Adjuvant breast cancer therapy is a term which encompasses all of the extra treatments which are applied to help prevent the breast cancer from returning. (By contrast, ‘neoadjuvant’ breast cancer therapy is given prior to any other treatments in order to improve the benefits of subsequent treatments). There are basically five types of adjuvant therapy. These are chemotherapy, radiation therapy, hormone therapy, immunotherapy, and targeted therapy. The type and degree of adjuvant breast cancer therapy to apply will in large part be determined by of the specific type of cancer involved, and the cancer stage.
Primary breast cancer therapies
Radiation therarpy and surgery are usually considered to be the ‘primary’ treatments, whereas adjuvant therapy is used to limit the chances of the breast cancer returning. Breast cancer surgery can usually remove all of the malignant cancer cells, but adjuvant therapy is a way to kill off cancer cells which may have remained behind, or which have migrated undetected to other areas of the body. There are many benefits to adjuvant therapies, but they are not without side effects, so the decision has to be weighed carefully.
Chemotherapy is ‘toxic’ to breast cancer cells
Chemotherapy is a broad term but it essentially refers to the use of drugs to ‘kill’ cancer cells. There are various ways that breast cancer chemotherapy accomplishes this, but generally speaking it is through either interfering with the breast cancer cell’s ability to multiply, of by killing the cells themselves. Chemotherapy is also called ‘systemic’ therapy, because it reachers virtually every area of the body, not just a specific site. Sometimes chemotherapy is used as ‘primary’ therapy, especially if the breast cancer is already at a later stage. There can be many side effects from chemothgerapy, but it can be a highly effective and beneficial modality of breast cancer treatment. Chemotherapy is administered by the oncologist, who is an expert in this area.
Hormone or Endocrine therapy for breast cancer treatment
A sub-category of breast cancer chemotherapy is ‘hormone’ therapy (also termed ‘endocrine therapy’). Hormones are like signals that the body creates in order to stimulate certain biological processes and functions, and one of the most important hormonal functions is as a signal for ‘growth’, specifically cell growth. Certain hormones act like ‘fuel’ to stimulate breast cancer growth, which is of course the opposite of what is desired. Breast cancer hormone therapy acts in a way that either reduces the body’s production of certain hormones or by limiting a breast tumor’s ability to ‘accept’ hormones. When a breast tumor biopsy sample is examined by a pathologist, this ‘histological evaluation’ will include information as to whether or not the breast cancer is sensitive to certain hormones. In fact, if a breast cancer tumor is determined to be highly sensitive to ‘growth’ hormones such as estrogen and progesterone, this is actually a positive thing. That means that the breast cancer can be effectively countered with hormone therapies which inhibit the ability of these hormones to function, slowing and possibly stopping breast tumor growth.
Radiation therapy is highly localized
Radiation therapy can either be considered primary or secondary breast cancer treatment. Radiotherapy uses high-powered X-rays focused on a very specific area of the body to kill breast cancer cells. It is very common to use radiation therapy at the site of a breast cancer lumpectomy or mastectomy to kill any breast cancer cells which may remain undetected in the margins of the surgical site. There are side effects to radiation therapy as it is quite hard on the body. In fact, some side effects might only surface many years after treatment. However, breast cancer radiation therapy in combination with surgery is a tried and tested method of breast cancer treatment.
breast cancer immunotherapy supplements the body’s defense systems
Breast cancer immunotherapy is a relatively new approach to breast cancer treatment. Our own bodies have a powerful immune system in place to fight off infection and disease, and breast cancer immunotherapy is a means of ‘amplifying’ the effectiveness of the body’s own defense systems. It’s much like receiving a vaccination for the flu or measles, but on a larger scale. By placing antibodies or immune cells from someone else into a breast cancer patient’s system, the body’s own defenses receive a huge boost. Breast cancer immunotherapy is still considered an ‘experimental’ breast cancer treatment, largely informed by advances fighting immune system diseases such as AIDS. Physicians will tend to be cautious before utilizing this modality to fight breast cancer, but when the cancer is not responses to the usual treatments, it is a reasonable approach. There can be rather serious side effects to breast cancer immunotherapy, so the decision to proceed with it must be considered vary carefully.
targeted breast cancer therapy is specific to cellular abnormalities
“Targeted” breast cancer therapy is somewhat of a misleading term, as like hormone therapy, it is really a sub-category of breast cancer chemotherapy. What targeted therapy implies is that a highly specific abnormality found in an individual patient’s breast cancer cells is being ‘targeted’. By limiting the ability of a particular cellular abnormality to grow and flourish, the overall growth of the breast tumor may be slowed or even halted. As an example, some breast tumors over-express a protein called “HER2” , and high levels of this particular hormone have been shown to have a negative effect on overall prognosis. By specifically targetting and blocking the action of this protein, breast cancer growth is inhibited.