Cancer Care Associates, Oklahoma City, OK

Many new options are becoming available to help treat and cure breast cancer patients.Of course, the earlier the treatment begins the greater the chances of defeating the cancer.The first step is to surgically remove the cancer from the breast and lymph nodes. In most cases now a lumpectomy can be performed, in which only the cancerous tissue, or lump, is removed.

Lumpectomy followed by radiotherapy is as effective as mastectomy. Many women fear that unless a mastectomy is performed they will not become cancer-free - this is simply not true. When, for specific reasons or personal choice, a lumpectomy is not feasible, mastectomy remains an appropriate option.After surgical removal, patients are technically cancer-free, but small cancer cells may be circulating in the blood and could return later," explained Dr. Ritwick Panicker, an oncologist with Cancer Care Associates.

To diminish the risks of cancer recurrence, additional therapies are often needed. These include chemotherapy, radiotherapy, anti-estrogen therapy and biological therapy.Sophisticated testing helps define the aggressiveness of a patient's cancer and identify specific drugs that will effectively treat the disease.We've had advances in better defining the biology of each patient's cancer and predicting their risk of the cancer returning," said Dr. Panicker. The treatment is more and more individualized. It's the way of the future for a lot of cancers."

One of the newest biological therapies is the use of a synthetic protein that switches off the breast cancer cell growth. This drug, called Herceptin, was approved by the FDA in 2005 for use in early stage breast cancer. It targets the Her-2-Neu receptor, found on the surface of some breast cancer cells. Patients' tumor tissue is tested to see if the Her-2-Neu gene is over expressed" (too many copies of the gene).The gene is over expressed in about 30 percent of breast cancers.

By using Herceptin in combination with the chemotherapy, the rate of recurrence in these patients has been reduced significantly.In advanced cases of breast cancer in which the disease has spread to other organs, there are newer options as well, according to Dr. Panicker. Even though eventually the disease may prove fatal, it can often be controlled for a long period of time," Dr. Panicker said. Instead of approaching advanced breast cancer as a terminal illness, we now approach it as a chronic illness."

One of the newest biological therapies for advanced breast cancer is a drug called Avastin. This drug prevents the growth of new blood vessels required for the cancer cells to grow and spread. By blocking the growth of new blood vessels, Avastin halts growth and progression of cancer cells.Anti-estrogen therapies have been widely used in the fight against breast cancer, in both the early and advanced stages. Some "hormone sensitive" cancers need the estrogen to flourish. Thus by turning off the production of estrogen or blocking the effects of estrogen, results in the death of cancer cells.

"There are lots of advances being made," said Dr. Panicker, "But there are lots of questions we still need to answer."