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Improved Treatments for a Better Quality of LifeAdvances in treatment have led to an increase in the survival rate for breast cancer. At Lehigh Valley Hospital’s Cancer Center, every woman’s breast cancer treatment is personalized. In many cases you have options, and we’ll explain the pros and cons of all of them. It’s your health and your body, and we want you to be a part of all decisions.New Treatments for Breast Cancer“The death rate for breast cancer has declined continuously for more than 10 years because of new treatments more effective against early-stage breast cancer,” says medical oncologist Gregory Harper, M.D., of Lehigh Valley Hospital and Health Network. “These treatments include new hormonal approaches, better chemotherapy agents and new antibody treatments aimed at specific proteins associated with the growth and spread of breast cancer.”For breast cancer patients, our surgical and radiation oncologists are delivering accelerated partial breast irradiation using the FDA-approved Proxima Therapeutics MammoSite® system, reducing patient treatment time from 34 days to just 5 days. Accelerated partial breast irradiation is an outpatient procedure in which a plastic catheter with a balloon tip is inserted into the lumpectomy cavity. The single catheter delivers radiation directly to the lumpectomy site, minimizing radiation exposure to healthy tissue and reducing the potential for side effects. For women with fibroadenoma, a benign breast tumor, our breast cancer surgeons offer a new, non-surgical option called cryoablation (freezing) using the Visica Treatment System®. This procedure uses cold therapy, not surgery, to selectively destroy tissue in the target area so it won't grow back. A small instrument (about the diameter of a matchstick) is inserted into your breast, guided by ultrasound for greater accuracy. The instrument is so small that the incision site does not require stitches afterward. This minimizes scarring. The treatment takes approximately 30 minutes, and can be performed in your doctor’s office under local anesthesia. SurgeryFor most women with breast cancer, our standard of care for surgery is breast conservation. We will save as much of your breast as we possibly can without putting your life and health at risk. Treatments are planned to conserve the breast, either by removing the tumor first (a lumpectomy), or shrinking the size of the tumor with chemotherapy before lumpectomy. Chemotherapy before surgery is called neoadjuvant chemotherapy. Treatments that are given after surgery are called adjuvant therapies. The purpose of adjuvant therapies is to kill cancer cells that might remain after surgery. Either way, the usual approach is to conserve the breast and check the lymph nodes under the arm without performing a mastectomy.ChemotherapyChemotherapy works because it targets fast-growing cells. Unfortunately, hair is fast-growing, so hair loss is a side effect of chemotherapy. Other devastating side effects of chemotherapy are nausea, vomiting, profound fatigue and risk of infection.In the past 10 years, breast cancer treatments that don’t have these side effects have been developed. If these treatments are appropriate for your type of cancer, we’ll recommend them. But remember, breast cancer is not one disease, and women are diagnosed at different stages. Some women diagnosed with cancer that has spread to another part of the body (metastatic breast cancer) will have a better chance if they receive aggressive chemotherapy. Newer chemotherapy agents can sometimes be administered in lower, weekly dosages that avoid the common side effects of chemotherapy such as hair loss, disabling fatigue and lowering of blood count. These include the taxanes [paclitaxel (Taxol®) and docetaxel (Taxotere®)], vinorelbine (Navelbine®), gemcytibine (Gemzar®) and others. Even if you need more toxic therapy, we have new treatments that can reduce nausea, limit fatigue and decrease risk of infection. Hormonal TherapyNewer hormonal therapies delay the need to use chemotherapy. They are effective in controlling breast cancer and don’t have the side effects of chemotherapy. The hormonal treatments work in a variety of ways, and they can be used sequentially (one after another). Tamoxifen (Nolvadex®), anastrozole (Arimidex®), letrozole (Femara®), exemestane (Aromasin®) and fulvestrant (Faslodex®) are some of the hormonal therapies.In addition to hormonal therapies, monoclonal antibody therapy is now widely used to fight breast cancer and improve survival rates. The most common of these drugs is Herceptin®. Herceptin attaches to the HER2Neu receptor, a protein that is present in increased amounts in 25-30 percent of breast cancers. This drug attacks breast cancer cells that overexpress the HER2Neu protein without attacking normal cells that do not overexpress this protein. Many women who are diagnosed with metastatic breast cancer are candidates for these newer therapies. These drugs can stop the progression of breast cancer for long periods of time and have fewer side effects. Other women will require more intensive combinations of chemotherapy drugs and more intensive dosing schedules at the outset, but eventually may be able to receive lower dose maintenance treatments once their disease is controlled. Radiation TherapyRadiation oncology is an integral part of the treatment planning process. Many procedures are now used to complement other therapies early in treatment. In recent years, radiation therapy has gotten safer, easier for the patient and more effective in eliminating cancer and improving quality of life. It can reduce pain and prevent complications down the road. Our five linear accelerators give us the flexibility to tailor the most appropriate treatment to your specific needs.While the equipment is the most advanced available, the real difference is the skill and compassion of the therapist. We will stay with you throughout the process, answering any questions and doing everything we can to give you peace of mind. Now there's an MRI for breast cancerLehigh Valley Hospital offers breast MRIs to complement mammograms and ultrasound. Breast MRIs are mainly used as a diagnostic tool for women who have breast cancer, have been treated for cancer or have a high risk for breast cancer. Breast MRI is most often used to "stage" breast cancer -- to determine how advanced cancer is in order to plan surgery.
“People here are passionate about cancer care. They wake up in the morning and go to sleep at night thinking about ways to make their patients’ lives better.”
“Radiation therapy is so much more than machines. The skill and experience of the person using it and properly planning how it's used are what make a difference. We see much better results, whether we're trying to cure someone or just make them more comfortable, when radiation oncology is involved right from the beginning, as it is here.”
"It doesn't matter how many times I've performed cancer surgery. For this one person, this experience is everything. A person facing breast cancer or any other kind of cancer doesn't just need my surgical skills. That individual needs my emotional support, too."
“My dear aunt and grandmother both had breast cancer. I know how it affected my own family, and living through it with them made a real difference to me. Even then, when I first thought of becoming a doctor, I committed myself to treating all my patients as if they were members of my own family.” This page last updated 2/12/08 04:08 PM
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