Healthy Focus – November 2021

Better Breast Cancer Treatment Gets Personal

Dramatic advances in breast cancer care that customize the treatment to the tumor have boosted survival rates for women in all stages of the disease during the past decade.

Breast cancer care is now much more targeted and individualized. It used to be that every woman with a tumor over a certain size had chemotherapy—but we’ve moved beyond one-size-fits-all.

Breast cancer specialists, for example, can now check the genomes of breast cancer tumors to see how likely they are to grow, spread or return after initial treatment. That knowledge helps doctors counsel women so they can make well-informed decisions about their care, such as deciding to forgo chemotherapy because a tumor is unlikely to recur.

Developments also include expanding options for screening and early detection, precision surgical and radiation oncology techniques, and a growing number of targeted medical therapies.

Let’s take a look at the newest medical advances that are giving breast cancer patients a better chance for long-term, cancer-free survival and improved quality of life.

Oncoplastic Surgery

Oncoplastic surgery, an option for a tumor that is too large for a conventional lumpectomy, combines techniques from plastic surgery and breast cancer surgery. The goal is to preserve as much breast tissue and skin as possible to rebuild a natural-shaped breast.

If a woman has enough breast tissue, a larger tumor can be removed and the breast can be reshaped. Because the treated breast will be smaller than the other side, some women have a reduction on the untreated side—or get an implant on the treated side—after cancer treatment is complete.

Genomic Testing

Using the genes of a specific cancer, genomic testing gives oncologists individualized estimates of recurrence risk to patients, helping physicians suggest the best course of treatment.

Based on the risk, the least toxic treatment van be used that will be most effective at reducing the risk of recurrence for specific patients. It can tell us which patients will benefit from chemotherapy in addition to hormonal therapy, and which patients will receive no benefit from chemotherapy, so patients can avoid unnecessary toxicities and side effects.

Genomic testing can also help doctors gauge a woman’s risk of the spread and recurrence of ductal carcinoma in situ (DCIS), a noninvasive early type of breast cancer.

Targeted Medical Therapy

Targeted therapies for breast cancer interfere with specific proteins on the surfaces of cancer cells to block the cells’ growth and spread. These therapies may work when chemotherapy doesn’t and may increase the effectiveness of other treatments. In addition, side effects are often less severe than with chemotherapy.

Although they aren’t yet available for all types of breast cancers—scientists have yet to discover targets for triple negative breast cancer, for example—existing therapies have significantly lengthened survival rates. In women with HER2 (human epidermal growth factor receptor 2) positive breast cancer, for example, using therapies like Herceptin [trastuzumab] gives up to 60 percent of women a complete response, meaning no detectable residual tumor after treatment is done.

Intraoperative Radiation Therapy 

With intraoperative radiation therapy (IORT) for partial breast irradiation, a single dose of radiation is delivered directly to affected breast tissue at the time of breast cancer surgery.

As a result, the use of intraoperative partial breast radiation allows patients with early stage breast cancer to decrease radiation exposure and the duration of treatment from weeks or months to one day or week.

In addition to accelerating treatment, IORT may cut down on radiation side effects, particularly those involving the heart and lungs.

 Advanced Imaging for Early Detection 

Detecting breast cancer early can result in the most treatment options and the best chance of a cure. Yet it’s harder to detect breast cancer in women with dense breasts, especially using traditional mammography.

 

Although dense breasts are common and normal, especially in younger women, most studies find they increase the risk of breast cancer. If you’ve been told you have dense breasts or a heightened risk of breast cancer due to family history or other factors, ask your doctor about supplemental screening.

These advanced imaging technologies give doctors a more precise view of breast tissue:

  • Breast tomosynthesis, also called a 3D mammogram, takes multiple images and compiles them into a 3D model for a clearer picture of any masses.
  • Breast cancer MRI (magnetic resonance imaging) can increase the chances of detecting breast cancer in women with a higher-than-average risk of breast cancer or those who have already had breast cancer, and for women with dense breasts.

A Team approach

It takes a multidisciplinary team to deliver the personalized medicine that’s a hallmark of modern breast cancer care.

These physicians form the core breast cancer care team, working closely with oncology nurses, oncology social workers, genetic cancer specialists, nutritionists and other care providers:

  • Medical oncologists manage and coordinate the team, handling diagnosis, decisions about genetic testing and treatment with chemotherapy, targeted therapies and other drugs.
  • Breast surgeons, also called surgical oncologists, remove tumors during surgery.
  • Radiation oncologists prescribe and deliver radiation to shrink or destroy tumors.

For more information on the Cancer Care Center of Henry County, call 731-644-3522. This comprehensive approach to cancer care ensures that patients can receive the most advanced, effective and state-of-the-art treatment for their disease – all on their home front.

How to Help a Loved One Prepare for a New Baby

Becoming a parent for the first time is exciting, joyful–and overwhelming. Helping your loved one prepare for the baby’s birth will make the transition to parenthood easier, and can help get the new family started on the right foot for a lifetime of health and happiness.

Share Information on Classes
Many of these classes are offered through your local hospital. Here is a list of classes that may be helpful to new parents:

  • Birthing classes. These classes give instruction on what to expect during the labor and delivery process, and help both parents prepare for their arrival of their new baby. Most hospitals also offer tours of the hospital labor and delivery areas, and offer parents the opportunity to ask questions of hospital staff and healthcare providers, and meet other expecting parents.
  • Infant Safety Classes. This safety class is designed for new and expectant parents and their caregivers. Topics include infant development, baby safety, injury prevention and immediate care of common injuries for infants.
  • Child & Baby CPR. While you hope you’ll never use CPR for a child or infant, it’s essential to know the steps to help in case of a cardiac or breathing emergency. These classes are often held through your local hospital or your local American Red Cross.
  • Breastfeeding. Like anything new, nursing a new baby takes practice and knowledge to get it right. Pregnant moms who learn about breastfeeding through classes are more likely to have success. Reach out to your local hospital to find a breastfeeding class in your area.

Baby-Proofing the Home
One of the most important ways you can help a new family feel prepared and ready for their new arrival is help them make sure their home is safe and secure. Here are some tips on making sure the baby’s new environment is ready:

  • Check the safety of the crib and other baby items. To learn whether the baby’s crib and mattress is safe, contact the U.S. Consumer Product Information Safety Commission, at www.cpsc.gov or call them at 800-638-2772.
  • Prevent suffocation by removing all pillows, blankets, and stuffed animals from the crib.
  • Make sure handrails are installed and secure in stairways, and always hold the handrail when using stairs while holding the baby.
  • Check to see that smoke detectors and carbon monoxide detectors in the baby’s home are working.
  • Make sure there are emergency numbers, including poison control, near each phone.
  • Verify that the home or apartment number is easy to view so fire or rescue can locate the home easily.

Choosing the Birthing Experience
Now is a good time to think about the type of birth your loved ones would like to have. Here are some conversation starters to help them think about their preferences:

  • Who do you want in the delivery room with you?
  • Do you want medications to keep you comfortable during labor?
  • Do you want to breastfeed your baby?
  • If you have a boy, do you want to circumcise him?
  • What else is important to you?

HCMC offers many resources for expecting parents. You can play a key role in

helping a loved one prepare for the birth of a new baby by sharing information on classes offered. You can also help ease the stress of welcoming a newborn by assisting them in selecting their healthcare provider, having conversations on making decisions on their birthing experience, and helping them babyproof the home. For more information on the Women’s Center at HCMC, call 731-644-8510.