Radical treatments for breast cancer often not needed

Borgman / MCT

A breast cancer diagnosis and the treatment for it are no longer the same for every woman who hears those heart-stopping words from her doctor. There are many different approaches to breast cancer treatment today and a shocking number of women are unaware of that fact. Even with all the information at our fingertips through the Internet, social media and 24/7 news cycle, some of the most important information for current and future breast cancer patients is not getting through.

We have all heard knowledge is power, and that phrase cannot be more relevant when it comes to breast cancer treatment.

Women need to know all of their options when making treatment decisions with their oncologist. Angelina Jolie’s decision to undergo a prophylactic double mastectomy triggered a new conversation about breast cancer treatment, genetic biomarkers, and the turning point for those with the “breast cancer gene.”

But what are women, beyond the small percentages of those who actually do harbor the breast cancer gene, choosing to do when diagnosed with breast cancer? A recent Harvard/Dana Farber study shows a growing number of women choosing to have their breasts surgically removed, even when equally effective breast conserving surgery is available. It is important to look beyond traditional surgery and know what latest medical innovations are available and who could potentially benefit from such treatment.

While Americans tend to look upon radiation treatment for cancer as a sharp double-edged sword — unpleasant and frightening, but necessary and effective in the battle against sometimes deadly cancers — radiotherapy is producing better outcomes than ever regardless of tumor placement and cancer stage.

Medical technology using curative radiation therapy has put breast cancer on notice: We will find you. And we will kill you.

October was all about pink as more and more people publicly acknowledge National Breast Cancer Awareness Month, but breast cancer is not an October disease. Women are diagnosed every day. Next year alone, more than 200,000 will be diagnosed in the U.S. This is why it is important to for all women to understand what treatment options exist for them. It can be challenging. The speed of technological advances can be likened to having lived through the Wright Brothers takeoff and later embarked on commercial jet travel.

An oncologist in medical school 40 years ago has seen the science of radiotherapy seemingly move forward in light years. Consider advances in radiation therapy similar to the shift in surgical approaches to breast cancer tumors. Whereas breast tumors once meant automatic mastectomy for millions of American women, today a lumpectomy is often all that is necessary to remove a cancerous mass. So it is with radiation therapy.

Precision radiation treatments focus only on the area at risk — the tumor — doing a better job of sparing normal breast tissues that were once collaterally radiated or removed altogether. Radiation is doing more with fewer negative effects and better long-term outcomes.

Some of the changes and advances we’ve made in treatments are simple, but have reduced complications and saved lives. For example, 25 years ago, left-breast cancer patients who underwent radiation therapy had a higher risk of dying of heart disease than from their cancer. Now, radiation oncologists are able to treat some left-breast cancer patients in the prone position, allowing the breast to fall away from the chest wall and creating a greater separation between the targeted area and the heart.

While certain biologics are used to shrink a breast cancer tumor prior to surgery, radiation serves as an insurance policy for post-surgical patients by eradicating any residual cancer cells surgery leaves behind. Brachytherapy, a targeted treatment that radiates from the inside out, gives less exposure to the body and drops treatment time. By inserting a radioactive pellet the size of a grain of rice temporarily into a catheter and into the breast for 2 to 3 minutes, eliminating the chance of over-radiation and reducing the risk of burns, women receive more favorable cosmetic outcomes during treatment.

Yet a new study by the BC5 project shows among those women with breast cancer surveyed, less than one in 10 even knew the option of brachytherapy existed and a full three-quarters of women who would have been candidates for the treatment report that they would have been interested in the therapy.

It is wise to take stock, not just in October, but year-round, to review survival benchmarks, celebrate groundbreaking techniques and constantly evaluate where we are in the war on cancer. I would encourage an American public all too familiar with cancer and its toll on our well-being, to continue to be mindful of radiation doses, to ask physicians questions and seek information on appropriate protocols. But I also submit that a new discourse on the value of radiation in improving prognosis, protecting what’s healthy inside us and extending life is worth exploring.

Women with breast cancer can take heart in knowing radiation treatment wears a white hat in the story on breast cancer. We have science and technology to thank for that.

Dr. Beatriz Amendola created the Innovative Cancer Institute (ICI) in 2008 in South Miami.

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