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Breast cancer: Nonsurgical treatments

A variety of treatments may be done in addition to surgery to help rid your body of cancer.

A diagnosis of breast cancer is certainly frightening. But here's a reassuring thought: There are a lot of options to help make you well. And more and more women are surviving breast cancer.

Surgery is an important—and usually the first—treatment for breast cancer, according to the National Cancer Institute. But to help ensure that all the cancer is gone from your body, your doctor may recommend additional treatments. These treatments, sometimes called adjuvant therapies, are especially likely to be recommended for women who have large tumors and women whose cancer has spread to lymph nodes.

Types of adjuvant therapy

Several therapies are available to help control cancer cells:

Radiation therapy uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. Radiation can be administered externally or internally.

  • External beam radiation is similar to an x-ray, but the radiation delivered is more intense. In this procedure, radiation is aimed at the cancer from a machine located outside the body. Special care is taken to ensure that radiation is directed to the right area of the body. The treatment is painless and lasts only a few minutes, according to the American Cancer Society (ACS).
  • Internal radiation (brachytherapy) is designed to harm as few normal cells as possible while attacking cancer cells. While you are under anesthesia, sealed radioactive implants in the form of seeds, pellets, ribbons, wires, needles, capsules, balloons or tubes are placed in or near the cancer.

    Implants that deliver high doses of radiation are taken out after only a few minutes.

    Implants that give off low doses of radiation may be left in place for many days or, in some cases, permanently. Radioactive material in these implants will stop releasing radiation over time.

    Radiation from implants should pose no harm to you or to other people. However, you may be advised to stay away from small children and pregnant women, especially just after you get the implants.

Chemotherapy drugs are used to destroy undetected cancer cells that may be left after the original breast tumor is removed or to attack cells that may have migrated to other places in your body. Sometimes chemotherapy is given before surgery to shrink large cancers so that they are small enough to be removed by lumpectomy instead of mastectomy. This is known as neoadjuvant chemotherapy.

Chemotherapy is given in cycles, with each period of treatment followed by a rest period.

Hormone therapy involves the use of drugs to remove or block natural hormones (such as estrogen) that can encourage the growth of cancer cells. A frequently used hormone therapy drug is tamoxifen. Other drugs may be prescribed when appropriate—in postmenopausal women, for instance.

Targeted therapy is a relatively new method of cancer treatment, but its potential is well regarded, according to the ACS. Treatment targets specific cancer cells with chemotherapy drugs or other substances, such as antibodies made in a laboratory. Targeted therapy does little damage to normal cells.

Each type of targeted therapy works differently, but all change the way a cancer cell grows, divides, repairs itself or interacts with other cells.

Targeted therapies can be used alone or with other drugs. Many are used with radiation or chemotherapy to help boost the effects of the main treatment.

Working with your doctor

Your doctor will recommend a treatment plan that he or she thinks is best for you and describe what the treatment will be like. For example, each treatment has some side effects, such as nausea, vomiting and hair loss during chemotherapy. Some side effects can be controlled during treatment, but a few may have longer-lasting consequences.

If you have questions or concerns, don't hesitate to ask your doctor about the treatment, side effects and other details. Knowing what to expect can help you deal with the present and look forward to a cancer-free future.

Reviewed 5/21/2024

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