Breast Cancer Awareness Month: What are different stages of the disease? A look at available treatment options
Breast cancer is treated in several ways, and it depends on the kind of breast cancer and how far it has spread. People with breast cancer often get more than one kind of treatment. Choosing the treatment that is right for you may be hard. Health experts advise talking to the doctor about the treatment options available for the type and stage of cancer that a person has. The doctor will be able to explain the risks and benefits of each treatment and its side effects.
According to the American Cancer Society (ACS), it is often a good idea to seek a second opinion if time permits. This can help patients feel more confident about the treatment plan they choose. “When you’re facing cancer treatment, it’s normal to wonder if another doctor could offer more information or a different treatment option. You might want to find another doctor who can look at your test results, talk with you about your personal situation, and maybe give you a different take on it. Getting a second opinion can help you feel more sure about your diagnosis and treatment plan,” suggests ACS.
What are the different stages of breast cancer?
After someone is diagnosed with breast cancer, doctors will try to figure out if it has spread, and if so, how far. This process is known as staging. The stage of cancer describes how much cancer is in the body. It enables the doctor to determine how serious the cancer is as well as the best treatment options for a person. Breast cancer stage is usually expressed as a number on a scale of 0 through IV — with stage 0 describing non-invasive cancers that remain within their original location and stage IV describing invasive cancers that have spread outside the breast to other parts of the body. Within a stage, an earlier letter means a lower stage. You can find more details here.
Types of treatments
Typically, treatment plans are based on the type of breast cancer, its stage and any special situations. They depend on other factors as well, including a person’s overall health and personal preferences. Many procedures and drugs are available to treat cancer, with many more being studied. Some are "local" treatments like surgery and radiation therapy, which are used to treat a specific tumor or area of the body, without affecting the rest of the body. Drug treatments, such as chemotherapy, immunotherapy, or targeted therapy, are often called "systemic" treatments because they can affect the entire body. They can be given by mouth or put directly into the bloodstream. A stem cell transplant, also called a bone marrow transplant, can be used to treat certain types of cancer. For more details regarding the treatment of breast cancer by stage, you can refer to the ACS website.
Local treatments
Surgery: An operation where doctors cut out cancer tissue. Most women with breast cancer will have some type of surgery to remove the tumor. Depending on the type of breast cancer and how advanced it is, a person may need other types of treatment as well, either before or after surgery, or sometimes both.
Radiation therapy: Using high-energy rays (similar to X-rays) to kill the cancer cells. Some women with breast cancer will need radiation, in addition to other treatments.
Systemic treatments
Chemotherapy: Using special medicines to shrink or kill the cancer cells. The drugs can be pills you take or medicines given in your veins, or sometimes both. “Chemotherapy uses anti-cancer drugs that may be given intravenously (injected into your vein) or by mouth. The drugs travel through the bloodstream to reach cancer cells in most parts of the body. Occasionally, chemo may be given directly into the spinal fluid which surrounds the brain and spinal cord. Not all women with breast cancer will need chemo, but there are several situations in which chemo may be recommended,” explains the American Cancer Society (ACS).
Hormone therapy: Blocks cancer cells from getting the hormones they need to grow. Some types of breast cancer are affected by hormones, like estrogen and progesterone. The breast cancer cells have receptors (proteins) that attach to estrogen and progesterone, which helps them grow. Treatments that stop these hormones from attaching to these receptors are called hormone or endocrine therapy. Hormone therapy can reach cancer cells almost anywhere in the body and not just in the breast. It is recommended for women with tumors that are hormone receptor-positive. It does not help women whose tumors do not have hormone receptors.
Targeted therapy: Uses drugs or other substances to identify and attack specific types of cancer cells with less harm to normal cells. These drugs enter the bloodstream and reach almost all areas of the body, which makes them useful against cancers that have spread to distant parts of the body. Targeted drugs sometimes work even when chemo drugs do not.
Immunotherapy: It is the use of medicines to stimulate a person’s own immune system to recognize and destroy cancer cells more effectively. Immunotherapy can be used to treat some types of breast cancer.
Who treats breast cancer?
Based on the treatment options, a person may have different doctors from different specialties who will work together to treat breast cancer. These doctors could include:
Breast surgeon or surgical oncologist: A doctor who uses surgery to treat breast cancer.
Radiation oncologist: A doctor who uses radiation to treat cancer.
Medical oncologist: A doctor who uses chemotherapy and other medicines to treat cancer.
Plastic surgeon: A doctor who specializes in reconstructing or repairing parts of the body.
Clinical trials
Clinical trials use new treatment options to see if they are safe and effective. If you have cancer, you may want to take part. While they are also the best way for doctors to learn better methods to treat cancer, they are not right for everyone, say experts. If you would like to learn more about clinical trials that might be right for you, you can start by asking your doctor if your clinic or hospital conducts clinical trials.
You can also refer to the following sites for more information:
- NIH clinical research trials and you (National Institutes of Health)
- Learn about clinical trials (National Cancer Institute)
- Search for clinical trials (National Cancer Institute)
- ClinicalTrials.gov (National Institutes of Health)
- American Cancer Society
Complementary and alternative methods
They are medicines and health practices that are not standard cancer treatments. In other words, they are not usually used by doctors to treat cancer. Complementary methods refer to treatments used in addition to standard treatments, and alternative medicine is used instead of standard treatments. They may include yoga, meditation, supplements like vitamins, herbs, special diets, and acupuncture or massage, among others. However, many kinds of complementary and alternative medicine have not been tested scientifically and may not be safe. Hence, health experts advise talking to the doctor about the risks and benefits before starting any kind of complementary or alternative medicine. “Although some of these methods might be helpful in relieving symptoms or helping you feel better, many have not been proven to work. Some might even be harmful,” cautions the ACS. For more details, you can also visit the ACS and National Cancer Institute websites.