Stand Up To Cancer on Breast Cancer Awareness Month: The Most Common Treatment
If you’ve been following our blog, “The Drop,” this month, you’ve seen that we’ve been raising awareness for breast cancer by sharing stories and information to help educate those who are affected by the disease. So as we round out the month, the organization Stand Up To Cancer is sharing information on the most common treatment for breast cancer.
What is chemotherapy and why is it the most common treatment for cancer?
Chemotherapy (“chemo”) uses anti-cancer drugs to kill cancer cells that may be anywhere in your body. Chemo is typically given intravenously (injected into your vein) or by mouth. Chemo can be administered in a doctor’s office, in a chemotherapy treatment center or a hospital.
There are tests available that can help your doctor determine if you will most likely benefit from chemo after breast surgery. Not all women with breast cancer will need chemo, but there are several situations in which chemo may be recommended.
Adjuvant chemo is used after surgery to try to kill any cancer cells that might have been left behind after your surgery or may have spread but can't be seen, even on imaging tests. If these cells were allowed to grow, they could form new tumors in other places in the body. Adjuvant chemo can lower your risk of breast cancer coming back.
Neoadjuvant chemo administered before surgery can be used to try to shrink the tumor so it’s easier for the surgeon to remove it, hopefully with less extensive surgery. Neoadjuvant chemo is often used to treat cancers that are too big to be removed by surgery at the time of diagnosis. Also, if you receive chemo before the tumor is removed, your doctors can better see how your cancer responds. Just like adjuvant chemo, neoadjuvant chemo can lower the risk of your breast cancer coming back.
Sometimes chemo is given in combination with other treatments, sometimes two or three drugs. Ask your doctor why the combination she suggests is right for your cancer, since doctors use many different combinations.
What is radiation therapy and how effective is it?
Radiation therapy is treatment with high-energy rays, such as x-rays, protons or other particles that destroy cancer cells. This therapy may involve radiation that comes from a machine outside the body, focused toward the area to be treated; or an internal radiation treatment called brachytherapy where a radioactive source is put inside the body for a short time. Radiation is typically used in combination with other treatments such as surgery or chemo.[ii] Radiation therapy is effective to help reduce your risk of breast cancer recurring or spreading after surgery. In addition, it can be effective to ease the symptoms caused by cancer that has spread to other parts of the body.
The need for radiation depends on what type of surgery you had, whether your cancer has spread to the lymph nodes or somewhere else in your body, and in some cases, your age. Tumors that are large or involve the skin might also need radiation. You could have just one type of radiation, or a combination of different types.
Will someone being treated for cancer need radiation and/or chemotherapy after surgery, should surgery be a treatment option?
There are different types of breast surgery for different reasons. Surgery may be done to remove as much of the cancer as possible; to explore whether the cancer has spread to the lymph nodes under the arm; or for reconstruction to restore the breast’s shape after the cancer is removed. Surgery can also help relieve symptoms of advanced cancer. It’s important to talk to your doctor about why each aspect of your treatment plan is recommended and what are the goals, risks, and side effects of each of the treatments.
With respect to breast cancer specifically, what is the most common treatment plan?
Surgery is the most common form of breast cancer treatment. However, researchers have learned so much about breast cancer, treatment has become much more individualized based on your cancer’s characteristics as well as your general health. Your treatment plan will be developed by your doctors based on many considerations.
What affect, if any, could these treatment plans have on a person diagnosed with breast cancer?
Different treatments have different risks and side effects, as previously described. Talk over the proposed treatments and possible side effects with your doctor. Some side effects can linger after the treatment has ended. Ask your doctor if there are any ways to reduce the side effects.
What advice would you give to someone or their family who may be moving forward with any of these treatment plans?
Stand Up To Cancer offer this guidance for patients who are being treated for breast cancer.
· Patients and their caregivers need “time off” to be at their best. Therefore, it’s important to tell friends and family what you need and let them help you.
· As the patient, remember that you are always in control. Even if you asked questions at the start of your cancer journey, you are always entitled to ask more questions. You can get a second opinion even after you’ve started your treatment plan.
· Keeping a journal, nothing fancy, can be helpful both for treatment as well as for emotional well-being. There are patient-focused apps available that may allow you to record how you are feeling. It’s important to share side effects and symptoms with your medical team. For example, a series of headaches or fevers or other effects happening at a specific time, may be related to your treatment. Your doctor might be able to make an adjustment. It will be easier to share if you have notes. Even patients going to the doctor for minor health concerns have a hard time remembering details once they’re in the doctor’s office!
Where are there advances in treatment for breast cancer?
Early Detection of Breast Cancer:
Mammography is an effective screening test for breast cancer. Research is looking at ways to enhance current breast cancer screening options, for example, tomosynthesis, a new 3-D mammography technology. Although this technology is increasingly available in the clinic, we don’t yet know whether it’s better than standard 2-D mammography for detecting cancer at a less advanced stage.
As cancer treatment is becoming more individualized, researchers are also looking at ways to personalize breast cancer screening, appropriate for your level of risk, while limiting the potential for over-diagnosis.
Breast Cancer Treatment:
The mainstays of breast cancer treatment are surgery, radiation, chemotherapy, hormone therapy, and targeted therapy. But scientists continue to study new treatments and drugs not yet approved by the FDA, along with new combinations of existing treatments.
Researchers are using information about the subtypes of breast cancer and their behavior, and about genetic mutations involved in breast cancer, to develop new therapies that target the genetic alterations that drive those cancer subtypes, and to guide treatment decisions. They are also working to develop biomarkers that can predict which women can safely avoid chemotherapy, respond to a treatment, or may likely develop resistance to the treatment. Research is working to develop drugs that target specific genetic mutations in breast cancer.
Targeted (or precision) therapy:
Targeted therapy uses drugs or other substances to attack cancer cells with less harm to normal cells. There is a new focus on adding targeted therapies to hormone therapy for certain sub-types of breast cancer (metastatic HR positive). These treatments could prolong the time until chemotherapy is needed and ideally, extend survival. Several treatments have been approved by the FDA for use in combination with hormonal therapy for treatment of advanced or metastatic breast cancer.
HER2-Positive Breast Cancer Treatment:
The FDA has approved a number of targeted therapies to treat HER2-positive breast cancer subtype, including some to be used in combination with chemotherapy.
Triple-Negative Breast Cancer:
Research around triple-negative breast cancers (TNBC) aren’t just looking at new treatments. Research has found that while TNBC is twice as common in black women as white women, actual risk is influenced by your place of birth. Black women born in the US and West Africa carry higher risk.[vi] Chemotherapy continues to be used to treat TNBC. Ongoing studies are testing new treatments for this type of breast cancer, such as using a class of drugs called “PARP inhibitors” when the TNBC is caused by inherited BRCA gene.
Immunotherapy drugs have shown some promise in a small number of breast cancers, particularly those that are TNBC. Some data suggest that patients may be more likely to respond to immunotherapy if their tumor expresses certain proteins or if it has a large number of mutations. Scientists are also studying whether combining a variety of drugs with immunotherapy will work better than immunotherapy alone.
Additional areas of research include health disparities research examining why women of diverse genetic ancestry carry different risk of breast cancer and higher death rates. Research is also studying how underlying genetic ancestry relates to cancer risk and response to treatment. As previously mentioned, black women are at significantly higher risk for TNBC. Research in late 2018 found that black women with HER2-negative breast cancer who receive the same treatment as white women experience higher recurrence and death rates than white women. Researchers were not yet able to explain the disparities. White women are also more likely to be diagnosed at an earlier stage compared to black women. Hispanic women are 30 percent less likely to be diagnosed with breast cancer as white women. These disparities continue to be studied.
Quality of Life:
Studies are also examining the impact of cancer diagnosis and treatment on physical functioning, emotional well-being, cognitive impairment, sleep disturbances, and cardiovascular health. Other studies focus on financial impacts, the effects on caregivers, and models of care for survivors.
How has SU2C contributed to breast cancer research?
Stand Up To Cancer has been supporting breast cancer research since it launched in 2008, now the second largest segment of research cancer when our research is organized based on the primary organ of disease. SU2C has funded more than $53 million in breast cancer research.
Stand Up To Cancer research has supported the development of two new breast cancer therapies now approved by the Food and Drug Administration (FDA):
Alpelisib in combination with fulvestrant:
Stand Up To Cancer research from one of SU2C’s first Dream Teams launched in 2009, the SU2C Women’s Cancers (PI3K) Dream Team contributed to the development of a new combination treatment for breast cancer approved by the FDA in June 2019. The combination of alpelisib with fulvestrant is the first and only new therapy for a difficult to treat form of advanced or metastatic breast cancer in both post-menopausal women and in men. This is the sixth FDA approval for a new cancer therapy supported by SU2C research.
Scientists from this team continue to pursue research and clinical trials extending from the work initiated by the original Dream Team, developing additional new treatments, and adding to the collective impact of their collaboration.
In February 2015 the FDA granted accelerated approval to palbociclib to treat advanced breast cancer after the SU2C Breast Cancer Dream Team showed dramatically increased survival in women taking it. This approval is intended for postmenopausal women with ER-positive, HER2-negative metastatic breast cancer who have not yet received an endocrine-based therapy. As approved, palbociclib is to be used in combination with letrozole, another FDA-approved product used to treat certain kinds of breast cancer in postmenopausal women. It’s estimated this treatment could help approximately 25,000 women diagnosed with this kind of breast cancer each year.
This SU2C accomplishment also illustrates the concept of precision medicine -- that therapy is specific to people, and specific to the subtype of cancer for which it is likely to be effective. And, because all therapies have side effects, precision medicine means doctors can avoid giving this drug to women for whom it will not be effective and thereby avoid the expense and potential side effects of a treatment that won’t work for them.
Stand Up To Cancer Dream Teams and Research Teams:
Of the five original “signature” Stand Up To Cancer Dream Teams announced in May 2009, three involved breast cancer research, two contributed to developing new therapies approved by the FDA.
Another SU2C research team studied DNA-Guided precision therapy to treat breast and other cancers, making it possible to match treatments to the specific genetic characteristics of your breast cancer. Currently SU2C Canada has two ongoing teams focused on studying new treatments for breast cancer and a new combination treatment to prevent the spread of metastatic breast cancer.
Stand Up To Cancer Convergence:
In 2016, SU2C launched a new approach to cancer research called “Convergence,” bringing together traditional oncology researchers with engineers, physicists and computational experts. An interesting example is one team studying breast cancer. Using computers, physics and engineering, they have focused on the distribution of cancer cells and tissues that surround, support and protect cancer cells in a tumor (called the stroma). They have analyzed how that environment inside the breast cancer tumor supports or protects the cancer cells. If we know how they protect or support the cancer cells, we can figure out better ways to attack the breast cancer or make the breast cancer more vulnerable to treatment. The team has determined that it’s not just the number of cancer or surrounding stroma cells in a tumor that matters. The physical location and arrangement of those cells affect how the tumor responds to or resists treatment.
The SU2C Catalyst initiative was launched to rapidly explore new uses of potential compounds for cancer prevention, detection, and treatment. SU2C Catalyst clinical trials combine treatments in combinations, sometimes combining drugs from different companies. One SU2C Catalyst® project is performing clinical trials to study immunotherapy combinations to treat ER-positive Metastatic Breast Cancer.
Additional SU2C-supported breast cancer research:
Additional breast cancer research is conducted under a variety of grants. These include Innovative Research Grants (IRGs) to early career researchers to conduct “high risk/ high reward” research, that is research that may or may not pan out but has the potential to be valuable to cancer research and patients. Phillip A Sharp Awards for Innovation in Collaboration provide grants to support additional collaboration between SU2C researchers not already working together in a team and has supported collaboration between researchers from the 2009 SU2C Breast Cancer Dream Team and the current SU2C Canada Breast Cancer Dream Team. In addition, SU2C periodically awards the “Ziskin Prize” named for Laura Ziskin, legendary Hollywood producer, who co-founded SU2C and lived with breast cancer for seven years before she died in 2011. These one-year grants support two scientists at different institutions to collaborate on high-risk, high-reward breast cancer research.
We collaborated with our friends at Stand Up To Cancer to derive this informational and educational-based content. The content on this site does not constitute medical advice. You should consult your doctor before beginning any treatment, exercise, training or athletic program.
Stand Up To Cancer’s (SU2C) mission is to raise funds to accelerate the pace of groundbreaking research that can get new therapies to patients quickly and save lives now. By galvanizing the entertainment industry, SU2C has set out to generate awareness, educate the public on cancer prevention, and help more people diagnosed with cancer become long-term survivors.
We're celebrating Breast Cancer Awareness month with some of our favorite pink shades.