Category: treatment

4 Apr

The Prospect of Locoregional Treatment of Breast Cancer- Where to Go?

Personalized cancer care is usually regarded as using molecular information from growths to be able to identify which therapeutic agents is going to be best inside a given patient. For cancer of the breast patients, oestrogen receptor (ER) status can be used to find out who’ll take advantage of hormonal therapy HER2 overexpression is needed to calculate take advantage of trastuzumab(Drug info on trastuzumab) (Herceptin) and Oncotype DX, a multigene assay, helps you to clarify which patients with ER-positive, lymph node negative growths will enjoy the addition of chemotherapy. The content by Dr. Rizzo and Dr. Wood within this problem of ONCOLOGY reviews advances produced in surgical and radiation oncology that allow us also personalize locoregional strategy to cancer of the breast patients.

Sentinel Lymph Node Biopsy and the requirement for Completion Axillary Lymph Node Dissection

In the late 1800s before mid-seventies, women identified with cancer of the breast went through a Halsted radical mastectomy, by which surgeons removed the breast, pectoralis muscle, and axillary lymph nodes. Today, a substantial quantity of patients undergo breast-conserving therapy (BCT), that involves a segmental resection with obvious margins, evaluation from the axillary lymph nodes, and radiation. As Rizzo and Wood describe at length, patients identified with initial phase, scientifically node-negative cancer of the breast undergo sentinel lymph node (SLN) biopsy. SLN biopsy precisely stages the axilla and spares women a lot of the morbidity connected having a complete axillary lymph node dissection (ALND). If the commentary were written 18 several weeks ago, we’d claim that all ladies with metastasis recognized within their SLN require completion ALND. However, outcomes of the lately released American College of Surgeons Oncology Group (ACOSOG) Z0011 trial shown that properly selected patients might be treated without ALND. The trial enrolled patients with clinical T1-T2, N0 invasive cancer of the breast given breast-conserving surgery and a couple of positive SLNs recognized by hematoxylin-and-eosin discoloration. Patients were randomized to endure ALND or no further surgery all patients were to get whole-breast irradiation (WBI). The main endpoint from the trial was overall survival (OS), and also at a median follow-from 6.three years, 5-year OS was 91.8% with ALND and 92.5% with SLND alone. Locoregional repeated episodes (LRR) were reported in 3.6% of patients within the ALND group versus 1.8% within the SLND-alone group.[1,2] In The College of Texas MD Anderson Cancer Center, we talked about these data inside a multidisciplinary forum, and that we now advise nearly all women with clinical T1-T2, N0 growths with an optimistic SLN who’re going through breast-conserving surgery and WBI that they’re going to omit completion ALND without any significant effect on local-regional control or OS.[3]

Neoadjuvant Chemotherapy: Implications for Surgical Control over the Axilla

Utilization of neoadjuvant chemotherapy makes BCT a choice for additional patients. As examined by Rizzo and Wood, neoadjuvant chemotherapy produces a reduction in tumor size, therefore permitting breast upkeep. While not talked about in our review, research released by Search et al shown that SLN biopsy was appropriate in patients receiving neoadjuvant chemotherapy who given scientifically node-negative disease.[4] The research examined 575 patients going through SLN biopsy after chemotherapy, in comparison with 3,171 patients who went through surgery first. SLN identification rates were excellent (97.4% within the neoadjuvant group and 98.7% within the surgery-first group) and false-negative rates were low (5.9% within the neoadjuvant group versus 4.1% within the surgery-first group). When patients were examined depending on their showing T stage, there have been less positive SLNs within the group going through neoadjuvant chemotherapy, recommending that patients with clinical T2 and T3 growths were more prone to be able to escape a completion ALND when they received neoadjuvant chemotherapy. Importantly, carrying out the SLN biopsy after neoadjuvant chemotherapy didn’t result in greater LRR rates. Presently SLN biopsy is contraindicated in patients receiving neoadjuvant chemotherapy who present with scientifically node-positive disease. The question of whether SLN biopsy might be appropriate within this human population is being looked into within the ACOSOG Z1071 trial, a phase II study evaluating the role of SLN biopsy following neoadjuvant chemotherapy in females who present with clinical N1-2 disease. The trial built up well and was closed to new patient entry in June 2011.

Advances in Radiotherapy for Patients Going through Breast-Conserving Therapy

Additionally to carrying out less surgery, we’re also giving less radiation to choose breast cancer patients going through BCT. As talked about by Rizzo and Wood, there’s growing curiosity about using faster partial breast irradiation (APBI) instead of WBI. APBI could be given via several methods, including interstitial brachytherapy, catheter-based intracavitary brachytherapy, or exterior beam 3-D conformal radiotherapy. Purported advantages of APBI incorporate a reduction in overall treatment time in addition to a reduction in the dose of radiation shipped to uninvolved servings of the breast.[5] An essential trial looking into APBI may be the RTOG 0413/NSABP B-39 study. This can be a randomized, phase III study of conventional WBI versus APBI for ladies with stage , I, or II cancer of the breast, and also the primary objective would be to determine whether APBI provides equivalent local tumor control in comparison with WBI. The trial started enrolling patients in 2005 and after rapid accrual from the cheapest-risk patients (individuals ?Y half a century old with ductal carcinoma in situ and patients with invasive cancer who’re ?Y half a century old, node-negative, and hormone receptor positive) the research closed accrual to that particular population and urged enrollment of more youthful patients with node-positive, hormone receptor negative disease. It’s anticipated that enrollment is going to be completed within the next one to two years. Before data in the RTOG 0413/NSABP B-39 study can be found, physicians are encouraged to make reference to the consensus statement released through the American Society for Radiation Oncology to recognize patients considered “appropriate,” “cautionary,” or “unacceptable” for APBI.[5]

The theme of this article by Rizzo and Wood is the fact that “less is much But could it be? Data in the National Cancer Institute of Canada Clinical TGrials Group (NCIC-CTG) MA.20 trial presented in the 2011 meeting from the American Society of Clinical Oncology claim that this isn’t true in most cases. The MA.20 trial examined adding regional nodal irradiation (RNI) to WBI following breast-conserving surgery. Patients with node-positive or high-risk node-negative disease given breast-conserving surgery and adjuvant chemotherapy and/or endocrine therapy were randomized to WBI or WBI plus RNI towards the internal mammary, supraclavicular, and high axillary lymph nodes. All node-positive patients went through an ALND. The research enrolled a lot more than 1,800 patients, and following a median follow-from 62 several weeks, researchers reported that adding RNI was connected by having an improvement in local-regional disease-free survival (DFS) (HR = .59, P = .02, 5-year risk: 96.8% for WBI plus RNI versus 94.5% for WBI alone) in addition to distant DFS (HR = .64, P = .002, 5-year risk: 92.4% for WBI plus RNI versus 87.% for WBI alone). Additionally they shown a trend towards improvement in OS for individuals receiving RNI (HR = .76, P = .07, 5-year risk: 92.3% for WBI plus RNI versus 90.7% for WBI alone).[6] The research was randomized there doesn’t seem to be an discrepancy between your two arms that may explain the findings. Possibly probably the most striking finding within the MA.20 study was that addition of RNI decreased the complete chance of a distant metastatic event within five years of diagnosis, from 13% lower to 7.7%, showing that 41% of distant metastatic occasions within this patient population could be avoided by RNI. Suddenly, the five.4% absolute improvement in chance of distant metastases connected with RNI really exceeded the advance in chance of local-regional recurrence. We’d claim that this difference may talk to the significance of tumor biology.

Future Directions for that Locoregional Control over Cancer Of The Breast

Where will we range from here? Some might be frustrated with one of these emerging data recommending the outcomes of the Z0011 and MA.20 have been in conflict. We’d explain the patient populations signed up for both tests will vary, with patients within the Z0011 trial getting better tumor qualities and likely lower volumes of axillary disease. Both tests suggest, however, that patients benefit?asometimes less, sometimes more?afrom properly selected local-regional treatment methods. The task that continues to be would be to identify what each patient needs, to be able to personalize the neighborhood-regional care received. Coming in the answer will probably be more difficult than knowing routine clinicopathologic data which are presently collected, including ER status, the amount of involved nodes, or how big the metastatic tumor. To enhance local-regional remedies, we have to identify molecular markers both in the main tumor and then any metastatic nodes that predict for aggressive biology converting into distant repeated episodes and, ultimately, dying from disease. It was examined to some extent by Mamounas et al, who recognized a connection between Oncotype DX recurrence scores and the chance of local-regional recurrence in node-negative, ER-positive patients who had signed up for the NSABP B-14 and B-20 tests.[7] For example, they recognized a higher-risk subgroup (

4 Jan

A Different Approach To Metastatic Breast Cancer Treatment

There is important information that more than 155,000 women in the United States currently living with metastatic breast cancer and potentially receiving treatment should know.

Metastatic breast cancer is the most advanced stage of breast cancer. Women who are diagnosed with this disease have seen their cancer spread from the breast into other parts of their body. There are various treatment options available today for women with this disease, including chemotherapy, which continues to play a central role in the treatment of metastatic breast cancer.

However, certain chemotherapy treatments-most notably taxanes, which are one of the most commonly used types of chemotherapy for breast cancer-must be combined with chemical solvents to be delivered into the patient’s body. As a result, it can take a long time (in some cases up to three hours) for a patient to receive her chemotherapy. Additionally, chemical solvents can cause serious side effects such as allergic reactions, low blood pressure, rash and shortness of breath, among others. In turn, this could prevent patients from completing their treatment.

Offering a Different Approach

Science has yielded a different approach to treating metastatic breast cancer with a taxane chemotherapy that is free of solvents. Abraxane? for Injectable Suspension (paclitaxel protein-bound particles for injectable suspension) (albumin bound), the only solvent-free taxane chemotherapy, uses a unique technology to enable the delivery of the anti-cancer drug paclitaxel. This unique technology is based on a human protein called albumin, which is a natural carrier of nutrients throughout the body.

“Women diagnosed with metastatic breast cancer may not know that they have options regarding which chemotherapy they receive,” commented Virginia Kaklamani, M.D., DSc, assistant professor Division of Hematology/ Oncology, Northwestern University. “It is important that women with this disease speak with their doctor about their treatment options, which may include solvent-free taxane chemotherapy.”

The U.S. Food & Drug Administration approved Abraxane in January 2005 for the treatment of breast cancer after failure of combination chemotherapy for metastatic disease or relapse within six months of adjuvant chemotherapy. Prior therapy should have included an anthracycline unless clinically contraindicated.

“Abraxane is the only solvent-free taxane chemotherapy approved by the FDA for the treatment of metastatic breast cancer. Abraxane provides an important option for patients with this disease,” added Dr. Kaklamani.

The most serious adverse events associated with Abraxane in the randomized metastatic breast cancer study for which FDA approval was based included neutropenia, anemia, infections, sensory neuropathy, nausea, vomiting, and myalgia/arthralgia. Other common adverse reactions included anemia, asthenia, diarrhea, ocular/visual disturbances, fluid retention, alopecia, hepatic dysfunction, mucositis, and renal dysfunction.

Science has yielded a different approach to treating metastatic breast cancer, with a taxane chemotherapy that is free of chemical solvents.

Important Safety Information & Boxed Warning

You should receive Abraxane for Injectable Suspension (paclitaxel protein-bound particles for injectable suspension) under the care of a doctor who is trained to use cancer drugs. Because you may have side effects from your treatment, you should get this medicine in a clinic or hospital with doctors, nurses and pharmacists who are trained to give cancer drugs.

Abraxane therapy should not be given to patients with metastatic breast cancer who have low white blood cell counts, which may make you more likely to get an infection. Your doctor will schedule frequent blood tests for you in order to check for low blood counts.

Note: Abraxane is paclitaxel made with the human blood protein albumin. This makes it behave differently in the body than regular paclitaxel. DO NOT SUBSTITUTE FOR OR WITH OTHER PACLITAXEL DRUGS.

Important Safety Information

One of the more important side effects associated with chemotherapy is neutropenia, which is a decrease in the number of infection-fighting white blood cells (neutrophils). Normal levels range from approximately 1,500 cells/mm3 to 1,800 cells/mm3 (but vary according to several factors, such as age and race). If levels fall below 500 cells/mm3, your risk of developing an infection increases and treatment may be interrupted. To avoid the risk of serious infection and fever, your doctor will monitor your absolute neutrophil count (ANC) during therapy.

Women should avoid becoming pregnant while being treated with Abraxane. Tell your doctor if you are pregnant, if you become pregnant, or you plan to become pregnant while taking Abraxane. Discuss with your doctor how Abraxane may affect fertility. Nursing a baby while taking Abraxane is not recommended because the drug may be present in breast milk.

In the randomized metastatic breast cancer study, the most important adverse events included lower white and red blood cell counts, infections, tingling and numbness, nausea, vomiting, diarrhea, muscle and joint aches, and mouth sores. Other adverse reactions included weakness, visual disturbances, fluid retention, hair loss, and liver and kidney dysfunction. Low platelet counts, allergic reactions (which in rare cases were severe), cardiovascular reactions, and injection site reactions were uncommon.

Sensory neuropathy (numbness, tingling, or burning in the hands and feet) can occur with Abraxane and other paclitaxel medications. Severe sensory neuropathy can improve with proper management, as prescribed by your doctor. You should tell your nurse or doctor if you experience numbness, tingling, or burning in your hands or feet while taking Abraxane.

Please talk to your doctor or nurse if you have questions regarding the potential side effects of Abraxane therapy.

Abraxane is marketed under a copromotion agreement between Abraxis BioScience, Inc. and AstraZeneca.

Abraxis Oncology is a division of Abraxis BioScience, Inc. All Abraxis BioScience, Inc. corporate names, names of services, and names of products referred to herein are trade names, service marks, and/or trademarks that are owned by or licensed to Abraxis BioScience, its divisions or its affiliates, unless otherwise noted.

4 Oct

4 Powerful Foods That Fight Cancer

Cancer is 1 of the most dangerous diseases around. It is estimated that around a third of the UK population will suffer from this disease at some point in their lives. The good news is that there are a number of cancer fighting foods you can incorporate into your diet right now. In this article I will be looking at 4 of these in greater detail.


Apples are a popular fruit that many people eat daily as a health boosting snack. If you are not currently eating them, make sure you pick up a bag next time you do your grocery shopping. They contain a long list of cancer fighting nutrients which include dietary fibre, vitamin C and the phytonutrients caffeic acid, catechin, chlorogenic acid, cyanidin, kaempferol and rutin.


Chilli peppers are potent cancer fighting foods that can be used to spice up your favourite dish. They are a brilliant source of dietary fibre and vitamin C and also an exclusive source of the anti cancer phytonutrient capsaicin. If you find regular chilli peppers too spicy, give the milder peppers (such as coronado peppers and pimento peppers) a try. These less spicy options can still keep you safe from this harmful disease.


Green tea’s anti cancer effects are well publicised. The main reason this health boosting drink is so effective at preventing this disease is because it contains lots of flavan-3-ols. Green tea is 1 of the easiest foods on this list to add to your diet. Simply drink a few cups throughout the day and you are sorted. The taste does take a bit of getting used to but the benefits are definitely worth it.


Soybeans are extremely powerful cancer fighting foods. They contain high levels of dietary fibre but their most important ingredient is isoflavones. Isoflavones are a group of phytonutrients that are highly protective against cancer. It has been suggested that these phytonutrients are 1 of the main reasons for the lower rates of cancer in Japan (a country where soybean consumption is very high). Soybeans can now be purchased from most supermarkets so including them in your diet is not difficult. Simply mix them in with the other vegetables in your diet and you are good to go.


Eating the right foods can significantly lower your cancer risk. So make sure you fill up on the fruits, vegetables and teas listed in this article. Consuming these cancer fighting foods will boost your overall health and minimise your chances of contracting this nasty disease.

4 Jul

Important Things to Must Know About Breast Cancer

Breast cancer usually begins with the formation of a small, confined tumor. Some tumors are benign, meaning they do not invade other tissues, and others are malignant, or cancerous. Malignant tumors have the potential to metastasize, or spread. Once such a tumor reaches a certain size, it is likely to shed cells that spread to other parts of the body through the bloodstream and lymphatic system. Different types of breast cancer grow and spread at different rates, some take years to spread beyond the breast, while others move quickly. Men can get breast cancer, but their number is less than half percent of all cases. Among women, breast cancer is the most common type of cancer and the second leading cause of cancer deaths – behind lung cancer. Statistics show that one in eight women, who could reach 85 years, develop the disease at a certain point in life. Two thirds of women with breast cancer are over 50 years, and that the remaining, most are between 39 and 49 years old.

Breast cancer is treatable

Fortunately, breast cancer is very treatable if detected early. Localized tumors can usually be successfully treated before the cancer spreads, and in 9 of 10 cases, the woman will live at least another five years. Experts usually consider that a duration of 5 years survival is a cure.

Once the cancer begins to spread, getting rid of it completely is more difficult, although treatment can often control the disease for years. Improved screening procedures and treatment best options make that for more than seven in ten women suffering from breast cancer to survive minimum five years after initial diagnosis, and half will survive more than 10 years.

Tips to avoid breast cancer

??? Quit smoking. Gynecologists believe that active smoking increases the risk of cancer by 30%, especially if smokers started before age 20 and smokes at least 20 cigarettes per day. It is believed that nicotine promotes breast tumor growth and metastasis installation.

??? The first pregnancy before 30 years. An early pregnancy greatly increases the level of estriol, a hormone that reduces by 50 to 70% the risk of breast cancer.

??? Skip the saturated fat. Biscuits, pizza, pastries are full of saturated fat which has been found to increase the risk of breast cancer. The risk of breast cancer in women was almost twice in those with the blood levels were high in saturated fatty acids. Therefore, we recommend limiting intake of saturated fat (animal fats: butter, pork fat, lard, etc.).

??? Alcohol stimulates estrogen production. Excess alcohol stimulates the overproduction of estrogen (female hormones) that favors uncontrolled proliferation of breast cells, the mechanism underlying breast cancer. On the other hand, once ingested, alcohol can be turned into acetaldehyde, a substance known to be carcinogenic.

??? Attention to deodorants. Aluminum and parabens are two chemicals present in most deodorants, which can disrupt the hormonal function.

Adjuvant treatment for breast cancer using Calivita natural products

– Shark Aid supplement, based on shark cartilage extract, is beneficial in inhibiting of malignant and benign tumors. Has a significant effect in preventing cancer.

– In addition to many other health benefits, Noni extract (Noni Caps) has anticancer and immunostimulating effect. It can be used with positive effects as an adjuvant treatment in various cancers and tumors.

– Omega 3 fatty acids from fish oil have many health benefits, from reducing cholesterol, cardiovascular problems and attention disorders, to cancer, because of the property to reduce the risk of malignant cells.

– It has been proven in numerous studies that primrose oil (Evening Primrose Oil) may be beneficial for pain and injuries associated with the menstrual cycle, has a positive role in thyroid gland good function and improves immune function.

– Alkaline ionized water, improved with oxygen, obtained with Aquarion filter, has antioxidant properties and prevents the formation of cancer and many other diseases as alkaline environment is not conducive to their development. It also strengthens the immune system, removes toxins accumulated over time, ensures proper hydration and contributes to the overall recovery of the body.