Cancer Treatment Reviews

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 recurrence 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 mastecomy. 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. Read the full story

Interviews with families and patients show that a cancer diagnosis and treatment is unbelievably stressful and draining, and it feels as though a child who survives surgery, radiation, chemotherapy and any other issues and complications that come their way has certainly dealt with enough. Unfortunately, survivors of childhood brain tumors frequently develop problems after the initial battle is won, in the areas of intellectual ability, academic achievement, memory, and attention. Cognitive changes are not uncommon among brain tumor survivors; however, the extent to which any one change will take effect depends on many different factors, including tumor location and surgery, age at diagnosis and treatment with radiation therapy.

Neurological problems such as seizures and muscle coordination problems are relatively common among survivors of pediatric brain tumors. These kinds of defects often occur around the time of diagnosis or after initial surgery, but sometimes they might first appear months to years after diagnosis. Radiation injury to the brain may, on rare occasions, because delayed neurological problems that may be not be apparent until 10 years or more after treatment.

Neurosensory problems such as impaired vision and hearing may also develop, both early in the course of diagnosis and treatment and years after treatments are finished. Radiation can cause delayed visual problems through several different mechanisms. Direct damage to the eye nerves (optic nerves) can infrequently result in visual changes years after treatment. In rare instances, previous radiation can produce cataracts in the eyes that can interfere with normal vision. If your child has had surgery near the eye or eye nerves or has had radiation to the head, regular visits to an eye specialist (ophthalmologist) are highly recommended. Hearing difficulties are also common after treatment for brain tumors and, in general, remain stable or even decrease in severity over time. Under certain circumstances, though, hearing problems have been shown to get worse or appear for the first time months to years after treatment ends. Children who receive treatment with the combination of the drug cisplatin and radiation to the brain appear to be at the greatest risk for developing delayed hearing problems. Periodic hearing tests should be performed for all children at risk for hearing problems as well as for any child who is experiencing academic or learning difficulties.

Learning disabilities are particularly common among brain tumor survivors and are difficult and frustrating. Many children with learning disabilities require special education services at school. Moreover, one may observe deterioration in function over time, particularly in children who were treated with radiation to the brain at a young age. Like any other problematic issue, early detection of a problem is the best way to combat it, and this assessment is best accomplished by working closely with a pediatric neuropsychologist who has experience working with children with brain tumors. As symptoms may develop over time, it is extremely important to reassess cognitive functioning periodically in all survivors who are at high risk, as well as in survivors who are experiencing academic difficulties. This is done by administering a battery of tests known as psychometric or neuropsychological tests.

Most major medical centers will have trained neuropsychologists on staff, as will many schools, who can administer these exams. It is critical at the time of testing that you have available to you a detailed history of your child’s previous therapy. This should include the exact diagnosis and date of diagnosis, the names, modalities and total doses of all chemotherapy drugs, the doses and sites of all previous radiation therapy, the sites of all surgeries, and the start and stop dates for each treatment. This information can usually be obtained from the team supervising your child’s cancer therapy. At the end of treatment, it’s a good idea for you to ask your child’s neuro-oncology team to review with you the treatments your child received as well as any late effects that might occur as a result of these therapies. If appropriate, this may be the time to begin to make arrangements for follow-up treatment with specific specialists (for example, a neuropsychologist or pediatric endocrinologist), as preparing for your child’s follow-up care early, at the end of planned therapy, helps ensure a smooth transition from treatment to life after treatment. Read the full story

There are an estimated 12 million cancer survivors in the United States who are living beyond their doctors’ predictions, thanks to a combination of cutting-edge chemotherapy drugs, excellent treatment, and improved screening measures. However, cancer survivors face unique challenges related to their treatment after cancer and need to stay alert to possible late side effects from chemotherapy and/or radiation. It’s important to talk to your doctor about proper screening for late side effects of cancer treatment for the rest of your life. Here is a list of possible tests that you might need depending on the type of treatment you received for your cancer:

1. Regular echocardiograms. Patients who received radiation to the chest wall and/or received high doses of chemotherapy, especially with a class of drugs called anthracyclines (such as doxorubicin), should have yearly echocardiograms to check for any heart damage related to treatment.

2. Regular mammograms. If you are a survivor of childhood cancer and received high doses of radiation to the chest wall, you may need to start mammograms at an earlier age. Secondary cancers related to primary treatment are always a possibility, especially with radiation to the chest wall. Breast cancer is one of the possible secondary cancers that can develop. Discuss with your primary care physician or oncologist about the possibility of screening mammograms beginning at an earlier age. If you are a survivor of breast cancer, screening mammograms should be number one on your priority list every year. Read the full story