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Chemotherapy - the only solution to breast cancer?

Top view of a pale citrus fruit that represents Breast Cancer
Photo by Charles on Unsplash

Put simply, breast cancer is a disorder of the breast that happens when some tissues of the breast start to grow abnormally.

We don’t know exactly why this happens, but we know that certain conditions could increase the risk of it happening.


Conditions associated with developing Breast Cancer.

Currently, we think older age, family history i.e. close relative who has had breast cancer, being overweight, taking certain medicines containing hormones, and alcohol could increase a woman’s risk of developing breast cancer.

It is important to note that not all breast disorders are cancers.

There is a category of breast disorders which are noncancerous and thus described as benign.

We describe Breast disorders that are cancerous as malignant.


Benign and Malignant Breast Cancer

A benign breast disorder does not spread outside the local tissues where it began to grow.

Most breast disorders are benign.

Malignant breast disorders i.e. breast cancers on the other hand grow and with time often spreads within the breast to other parts of the body.

To date, there is no cure for breast cancer but with early detection, it is possible to destroy existing cancer cells before they can spread.

The treatment of breast cancer depends on the type, grade and stage of the disease.


Classifying Breast Cancer

By type, we mean whether it is invasive or non-invasive and there are many types. Most breast cancers are invasive.

By grade, we mean how different the cells are to the normal breast cells as well as how quickly the cells are growing.

Typically, we grade from 1, 2 and 3 –

  • In grade 1 the cells are like normal breast cells and growing slowly;
  • grade 2, the cells look less normal and growing a bit faster; and
  • grade 3, the cells are obviously abnormal and growing fast.

By stage, we mean the size of the breast cancer and how far the breast cancer is spreading.

Doctors may describe the disease as stage 1, 2, 3, and 4 depending on the size of the breast cancer, the involvement of lymph nodes and whether the cancer cells are spreading to other parts of the body.


Different options for treating Breast Cancer

Chemotherapy is not the only solution for Breast Cancer.

There are several options to treat breast cancer including:

Radiotherapy – In this treatment, we direct radio waves towards malignant cancer cells to kill them.

Chemotherapy – this refers to certain medicines that work to destroy the malignant cancer cells or inhibit their growth, preventing them from multiplying.

They are either taken by mouth or directly into the bloodstream through an intravenous infusion.

Hormone therapy – This therapy reduces the effect of hormones like Oestrogen and Progesterone.

These hormones stimulate some types of malignant breast cancer.

Surgery – The other method available for treating Breast Cancer is surgery. When
it comes to breast cancer, surgery also has different grades.


How Treatment Options are used

Malignant breast cancer is either primary when detected –
that is there is a lump in the breast; or secondary – in which case it has
already spread.

The treatment for malignant breast cancer depends on whether it is primary or secondary.

In primary breast cancer, surgery is usually the first
treatment.

For very small malignant lumps, removal of the lump (lumpectomy)
alone in addition to other forms of treatment such as chemotherapy or
radiotherapy may be used.

When the cancer is bigger, surgery is done to remove a part of
the breast or the whole breast (mastectomy).

In a mastectomy, (depending on the size of the cancer) some
extra tissues around the breast will also be taken away to ensure as many
cancer cells are removed as possible.  

This treatment would usually be followed by radio and/or
chemotherapy.

Now, it is possible to have chemotherapy without surgery or radiotherapy; but generally, this may be if a woman simply doesn’t want to consider either of these treatments (surgery or radiotherapy); or she is not fit enough to have them.

Sometimes chemotherapy or hormone therapy may be the first
option rather than surgery.

Usually, the recommendation will be to use a combination of options to ensure as much of the cancer cells are destroyed/removed as possible.


Role of Chemotherapy

Chemotherapy in treating breast cancer is generally used as
an adjuvant after surgery or radiotherapy. 
This means it can help to reduce the chance of the cancer coming back.

For secondary breast cancer – which is when the cancer has spread to another organ outside the breast, the usual treatment may be to shrink the cancer to allow control of any symptoms.

This may be with the use of radiotherapy or some forms of chemotherapy.

In some cases, when the spread is quite advanced or the woman is very frail (weak), treatment could be simply supportive or palliative.

This means it is thought that treatment may not make any difference and may even cause side effects or complications.

In this case, discussing with the woman and her family in respect of the terminal nature of the illness, so it is possible to come to terms with, and prepare for death is important.


Conclusion

The most important message is monitoring and early detection (and treatment) mean a huge difference in breast cancer.

This is linked with better outcomes for women who are at risk of the disease.

Learn more about breast cancer here.

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Dr Sylvia Kama-Kieghe

Founder, AskAwayHealth

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