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Breast cancer treatment: advanced disease. palliative therapy BREAST CANCER TREATMENT: ADVANCED DISEASE. PALLIATIVE THERAPY
For some women, chemotherapy or radiotherapy is used as a primary treatment rather than as an adjuvant following surgery. In the case of rapidly growing breast cancer, by the time a diagnosis is made the tumour may be too large to be removed surgically, or cancer cells may already have spread to other parts of the body. Although the surgeon may take a biopsy of the tumour for examination, the first line of treatment in these cases may be chemotherapy or radiotherapy.
Primary chemotherapy
The drugs used are the same as those mentioned above for adjuvant chemotherapy, but they may be given more often or in higher doses.
You may have to stay in hospital during your treatment, or it may be given in the outpatients' clinic. The doctor will monitor your chemotherapy carefully and will examine you regularly to make sure that the tumour is shrinking.
Once the tumour has been reduced to a more manageable size, it may then be removed surgically or be treated by radiotherapy. This form of chemotherapy is used most commonly for young women with large, fast-growing breast cancers for whom subsequent surgery is less mutilating once the tumour has shrunk.
Primary radiotherapy
Similarly, radiotherapy may be used as a primary treatment for a tumour that is too large to be removed surgically. The course of primary radiotherapy treatment is longer than that for adjuvant radiotherapy following surgery, and it may be administered by X-ray beam as well as internally through radioactive wires inserted into the breast under anesthetic. Internal radiation treatment is given over a period of 3 to 4 days, during which time you will have to remain in hospital.
Palliative therapy
When breast cancer is very advanced, and cannot be cured, chemotherapy and radiotherapy can be used to slow its growth or help relieve its symptoms. Hormones other than tamoxifen may also be used to slow the growth of the tumour without causing too many side-effects.
Palliative treatment of this sort may successfully prevent the cancer from growing for many months or years, even though it cannot be completely eradicated.
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