TREATMENTS
In the past the treatment options for a particular disease were limited to only a few With the advancements in medical science we have scores of treatment options available for any disease
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The various treatment options available for breast cancer have increased in number too Today there are many ways to combat and deal with breast cancer They can be broadly classified into the following categories
Surgery Surgery has been the traditional mode of treatment for breast cancer However changes have taken place during recent times The surgery now is more precise and is directed to the exact spot of the disease so that the damage to the unaffected area is minimized
Lumpectomy The cancerous lump is removed surgically without removing the surrounding lymph nodes
Mastectomy This is performed if the lump has become large or in case the cancer has spread to other areas The affected breast is surgically removed
Lymph Node Dissection This is the surgical removal of lymph nodes Usually done in case of invasive breast cancer it is a procedure performed at the time of mastectomy or lumpectomy During mastectomy it is an extension of the breast incision to the armpit area If done during lumpectomy a separate incision is performed in the armpit A part or all of the lymph nodes are removed Usually it also involves cutting the nerve carrying sensation to the area
Radiation Therapy Radiation is a highly targeted and effective way of treatment which destroys the cancer cells High levels of radiation are sent directly to the cancer cells Radiation therapy undertaken after surgery can also kill those cancer cells that could not be treated by surgery It can also be combined with chemotherapy to relieve pain or to shrink the tumor It is short and relatively easy but side affects can also occur The traditional radiation therapy is external in nature Internal radiation therapy is also being experimented In this process radiationproducing substances are either implanted directly in to the tumor or injected through a tube
Herceptin Applicable only to women with HER2positive breast cancer it consists of an antibody the primary role of which is blocking the HER2 protein in cancer cells It is useful in cases where the breast cancer has spread to other parts of the body Also known as immune treatment it is approved by US FDA for women with metastatic disease
Hormone Therapy It is another effective treatment It is useful for women having hormone receptive positive breast cancer Aromatase inhibitors are more effective in women with post menopause and Tamoxifen in women with pre menopause hormone receptive positive breast cancer
Chemotherapy Chemotherapy or use of chemicals to treat a disease is a systematic therapy Since the use of chemicals affects the whole body by going through the blood stream it is very effective as it can act on the cells which are rapidly dividing A major drawback in this mode of treatment is that the drugs act not only on the cancer cells they act on healthy cells as well leading to various sideeffects like losing hair nausea skin diseases and so on
Alternative Therapies In addition to the above modes of treatment there are many alternative therapies as well e g yoga acupuncture etc Since sufficient research is not available in respect of such therapies it is difficult to come to any decisive conclusion
Since the disease conditions differ from patient to patient the ideal treatment for an individual would depend on various factors The best mode of treatment can be formulated with due consultation between the patient and the doctor
Radiation Therapy
Radiation therapy is a simple painless and generally welltolerated tool for treating and even curing breast cancer One of the most common side effects of radiation therapy to the breast after a lumpectomy or to the chest wall after a mastectomy is skin irritation The reaction and its extent differ for every woman Because radiation therapy is often such an important part of breast cancer treatment it is important to know how to mitigate its side effects in order to gain the greatest benefit from the therapy
Coping with Skin Irritation
Radiationinduced skin reactions are more likely to occur in people who received chemotherapy shortly before or during radiation therapy and in women who have a prominent fold under the crease of the breast In fact this area and the underarm are the most common areas of the breast to sustain a skin reaction Most skin reactions resolve within a few weeks of completing radiation therapy
Skin reactions are almost inevitable for women receiving radiation to the chest wall after a mastectomy As a result many radiation oncology facilities give such women a oneweek prophylactic break halfway through the course of treatment to reduce the severity of skin reactions
The severity of a skin reaction varies from person to person It can become more noticeable as the course of treatment progresses Faint pinkness of the skin brisk redness sun burnt sensation dryness itching peeling darkening like a suntan blistering and moist oozing can occur
When the reaction is severe such as a brisk redness that evolves into blistering and moist weeping of the skin women receive a treatment break usually lasting a week or two This rest is usually sufficient to alleviate the worst symptoms When necessary doctors can prescribe therapeutic creams Radiation can be resumed once the reaction resolves
Treating the Reaction
During radiation therapy women can avoid chafing the irradiated skin by going braless or by wearing a cotton sports bra without an underwire that fits well below the crease of the breast or the irradiated skin of the chest wall Women who can go braless altogether should If that is not a comfortable solution women should wear a bra as infrequently as possible to reduce the likelihood and or the degree of a skin reaction Also aerating the irradiated skin helps minimize skin reactions
Overthecounter moisturizing creams without alcohol and fragrance can reduce the extent of a skin reaction Often radiation oncology teams prescribe these creams at the beginning of radiation therapy
Women should also try to be kind to the irradiated skin which can be easily inflamed Radiation oncologists suggest
Do not rub scrub or scratch the skin in the treatment area instead pat the skin dry and massage physicianprescribed antiitch creams or ointments onto the affected area
Avoid sun exposure to the irradiated skin When going outdoors wear protective opaque clothing such as a cotton tee shirt
Steer clear of tightfitting blouses and bras over the area unless instructed otherwise
Use only lukewarm water and mild soap recommended by the radiation oncology team on the treated area
Avoid using ice packs or heating pads on the treated skin
Steer clear of commercial deodorants and skin care products not endorsed by the treatment team
Do not shave the underarm on the treated side with a nonelectric razor
Avoid skin care products for at least two hours before radiation treatment
Although a number of people who undergo radiation therapy do experience skin reactions most get past this temporary side effect By working with their radiation oncology teams people pass the metaphorical finish line of the course of radiation therapy usually victoriously Most importantly they derive substantial benefits from radiation therapy and move on to leading productive cancerfree lives
As women especially American women much of our femininity is centered on our breasts No matter where you look there are pictures billboards commercials television shows and movies with women with these beautiful breasts and ample cleavage The thought of losing one or both breasts to breast cancer can be devastating for many of us Sure theres reconstruction but will it ever really look the same again Even if you have reconstruction youll never have sensation there again and for many of us that definitely affects our sexuality. The breast is composed mostly of fatty tissue and of course milk ducts and lobes The removal of this breast tissue is way easier than operating on an organ but carries much more emotional impact for most of us Most surgeons will get as much of the breast tissue out as they can to help alleviate the chance of a recurrence of your breast cancer You will typically wind up with a horizontal scar about four inches long The scar may be red for quite a while but ultimately should fade to where you can hardly see it anymore
You want to be sure to take loosefitting buttondown shirts raiding your hubbys closet is helpful with you to the hospital as you wont be able to raise your arms over your head for a while You will also need a sports bra and I would highly recommend one that fastens in the front They will put that on you after your surgery Typically you should be able to stay in the hospital for one night If you are going to have lymph nodes removed a small pillow to slip under that arm will help make you more comfortable Check with your local American Cancer Society as they may have small pillows for you An extra pillow to hold to your chest if you need to cough sneeze or laugh can help keep your incision from hurting
When you wake up you will have a couple of drain tubes for each side you have done These tubes are important as they allow the excess fluid which your body will produce to drain out If you didnt have them the fluid would have to be aspirated with a needle The drains even though theyre no fun are better than that These drains will have to be emptied a couple of times a day and you will have to write down how much fluid you drain so the doctor will know when you have slowed down enough to remove them You may not know where to put these drains under your clothing I pinned mine up to the sports bra and that way they didnt pull when I moved
When you get home plan on having someone there to help you for the first few days You wont be allowed to reach into your cabinets and definitely wont be able to clean house or pick up your children if you have little ones Youll be sent home with pain meds and definitely take them if you need them Studies show that you will heal faster if you keep yourself out of pain so dont be afraid to take them as prescribed
If you have a recliner you might consider moving it into the bedroom as you wont be able to lie flat for a while Youll need to sleep in a partial sitting position If you dont have one or dont have space for it in your bedroom lots of pillows will work too Thats what I used Just be sure you have enough pillows to keep yourself comfortable propped up
If you would like someone whos been there before you to visit with be sure to call your local American Cancer Society and ask for a Reach 2 Recovery volunteer This is an American Cancer Society program where they try to match you with one of their volunteers who have as similar experience as you are facing This woman will come visit you and will bring you all sorts of brochures and information on conventional treatment She will also bring you a list of exercises you can start to do to regain your mobility and range of motion .It hurts to stretch your arm up after surgery but if you havent had reconstruction and you dont start soon you will lose that range of motion I would recommend starting to gently slowly reach your arm up … let your body be your guide … the day after your surgery This is ONLY if you have not had reconstruction If you have let your plastic surgeon tell you when to start stretching Push to where it hurts just a little but do not push too far past that Little by little youll find yourself able to stretch a little farther every couple of days. Most of all allow yourself to heal emotionally as well as physically Some of us just cant look at that incision right away Thats OK Take as much time as you need I know I felt like some kind of freak with no breasts and even six years later I still do sometimes But remind yourself that these scars are your battle scars They do not make you less of a woman They make you a warrior.
