Now I'll help you better understand the role of medicine
in treating breast cancer.
Medical therapies include
chemotherapy, hormone therapy and targeted therapy.
Not all breast cancer patients will need medical therapies.
That decision will be made with your medical oncologist
based on what we know about you, the features of your cancer
and your other medical issues.
We may have to wait until after your surgery
to gather all the information about your case
before we can make the right decision with you.
Medical therapies are drugs you take
that work throughout your whole body attacking cancer cells
even if we don't see them or know where they are.
This is opposed to local treatments
like surgery and radiation
which work on a targeted area of the body,
for example, the site of your tumor.
I'd like to start with chemotherapy.
Chemotherapy is a term used for medicines that are given
to destroy cancer cells.
If you need chemotherapy
your doctor will work with you to determine
which combination of drugs will be right for you.
All chemotherapy drugs work by killing cells.
They work system-wide throughout the whole body.
So even if we don't know where
your breast cancer cells have traveled to
the chemo drugs find them and get to work.
Most chemotherapy is administered through an IV
every one to three weeks for a total of two to six months.
This is an outpatient procedure
so you will go home after every chemotherapy session.
Chemotherapy can affect some healthy cells
in addition to cancerous ones
so you will most likely experience some side effects.
Everyone reacts to chemotherapy in their own way.
As much as I'd like to tell you
exactly what side effects you can expect
it's just not possible to predict.
Everyone is different.
All medical oncologists
work very closely with their patients
throughout their chemotherapy
to try to minimize those side effects
as most people still experience some.
The most common are
fatigue; hair loss, either partial or total;
loss of appetite; nausea; body aches
and a compromised immune system.
The good news is that hair will regrow after the chemo ends
and that new very effective anti-nausea drugs are available.
These drugs are one of the biggest advancements
in cancer treatment in recent years.
The extent of the nausea felt by chemotherapy patients
has been greatly reduced as a result of these new medicines.
We understand the anxiety associated with chemotherapy.
However, you should keep two things in mind.
One, it's a highly effective treatment
for killing cancer cells.
And two, the new drugs available
effectively relieve many of the side effects.
These are encouraging facts.
Most breast cancer patients will not need chemotherapy at all.
And for those of you who do
your medical oncologist will do everything possible
to ease your fears and make you comfortable.
There is another kind of medical therapy
that helps prevent cancer cells from growing and dividing;
it's called hormone therapy.
We test all tumors for hormone receptors.
This is done either at the time of your biopsy or your surgery.
Tumors can be either hormone receptor positive or negative.
About three quarters of all breast cancer tumors
are hormone receptor positive.
Negative means the presence of hormones in the body
does not affect the growth of the tumor.
People with this type of cancer
will not receive hormone therapy.
Hormone receptor positive means that either
estrogen or progesterone,
two naturally occurring female hormones,
bind with the tumor and accelerate its growth.
It's as if one or both of these hormones
feeds the tumor and makes it grow.
Hormone therapy starves the tumor of these hormones
either stopping or severely impairing
the cancer's ability to grow.
Hormone therapy is given in the form of a pill
that's taken daily for five to ten years.
Two commonly used drugs for hormone therapy include
Tamoxifen and Anastrazole.
Most women do well while undergoing hormone therapy.
However, some women do experience
menopause-like side effects.
For those who do
we can work together to manage them.
The final kind of therapy
that your medical oncologist may recommend
is called targeted therapy.
When your tumor is tested for hormone receptors
it will also be tested for another kind of receptor
with an unusual name: a HER2/neu receptor.
If your tumor is found to be a HER2/neu positive
you may be given targeted drugs
that will bind with the cancerous cells and kill them.
The most commonly used drug for targeted therapy is called
Trastuzumab; it's administered through an IV
and can be given along with chemotherapy.
Trastuzumab is given for several months or up to one full year
usually every week or once every three weeks.
So even after your chemo is complete
you may come back every three weeks to receive
targeted therapy.
I'd like to take a moment to discuss the topic
of clinical trials.
Clinical trials are the research programs
used by cancer specialists
to develop new and more effective treatments.
Kaiser Permanente's Oncology Clinical Trials Program
is recognized as a major national center
for state-of-the-art cancer research.
We are very proud to contribute
to the development of exciting advances in the field of
cancer treatment and to be able to offer these treatments
to our members.
You can be assured that any clinical trial we offer you
has been extensively reviewed.
We work hard to make sure that all of our clinical trials
involve the potential for substantial benefit
without undue risks.
Any participation in a research trial is
of course entirely voluntary.
If this is an opportunity you would like to know more about
be sure to ask your cancer care specialist
if you are eligible to participate.
In the next chapter you will hear from one of our patients.
Please take a moment to listen to Judy's very personal story.
Thank you.