Once breast cancer has been diagnosed, doctors discuss a suitable treatment plan with patient as per her individual condition and stage of cancer. The actual treatment plan may comprise more than one specific procedure because the aim is to target all cancer cells in different ways and minimize the risk of cancer recurrence in future. At times the patient may also have to revaluate her decisions and the medical team acts as a guide.
Successful treatment for breast cancer implies completely getting rid of the cancer or at least controlling the growth of tumors for an extended period of time. However as breast cancer is made up of several cancer cells, removal of those cells may call for various treatments.
Chalking out treatment strategy for an individual patient involves careful thought and good knowledge of diagnosis results. Doctors draft a treatment plan that can work against all internal parts of cells that cause cancer to develop, grow and spread to other parts of the body.
It must be understood that breast cancer is different for individual patients due to difference in multiplication and functioning of cells. Cancer cells are produced due to abnormal changes in DNA that force cells to grow at as faster rate and behave differently than they should. As these cancer cells multiply to create a tumor, they also continue to change and become increasingly different from each other.
With the growth of cancer, new and different kinds of breast cancer cells are created within the same cancer. The mixture of cells that grows as a cluster over time becomes more complex. Hence even if every cell of cancer was born out of the same parent cell, all cells that constitute cancer are not actually the same. The fact that different kinds of cells make up one cancer is known as "tumor heterogeneity” in medical literature.
By the time a breast cancer tumor grows to one centimeter in size, the numerous cells that make up the tumor lump are very different from one another. Each cancer has its own genetic identity formed by the DNA in its cells. The only thing the cancers have in common for all affected people is that they originate from a breast tissue cell.
It is because of the tumor heterogeneity as described above that pathology reports, blood tests and other medical tests can be so complex and so there is a range of treatments for breast cancer. Due to the difference in cancer cells, a drug or therapy that kills one cell may not affect another at all. In this case the best remedy is to get the best if each treatment. Chemotherapy, radiation, hormone therapy and targeted therapy are used in right combination to kill different cancer cells and stop their growth and multiplication.
During the course of breast cancer treatment, there is a possibility that some tumors might develop an immunity or resistance towards treatment. Some of the cells are not killed by the treatment even as tumor cells surrounding them get destroyed. These cells that escape killing effects of medical procedures are known as resistant cells. After escaping treatment attack, they have a tendency to grow and this is how recurrence of cancer happens.
To be free from these resistant cells, the patient needs to take new forms of therapies tat work in a different way than the ones used earlier. Often, second round of treatments can help in destroying the cells that could not be killed in first round. But if this does not happen, new therapies are required.
The order of treatments for breast cancer is suggested by the surgeon as per the diagnosis and medical reports. The most commonly used sequence goes in the following order:
One of the aims of breast cancer treatment is to prevent the recurrence of cancer. Doctors usually recommend one course of action over another because it lowers the risk of relapse.
If you are told that a certain treatment can reduce risk of recurrence by 20%, what would it imply? To comprehend the meaning of such numbers, you need to have a clear idea of Relative Risk and Absolute Risk.
Relative Risk is the percentage that advises you how much something you do, such as taking a therapy, can alter your risk, compared to your risk without taking the therapy.
Absolute Risk is the percentage point by which your own risk changes if you do something, like taking a therapy. The size of absolute risk depends on what the risk is to begin with.
Your decision to work during breast cancer treatment procedure is a very personal one that concerns several factors – your work and financial situation, your general health’s reaction to treatment and its side effects, and your personal preferences to keep your daily routine going.
Before you ask for a medical leave or cancel your annual leisure holiday plans for the treatment, it is good to discuss the complexity and stage of the disease with your doctor. If you are getting the treatment as a clinical trial, the schedule may be somewhat rigid. A candid discussion with your doctor will help you to know the scope for adjustment and changes in treatment schedule wherever possible.
Common concerns for treatment include worries about getting a leave from office, changes in daily schedule, modifying or canceling pre planned vacations and sabbaticals. But at the end of it all, you need to remember that it is about your personal health and your willingness to fight a malignant disease. Support of family and good friends also matters and they can help you to make required adjustments in your work life schedule for a stress free and successful breast cancer treatment.