Breast Cancer Treatment Choices

Breast cancer can be treated with a mastectomy or breast preservation surgery, lumpectomy, followed by radiation and sometimes chemotherapy. These are the best ways to prevent reoccurrence of cancer. The most common place for cancer to come back is in the same area where it was found the first time.

The determination of which treatment is best for an individual is based on the pathology of the disease. The initial biopsy, which is done when the cancer is first suspected, will tell what type of cancer is present and whether it is hormone receptive. The knowledge of hormone receptors, or not, found will be part of the decision making information for an individual's treatment. Some types of tumors are stimulated by normal hormones found in a woman's body, such as progesterone, estrogen, and HER-2. A tumor may show a positive response to one or more of these hormones. By knowing this information, a plan of treatment can be offered that will improve a woman's chances of cancer free survival.

The pathology from the surgery, done to remove the cancer tumor, will tell if the entire tumor was removed and if cancer was found in the lymph nodes. During surgery the surgeon can see the cancer tumor, but not all of the cancer cells can be visualized. So the tumor is sent to a pathologist who puts the tumor and the surrounding tissue that was removed by the surgeon under a microscope. This way cancer cells that might be outside the main tumor can be seen. The lymph nodes that were removed in surgery can also be looked at under a microscope and it can be determined if there are cancer cells found in the lymph nodes. Often a Sentinel Node can be found, if a dye is used before surgery. This dye is injected before surgery and will show which node is the main node that drains fluid from the cancer tumor site. (The lymphatic system drains non blood fluids throughout the body.)

If lymph nodes are found to have cancer cells within them the cancer has moved from the tumor site to other areas in the body. This movement of cancer cells away from the tumor indicates metastasis, or stray cancer cells that are traveling in the body. The final pathology will offer much information about the type of cancer, the location of the cancer and how best to treat the cancer to provide a cancer free life for the woman.

A woman who has been diagnosed with cancer, from a biopsy, then will see a surgeon who specializes in breast cancer. Surgery to remove the tumor is always needed, as long as the tumor is in the breast it will grow and chances are the cancer cells will travel away from the main tumor and spread throughout the body. These cells that move away from the main tumor will settle and grow into tumors in other parts of the body, not just the breast. The surgeon will ask questions about the woman's health and ask about the woman's family. If a woman has family members that have, or have had breast cancer, this information will be included in treatment decisions. The surgeon then will discuss ways to treat the cancer. A mastectomy which is a removal of the breast that has the cancer in it, with one or more lymph nodes removed is one choice. A lumpectomy which is removal of the cancer tumor and a small amount of tissue surrounding the tumor is another choice. The size of the tumor, determined by the mammogram, will influence these choices. If the tumor is large a lumpectomy may not be a good choice. The smaller the tumor, the better the chances of survival for the woman. The larger the tumor the more involved the surgery will need to be, such as a mastectomy. Sometimes chemotherapy is needed before surgery; the chemotherapy will hopefully shrink the tumor and kill cancer cells that may have moved away from the main tumor (metastasized). When this is done before the surgery, the hope is that after surgery most or all of the cancer will be gone and only radiation will be needed. Chemotherapy may be needed after surgery depending on the type and stage of the cancer.

Often the surgeon will ask a woman to see a radiation oncologist before her surgery. This consultation will allow the radiation oncologist, another cancer doctor who specializes in radiation, to review the woman's case and to offer choices of treatment. The options this doctor may offer are whole breast radiation after surgery, or partial breast radiation after surgery, or no radiation if a woman has a mastectomy and no cancer cells are found outside the breast that was removed in surgery.

One type of partial breast radiation is brachytherapy. Breast brachytherapy has been available for some time, but not all doctors are familiar with it. Brachytherapy of the breast is a good choice for some women. The size of the tumor and the location of the tumor are two of the determinations if this is a good choice. If the cancer is found out side of the breast, brachytherapy is not a choice for a woman. Brachytherapy is radiation given to the area where the cancer tumor was. This is where most cancers come back, in the same area they were to begin with. Brachytherapy can be given over five days, where as whole breast radiation if given over 6 weeks. This is an advantage for women who do not live near a cancer treatment center, women who live busy lives (most women do), or women who don't want to prolong their treatments. When a woman chooses breast brachytherapy the applicator that will allow radiation to go right into the space where the cancer was; is placed at the time of surgery. Brachy means close. It is another advantage of brachytherapy. Only the tissue around where the cancer tumor was is radiated; the normal tissue is exposed either not at all or to such a low level of radiation it is not affected by the radiation.

The brachytherapy treatments are given two times a day, at least 6 hours between treatments, for a total of ten treatments. This type of radiation requires special equipment and knowledge, many cancer centers now have both the equipment and the radiation oncologists that are specialized in this treatment.

The other type of partial breast radiation is accelerated partial breast radiation. This type of treatment also requires that the tumor is small and no cancer has been found outside the breast. This type of radiation can be given over a shortened time, days instead of weeks. The equipment to give these treatments is IMRT, which most if not all cancer centers have. This is external beam radiation that goes from the outside of the breast to the inside of the breast and radiates all of the tissue in the area. The advantages to this treatment are it takes less time, although it is also two treatments a day at least 6 hours apart, and it only radiates the portion of the breast where the cancer tumor was.

Whole breast radiation has been around for a very long time and is what all women received until the past 15 years or so. This type of radiation involves one treatment a day Monday through Friday for 6 weeks, a total of 30 treatments. It is external beam radiation that goes from the outside of the breast to the inside of the breast and radiates all of the tissue in the breast and surrounding area, not just the area where the tumor was. This type of treatment is favored when the tumor is larger or the cancer cells were found outside of the breast, such as in one or more lymph nodes. The lymph nodes can be included in the whole breast radiation. Some women will choose whole breast radiation because it has been used for so very long. Partial breast radiation has shown the same effectiveness in studies, when the woman is a candidate for brachytherapy.

Chemotherapy and biological therapy or hormone therapies are needed in specific cases. These treatment choices should be discussed with the surgeon, the radiation oncologist and a medical oncologist.

What ever choose a woman is given they need to be well understood before she makes her decision. Asking questions of her doctors and talking to her loved ones will be helpful. If a woman's decision is thought out it will probably be the best choice for her. Prayer always is beneficial.

God Bless you.
For More Detail:

Types of Skin Cancer - The Differences and The Common Ground

How Can Breast Cancer Be Treated?

Types of Skin Cancer - The Differences and The Common Ground

Do a search for "the types of skin cancer" and you'll find lots of information. The 3 types of skin cancer most common, as you will find out are basal cell carcinoma, squamous cell carcinoma and malignant melanoma, in that order.

You can find it described in medical terms or simplified in the words of a layman. It's very useful for you to know how it appears and grows and see the photos of it.

I'll cover each one of them and tell you what I conclude to be of most importance about all of them, even the more rare types not covered here.

Starting with basal cell, it rarely spreads and grows slowly. It first appears as a small growth on your skin, often undetected at first. It doesn't usually pose a big threat, but in time it could.
Here's a little experience I recently had. I noticed a small growth on my jaw line. After a few weeks there was another little tiny one next to it. I immediately went to my dermatologist and it was biopsied as basal cell carcinoma. It was 100% removed by mohs surgery and found to have travelled about 3 inches beyond what was visible to the eye. GLAD I WENT! It had been invisibly there for quite some time.

The next is squamous cell carcinoma. It also grows slowly and can be hard to notice in the early stages. It can be more serious than basal cell in that it can spread inward to vital organs. It first appears as a growth and can be quite innocent looking. I had an experience with this back in 1990. It had progressed to a stage 3 and it took the entire conventional arsenal to destroy it,...Chemotherapy...Major surgery...and Radiation.

The third of the most common types of skin cancer is malignant melanoma, the most deadly. It can appear as a new mole growth, freckle or an existing one showing some changes. Melanoma can spread rather quickly to internal organs without being detected; therein lays the deadly danger. That is why you should see a dermatologist to have those moles checked out, especially when you see any changes. It wouldn't be a bad idea to go once a year if you're over 40 years old and definitely if you're over 50.

So you see how the three types of skin cancer differ, but pay closer attention to what they all have in common and that is GROWTH ON YOUR SKIN. You can go to the internet and learn what the different ones look like but keep in mind that they all are an unusual growth on your skin. Growth isn't limited to elevation alone; it could be a change in skin color, spreading of the discoloration or a patch of dry scaly skin,...anything unusual. It also may not match up with any description or photo you see. It's all cause for concern and warrants a visit to your health professional.

So the big message here is for you to play a big role in early detection by being aware yourself. Notice what's going on and spot it even before your doctor does.

And the good news is that they are all most highly curable when detected early.

For More Detail:
Skin Cancer - Basal Cell Carcinoma (BCC)