Cancer treatment is tailored to the individual
How many people do you know who have had breast cancer? It’s not always a question that is brought up in polite conversation. Today, there are about 3 million women in the U.S. living with breast cancer.
When most people think of cancer, especially breast cancer, they think of an incurable illness with terrible side effects from treatment. In fact, most Americans have at least one family member who has died from cancer. But over the past few years, there are more and more cancer survivors.
Why is this? Advances in treatment!
It is difficult to talk about new treatments, without first looking at the old treatments. In 1943, we first began treating lymphomas and leukemias with chemotherapy. Early successes brought treatments for other cancers. But, we were still trying to treat cancer as one entity, applying the same drugs to all types of cancer. But, 90 percent of all responses only occurred in 10 percent of cancer types.
But that was the 20th century. This is the 21st century. Now, of course, we know that “cancer” is not one disease. You cannot treat leukemia the same way you treat breast cancer. And, you cannot treat one patient with breast cancer the same way you treat another patient with breast cancer.
Breast cancer treatment is now personalized. Using the genetics of the breast cancer cells, we are able to determine the best treatment. Since we know that not all cancers are alike, we can now find specific targets in certain cancers, and match the treatment to the target. One of the first examples of targeted therapy was in breast cancer.
In the early 1990 we found that some breast cancers over-expressed estrogen receptors and that these tumor cells grew in the presence of estrogen. Thus, we found a new target, which led to a way to block the estrogen receptor and treat the cancer, namely tamoxifen and now, the aromatase inhibitors. These are pills (not IV chemotherapy) that are taken to prevent any growth of cancer or pre-cancer cells. Now, there are more targeted agents being used for cancer treatment than there are chemotherapy agents.
Why are targeted agents better? First, they have less side effects, because the only kill the targeted cells, thereby sparing most of the normal cells. Second, they work better because they are more specific.
Although we still use chemotherapy for very aggressive cancers, even these treatments have come a long way. New agents and chemotherapy regimens have less side effects and less chance of causing another cancer in the future.
But the bottom line is breast cancer is still a curable disease. We treat it aggressively, because we never want it to return. And we are achieving this goal. So, how many people do you know who have had breast cancer? I’ll bet it’s a much higher number than you think.
Dr. Shonda M. Asaad is a Hematologist and Oncologist treating blood disorders and all types of cancers. Her office is located at 20 Medical Park Dr., Asheville, NC.