Treatment

Getting a Second Opinion
Treatment Methods

Surgery
Radiation Therapy
Chemotherapy
Hormone Therapy
Biological Therapy

Treatment Choices by Stage

Many women with breast cancer want to take an active part in making decisions about their medical care. It is natural to want to learn all you can about your disease and treatment choices. Knowing more about breast cancer helps many women cope.

Shock and stress after the diagnosis can make it hard to think of everything you want to ask your doctor. It often helps to make a list of questions before an appointment. To help remember what the doctor says, you may take notes or ask whether you may use a tape recorder. You may also want to have a family member or friend with you when you talk to the doctor - to take part in the discussion, to take notes, or just to listen. You do not need to ask all your questions at once. You will have other chances to ask your doctor or nurse to explain things that are not clear and to ask for more details.

Your doctor may refer you to a specialist, or you may ask for a referral. Specialists who treat breast cancer include surgeons, medical oncologists, and radiation oncologists. You also may be referred to a plastic surgeon.

Getting a Second Opinion

Before starting treatment, you might want a second opinion about your diagnosis and treatment plan. Many insurance companies cover a second opinion if you or your doctor requests it. It may take some time and effort to gather medical records and arrange to see another doctor. You may have to gather your mammogram films, biopsy slides, pathology report, and proposed treatment plan. Usually it is not a problem to take several weeks to get a second opinion. In most cases, the delay in starting treatment will not make treatment less effective. To make sure, you should discuss this delay with your doctor. Some women with breast cancer need treatment right away.

There are a number of ways to find a doctor for a second opinion:

• Your doctor may refer you to one or more specialists. At cancer centers, several specialists often work together as a team.
• NCI's Cancer Information Service, at 1-800-4-CANCER, can tell you about nearby treatment centers.
• A local or state medical society, a nearby hospital, or a medical school can usually provide the names of specialists.
• The American Board of Medical Specialties (ABMS) has a list of doctors who have had training and passed exams in their specialty.
• NCI provides a helpful fact sheet called "How To Find a Doctor or Treatment Facility If You Have Cancer."

Treatment Methods

Women with breast cancer have many treatment options. These include surgery, radiation therapy, chemotherapy, hormone therapy, and biological therapy. These options are described below. Many women receive more than one type of treatment.

The choice of treatment depends mainly on the stage of the disease. Treatment options by stage are described below.

Your doctor can describe your treatment choices and the expected results. You may want to know how treatment may change your normal activities. You may want to know how you will look during and after treatment. You and your doctor can work together to develop a treatment plan that reflects your medical needs and personal values.

Cancer treatment is either local therapy or systemic therapy:

• Local therapy: Surgery and radiation therapy are local treatments. They remove or destroy cancer in the breast. When breast cancer has spread to other parts of the body, local therapy may be used to control the disease in those specific areas.
• Systemic therapy: Chemotherapy, hormone therapy, and biological therapy are systemic treatments. They enter the bloodstream and destroy or control cancer throughout the body. Some women with breast cancer have systemic therapy to shrink the tumor before surgery or radiation. Others have systemic therapy after surgery and/or radiation to prevent the cancer from coming back. Systemic treatments also are used for cancer that has spread.

Because cancer treatments often damage healthy cells and tissues, side effects are common. Side effects depend mainly on the type and extent of the treatment. Side effects may not be the same for each woman, and they may change from one treatment session to the next.

Before treatment starts, your health care team will explain possible side effects and suggest ways to help you manage them. NCI provides helpful booklets about cancer treatments and coping with side effects. These include Radiation Therapy and You, Chemotherapy and You, Biological Therapy, and Eating Hints for Cancer Patients.

At any stage of disease, supportive care is available to control pain and other symptoms, to relieve the side effects of treatment, and to ease emotional concerns.

You may want to talk to your doctor about taking part in a clinical trial, a research study of new treatment methods. The section on "The Promise of Cancer Research" has more information about clinical trials.

Breast Reconstruction

Some women who plan to have a mastectomy decide to have breast reconstruction. Other women prefer to wear a breast form (prosthesis). Others decide to do nothing. All of these options have pros and cons. What is right for one woman may not be right for another. What is important is that nearly every woman treated for breast cancer has choices.

Breast reconstruction may be done at the same time as the mastectomy, or later on. If you are thinking about breast reconstruction, you should talk to a plastic surgeon before the mastectomy, even if you plan to have your reconstruction later on.

There are many ways to reconstruct the breast. Some women choose to have implants. Implants may be made of saline or silicone. The safety of silicone breast implants has been under review by the Food and Drug Administration (FDA) for several years. If you are thinking about having silicone implants, you may want to talk with your doctor about the FDA findings. Your doctor can tell you if silicone implants are an option.

You also may have breast reconstruction with tissue that the plastic surgeon moves from another part of your body. Skin, muscle, and fat can come from your lower abdomen, back, or buttocks. The surgeon uses this tissue to create a breast shape.

Which type of reconstruction is best depends on your age, body type, and the type of surgery you had. The plastic surgeon can explain the risks and benefits of each type of reconstruction.

Complementary and Alternative Medicine

Some women with breast cancer use complementary and alternative medicine (CAM):

• An approach is generally called complementary medicine when it is used along with standard treatment.
• An approach is called alternative medicine when it is used instead of standard treatment.

Acupuncture, massage therapy, herbal products, vitamins or special diets, visualization, meditation, and spiritual healing are types of CAM.

Many women say that CAM helps them feel better. However, some types of CAM may change the way standard treatment works. These changes could be harmful. And some types of CAM could be harmful even if used alone.

Some types of CAM are expensive. Health insurance may not cover the cost.

NCI offers a booklet called Thinking About Complementary and Alternative Medicine: A Guide for People with Cancer.

You also may request materials from the Federal Government's National Center for Complementary and Alternative Medicine. You can reach their clearinghouse toll-free at 1-888-644-6226 (voice) and 1-866-464-3615 (TTY).

Nutrition and Physical Activity

It is important for women with breast cancer to take care of themselves. Taking care of yourself includes eating well and staying as active as you can.

You need the right amount of calories to maintain a good weight. You also need enough protein to keep up your strength. Eating well may help you feel better and have more energy.

Sometimes, especially during or soon after treatment, you may not feel like eating. You may be uncomfortable or tired. You may find that foods do not taste as good as they used to. In addition, the side effects of treatment (such as poor appetite, nausea, vomiting, or mouth sores) can make it hard to eat well. Your doctor, dietitian, or other health care provider can suggest ways to deal with these problems. Also, the NCI booklet Eating Hints for Cancer Patients has many useful ideas and recipes.

Many women find they feel better when they stay active. Walking, yoga, swimming, and other activities can keep you strong and increase your energy. Exercise may reduce nausea and pain and make treatment easier to handle. It also can help relieve stress. Whatever physical activity you choose, be sure to talk to your doctor before you start. Also, if your activity causes you pain or other problems, be sure to let your doctor or nurse know about it.

Cancer is one of the leading causes of death worldwide. Numerous cancer researches have been done to understand the disease better. In women, breast cancer is the second most common cancer next to lung cancer. There are millions of affected women in the world and 200,000 more will be diagnosed with the disease in 2007. Current statistics show that breast cancer claims the life of 1 woman every 13 minutes. It would be really beneficial if there is higher awareness on breast cancer. Knowing about the disease, its causes, symptoms, treatment and management, will greatly help patients and families of these patients understand the disease better. 

One of the most effective breast cancer awareness programs is the breast cancer walk. In the United States, there is the Breast Cancer 3-Day benefit. A fund raising program participated by men and women who want to make a difference in the lives of these breast cancer victims. The program involves 3 days or 60 miles of walking and participated by millions of people from all over the nation. It is a chance for the participants to learn about cancer and at the same time help in promoting awareness. 

Although it may seem a lot of work, the breast cancer walk is actually fun. Since a breast cancer walk is not a race, participants can actually walk leisurely. It's the perfect chance to meet people from all walks of life and share experiences. The route is filled with safety and support nets with people standing by to offer food and drinks. There are medical volunteers on stand by for emergency medical attention. At the end of each day, participants get to rest, shower, and eat a scrumptious dinner. Comfortable sleeping bags and tents are supplied for a good night's rest. All these friendly accomondations can make the Breast Cancer Walk a truely unique experience. 

If you want to participate but feel like you are not ready for such physical activity, you should not worry. There are training manuals provided that will put you in perfect shape to walk in no time at all. Training walks will even be organized in your area to practice long-distance walking. Since the Breast Cancer 3-day Series are held in different cities like Boston, Chicago, Seattle, Michigan and Philadelphia, you can practice at the city nearest you. 

It's a good idea to join in on the Breast Cancer Walk. Not only is it great exercise, but it's also fun and it's for a great cause. 

Since a breast cancer walk is mostly a fund raising program to support breast cancer research, education, treatment and screening, you will be asked to raise a certain amount for the cause. You would be surprised to know that most participants exceed this amount because of the amazing generosity of friends, co-workers and families. Even people you do not know will eagerly support you in your cause. 

Proceeds of the breast cancer walk will be distributed to the Susan G. Komen for the Cure movement, which has already generated $1 billion to date for fighting breast cancer, and the National Philanthropic Trust Breast Cancer Fund, a public charity that is considered to one of the largest independent charitable institutions in the United  States