greatly; mostly because the disease is found in older men who may have a variety of other complicating diseases or conditions, such as cardiac or respiratory disease, or disabilities that immobilize or greatly decrease their activities. Whatever the stage of your cancer it is important to consider all of the options carefully and weigh the advantages, disadvantages and risks of each carefully before choosing the treatment that is best for you.
Is There A Preferred Way To Detect Breast Cancer? Both Digital And X-Ray Film Mammograms Can Help Save Lives
In 2006, more than 250,000 U.S. women will be diagnosed with breast cancer. This deadly disease will claim the lives of more than 40,000 friends, neighbors, mothers and daughters. These are staggering statistics.
However, breast cancer death rates are going down. This decline is largely attributed to the benefits of annual mammograms that enable physicians to detect cancer at its earliest stages, and improved treatment programs that help patients better manage their cancer.
Both digital and film-based mammography can identify breast disease in women who may have no obvious signs of breast cancer. Historically, mammograms have been conducted using medical X-ray film. Now, new digital imaging technologies are emerging that offer a complementary method for early detection of breast cancer.
The arrival of more digital imaging options sometimes can cause some patients to “wait it out” until their health care provider installs digital imaging systems. But the advice from physicians appears to be overwhelming: Do not wait for the latest digital technology. One of the most critical aspects for a full recovery is early detection, and it is far better to have any kind of mammogram than to delay or skip a mammogram entirely. The decision on which imaging technology to use should be a secondary issue that patients can discuss with their physicians.
“Digital technologies show great promise in helping to detect breast cancer in certain patients,” said Dr. John M. Lewin, Diversified Radiology of Colorado, a leader in providing technologically advanced radiology imaging. “In fact, the Food and Drug Administration (FDA) is considering relaxing guidelines that may make it easier for manufacturers of digital mammography systems to bring new products to market faster.”
Should the FDA adopt revised guidelines, it is possible that health care providers and patients could have access to a broader range of new digital mammography products earlier-and perhaps at a lower cost-as more competition among manufacturers may drive down prices of these systems.
One of the innovators of digital medical imaging systems is Eastman Kodak Company, which currently markets a digital mammography system for use in Europe, Latin America, Asia and other parts of the world. Kodak has applied to the FDA for approval to market this system in the U.S. and the company is conducting clinical trials of this system in the U.S. and Canada. “We applaud the FDA for examining ways to streamline the approval process for digital mammography products that may lead to increased adoption and improved access to these innovative systems,” said Michael Marsh, vice president, Kodak’s Health Group.
Given the benefits and improvements in both digital and film mammogram technology, there is more reason now than ever before to encourage mothers, grandmothers, sisters and friends to get an annual mammogram.
The American Cancer Society continues to recommend the importance of mammograms as a highly effective tool in the detection of breast cancer. What is critical is not the technology used to produce a mammogram, but ensuring that women age 40 and older have regular mammograms as part of maintaining a healthy lifestyle.
