Personalized breast cancer treatment
The probability of full breast cancer recovery in recent decades has increased significantly, due to the introduction of new scientific developments and research.
Today, in addition to surgery, radiotherapy and systemic treatment according to standard protocols in Israel most of patients receive personalized treatment that really increases the chances of survival and a positive prognosis for each individual patient.
The main problems of standard management are the excessive treatment and the absence of an individual therapy protocol. To prevent over-treatment, it became necessary to classify patients, that allows to determine a positive prognosis for them accordingly and to cancel or reduce adjuvant therapy as well. Another factor that strongly affects the patient is the use of endocrine therapy for many years.
Studies show that lifestyle changes affect the effectiveness of drugs and itself helps to improve the prognosis. Therefore, it is important to focus not only on treatment of a cancerous tumor, but on the patient as a whole.
Each tumor has many different subtypes.
Due to the molecular medicine achievements and special tests for oncomarker genes, it is possible to determine the type of tumor. Medical care for women with breast cancer is improved by adapting treatment to the molecular characteristics of individual tumors, through personalized treatment, and taking into account the size and location of the tumor, the hormonal status of the patient during menopause.
Personalization begins with screening or preventive screening.
The number of breast cancer cases is growing because of an earlier detection with the help of mammography and general aging of the population, due to this fact cancer is now being cured, and the personalized treatment makes a huge step in this direction.
This approach starts with screening. Women from families with known cases of breast cancer are at a higher risk of developing this disease. This is especially important if the woman is a carrier of BRCA1 or BRCA2 genes mutation. It means that cells do not effectively repair their own DNA. Women with a family history of breast cancer (and ovaries) can be diagnosed for a mutation of the BRCA marker gene and need more frequent screening. The use of magnetic resonance imaging (MRI) and positron emission computed tomography (PET-CT) expands the possibilities in detecting tumors at an early stage.
Currently, anti-cancer treatment continues to depend on the evaluation of critical targets in the tumor – hormonal receptors and HER2 overexpression, and since tests for their identification are very sensitive, it is important that samples of tumor tissue be evaluated in a laboratory that corresponds to strict quality criteria.
Such a study to determine a personalized protocol of treatment can be done in Israel under the guidance of well-known oncologists.
Science is developing rapidly: patients are invited to participate in clinical trials where a comprehensive molecular tumor profile is compiled and patients are given access to drugs that accurately affect certain types of cancer cells.
Determination of protocol for the breast cancer treatment.
Nature of treatment should be determined taking into account specific conditions such as type of malignant cells, the size of the tumor and its variety (differentiation degree between cancer and normal cells when viewed under a microscope). One more important thing here is to determine with the help of PET-CT, whether the cancer has spread only to the breast or has passed to the lymph nodes in the armpit, knots and organs in another place of the body. The spread of cancer cells to body organs distant from the primary tumor is called metastasis.
The initial treatment of most women with breast cancer diagnosed at an early stage begins with surgery. With lumpectomy it is possible to maintain a healthy breast tissue, while removing the tumor and the surrounding tissues, in contrast to the mastectomy, when the thoracic gland with the adjacent lymph nodes is completely removed.
In the case of inoperable tumors, chemotherapy is sometimes prescribed.
The current or potential spread of cancer within the breast or in the surrounding area can be restrained by radiation therapy. But systemic cytotoxic chemotherapy is often required if there are metastases in another part of the body. This therapy rapidly kills dividing cells. The disadvantage of this therapy is that quickly divide cells may be both cancerous and healthy, for example, rapid division of cells in the bone marrow and gastrointestinal tract is a part of a normal physiological process. But the chemotherapy do not differ this cells. Side effects of this therapy is increased risk of concomitant infectious diseases, as well as nausea and vomiting.
Personalized protocol based on special molecular genomic tests allows woman to avoid not necessary toxic drugs that do not affect the tumor.
Treatment based on the molecular characteristics of breast cancer.
When making a decision about treatment, oncologists increasingly take into account the molecular characteristics of the tumor of an individual patient. In order for a personalized therapy to match the patient, it is necessary to determine the biological factors that lead to tumor growth in specific cases.
Due to respond of the breast tissue to hormonal changes in the woman’s body, many cancers have estrogen receptor expression and growth in response to their activation. Many years ago doctors determined that the growth of female breast tumors that are positive for the estrogen receptor (ER +) can be prevented or delayed by anti-estrogen drugs tamoxifen and aromatase inhibitors. These were the first targeted drugs for breast cancer. Now, the tumor profile test allows to check action of different drugs on the tumor (chemotherapy, immunotherapy and biological drugs). So, our doctors get a wider range of drugs and their combinations that may have effect for a specific patient but were not considered before according to the standard treatment.
Personalized treatment is widely used by our Israeli oncologists in the treatment of female breast tumors and proves effective with every successful case of curing cancer.
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