Sunday, March 3, 2024

Should I Do Chemo Or Not

What Antioxidants Are Good For Cancer Patients

Should you have Chemotherapy or NOT?

Beta carotene According to the American Cancer Society, this nutrient may prevent certain cancers by enhancing the white blood cells in your immune system. White blood cells work to block cell-damaging free radicals. Good sources of beta carotene are dark green leafy and yellow-orange fruits and vegetables.

Individualized Breast Cancer Treatment For Older Adults

Tran says her groups approach to dealing with breast cancer in patients of any age is highly individualized. We recommend both the treatments and the order in which the patient will receive them, which is very important. For instance, radiation is not common before surgery, since it makes wound healing more difficult.

She notes that most cancers are found early, and generally surgery is the first step in treatment. But for cancers that are more advanced when they are diagnosed, starting out with chemotherapy can offer some advantages.

In cases where the cancer is advanced, chemotherapy is often done first to shrink the tumor. Another benefit of doing chemotherapy first is the tumors response to the chemotherapy gives us information on your prognosis, and surgery afterward can confirm those findings.

Cancer Without Chemotherapy: A Totally Different World

A growing number of cancer patients, especially those with breast and lung cancers, are being spared the dreaded treatment in favor of other options.

Dr. Seema Doshi, a dermatologist near Boston, thought it was a foregone conclusion that she would have to undergo chemotherapy when a cancerous lump was found in her breast in 2019.Credit…Lauren Justice for The New York Times

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Advances In Cancer Care That Have Improved The Chemotherapy Experience

Cancer clinical trials, such as those we offer here at CTCA®, have resulted in an increasing number of treatment options and chemotherapy drugs. More options means your oncologist may have more choices if a treatment isnt working for you or if youre experiencing difficult treatment-related side effects. A quick look at the National Cancer Institutes list of drugs approved to treat breast cancer provides a good example of how treatment options have increased.

Researchers have also worked hard to reduce the toxicity of some drugs. Modifications include changing the dosage amounts, the intervals of administration and even how theyre administered. For example, researchers found that giving Velcade® to patients newly diagnosed with multiple myeloma may in most patients when its given by subcutaneous injection instead of by infusion.

Medications to prevent nausea and vomiting in those patients who experience it have also improved over the years. Some anti-nausea medications may be given at the same time as a patients chemotherapy infusion.

Chemotherapy drugs are sometimes used in combination with other innovative treatment options, such as targeted therapy or immunotherapy. In patients whose cancer exhibits certain genomic mutations, immunotherapy may keep their cancer in check on a long-term basisalmost as if it were a chronic illness like type 2 diabetes or heart disease.

Practical Hints For Nausea

Confused if you should have chemo.
  • Eat a small, light meal before your chemotherapy appointment. Most people do better if they have something in their stomach.
  • Eat what sounds good to you. In general, starches such as rice, bread, potatoes, hot cereals and puddings are well tolerated.
  • Try not to skip meals. An empty stomach will worsen all symptoms. If you don’t feel like sitting down to a meal, try nibbling on something that appeals to you.
  • Drink plenty of fluids. Herbal teas, water, sports drinks and diluted juices are recommended more than soda.
  • Avoid unappealing smells.
  • Freeze meals so you don’t have to cook. Ask your family and friends to help with meals, especially following chemotherapy when you are most likely to feel nauseated.

For more practical tips on dealing with nausea, schedule a free appointment with the dietitian by contacting the Patient and Family Cancer Support Center.

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What Are The Risks Of Chemotherapy

While chemotherapy may kill rapidly growing cancer cells, the downside is that it may also damage healthy cells in the process. This is often the cause of some common side effects of chemotherapy. For example, chemotherapy may temporarily decrease the production of red and white blood cells in the bone marrow, which may lead to anemia, fatigue and a suppressed immune system. Certain drugsnot all damage cells that help hair grow, which may lead to temporary hair loss. Damage to cells in the digestive system may cause vomiting, diarrhea or constipation.

Not everyone experiences the same side effects to the same degree. The side effects you may experience depend on the type of chemotherapy you receive, the combination of drugs youre treated with, whether you have any other chronic illnesses, the medications you may be taking for other conditions and how active or fit you are going into treatment. Your oncologist considers these issues when determining which treatment options may benefit you and whether you can tolerate treatment.

Common short-term side effects include:

Long-term side effects are less common, but they may include:

Before therapy, patients have to sign consent forms that list every potential side effectmany of which are very rare but still quite scary. Your doctor can tell you which ones you may be more likely to experience.

Chemo Does Not Kill Cancer Stem Cells

The only person that can answer this question is you! Since I am schooled in an integrative approach to cancer, I do not believe that all chemotherapy is bad. Low-dose chemo and insulin potentiated chemotherapy have shown to be tremendous aides in slowing fast-growing tumors, but remember, chemo does not kill cancer stem cells and can create drug resistant circulating tumor cells. Former White House press secretary Tony Snow died in July 2008 at the age of 53, following a series of chemotherapy treatments for colon cancer. Three years prior to his death, Snow had his colon removed and underwent six months of initial chemotherapy after being diagnosed with colon cancer

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Will I Have To Have Chemo If I Have Breast Cancer

Tran says chemotherapy can be an effective way to reduce the size of a tumor, but admits the regimen can be tough. Depending on your individual situation, chemo is not always necessary.

For postmenopausal patients with invasive cancer where the tumor is greater than 1 centimeter and hormone receptor positive, the information we get from the oncotype genetic profile of cancer can help predict if chemotherapy will be beneficial, she says.

If tests come back with a low score for certain factors, even if theres cancer in lymph nodes, the patient may be able to skip chemotherapy and instead receive hormone-blocking treatment, which is easier to take and involves fewer side effects. Tran says hormone therapy is given over five years, and can be administered in pill form.

Most Women In The Mid

What to Expect During Chemotherapy

The new study looked at the 6,711 women from the trial who fell in the mid-range of 11 to 25. The goal of the study was to find out if these women could safely skip the chemotherapy.

Following surgery, the women were randomly assigned to receive chemotherapy followed by hormone therapy, or hormone therapy alone. The study was intended to measure invasive disease-free survival, the proportion of women who had not died, or had their cancer return, or developed a new cancer. Results were very similar between the 2 groups.

  • Five years after treatment, the rate of invasive disease-free survival was 93.1% for those who had chemo and 92.8% for those who did not.
  • Nine years after treatment, the rate of invasive disease-free survival was 84.3% for those who had chemo and 83.3% for those who did not.

Rates of overall survival were also very similar between the 2 groups.

  • Five years after treatment, the rate of overall survival was 98.1% for those who had chemo and 98.0% for those who did not.
  • Nine years after treatment, the rate of overall survival was 93.8% for those who had chemo and 93.9% for those who did not.

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If You And Your Family Do Not Agree

Family members, friends, and caregivers might have different ideas about your treatment. They might want you to have more aggressive treatment. Or they might try to keep you from having certain treatments.

If this happens, your health care team can help you talk with your family and friends. Sometimes, it is best if your family and closest friends meet with you and your doctor to talk about the best treatment plan. Remember that you always have the right to make your own treatment decisions.

How Can Parents Help

Cancer treatment has come a long way. But it can be hard for kids and teens to cope with the sometimes painful or uncomfortable side effects. Fortunately, doctors have many ways to make treatments easier to manage.

Your child also might feel the emotional effects of having a serious illness. Answer questions and help explain what’s going on in an age-appropriate way. Turn to the care team when needed. A hospital support group, child life specialist, social worker, or psychologist from the team can help your child and your whole family before, during, and after cancer treatment.

You also can find information and support online at:

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Chemo Brain And Stress

Many people experience mental changes after chemotherapy treatment. This is sometimes called chemo brain. You may have problems such as poor memory, trouble finding words, difficulty focusing. This can affect parts of your life, including caring for your family and managing your job.

Some things that help with chemo brain include keeping a calendar, writing everything down, and exercising your brain with puzzles and reading. Try to focus on 1 task at a time instead of more than 1 task. You can also work with an occupational therapist for cognitive behavioral rehabilitation. This is a treatment to help you if you have cognitive issues. Occupational therapists work in the Department of Rehabilitation Medicine, Occupational and Physical Therapy. For more information about cognitive behavioral rehabilitation, talk with your healthcare provider for a referral.

Try to avoid having goals for yourself that are too high. This can add to your stress level and frustration. Most people say it takes 6 to 12 months after they finish chemotherapy before they truly feel like themselves again. Read the resource Managing Cognitive Changes for more information about managing chemo brain.

How Chemotherapy Is Used

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Doctors use chemotherapy in several ways to treat to treat all stages of breast cancer. Whether or not a doctor recommends chemotherapy for you depends on the breast cancer’s characteristics, your health history, and your personal preferences.

Doctors call chemotherapy given after surgery adjuvant chemotherapy. Chemotherapy is given after surgery to destroy any cancer cells that may have been left behind or may have travelled to other places in the body. These single cells or groups of two or three cells are very small and don’t appear on imaging tests. Chemotherapy after surgery reduces the risk of the cancer coming back, called recurrence by doctors.

Doctors dont recommend chemotherapy after surgery for everyone diagnosed with early-stage breast cancer, except in the following situations:

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    If there are cancer cells in the lymph nodes near the affected breast, doctors may recommend chemotherapy.

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    If the cancer has characteristics that make it more aggressive, such as being hormone receptor-negative or HER2-positive, doctors usually recommend chemotherapy.

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    If youre a pre-menopausal woman, your doctor is more likely to recommend chemotherapy because breast cancer in pre-menopausal women tends to be more aggressive.

Doctors call chemotherapy given before surgery neoadjuvant chemotherapy. Chemotherapy is given before surgery to shrink large cancers, which may:

  • breast cancers that have spread to the lymph nodes

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Breaking Down The Dogma

The breast cancer treatment guidelines issued by the National Cancer Institute 30 years ago were harsh: chemotherapy for about 95 percent of patients with breast cancer.

The change began 15 years ago, when the first targeted drug for breast cancer, Herceptin, was approved as an initial treatment for about 30 percent of patients who have a particular protein on their tumor surface. It was given with chemotherapy and reduced the chance of a recurrence by half and the risk of dying from breast cancer by a third, almost regardless of how much and what type of chemotherapy was used, Dr. Hortobagyi said.

In a few studies, Herceptin and another targeted drug were even given without chemotherapy, and provided substantial benefit, he added.

That, Dr. Hortobagyi said, started to break the dogma that chemotherapy was essential.

But changing cancer therapies was not easy.

It is very scary, to give fewer drugs, Dr. Hortobagyi said.

It is so much easier to pile on treatment on top of treatment, he continued, with the promise that if we add this it might improve your outcome.

But as years went by, more and more oncologists came around, encouraged by new research and new drugs.

There are now at least 14 new targeted breast cancer drugs on the market three were approved just last year with dozens more in clinical trials and hundreds in initial development.

Now some are in remission 10 or even 15 years after their initial treatment, Dr. Hortobagyi said.

Why Is Chemotherapy Used For Breast Cancer

Not everyone who has breast cancer needs chemotherapy. Depending on the cancer stage, your oncologist may recommend chemotherapy:

  • Before surgery : You may have chemotherapy to shrink a tumor. This option could make it possible to have a less-extensive surgery. It may also allow healthcare providers to discover more about the biology of the cancer itself by how it responds to chemotherapy.
  • After surgery : Sometimes, cancerous cells remain in your body but dont show up on imaging tests. Your healthcare provider may recommend chemotherapy after surgery to kill any remaining cancer cells. This treatment can also reduce the risk of the cancer from returning .
  • For advanced cancer: If breast cancer has spread to other parts of your body , chemotherapy may be the main treatment.
  • For IBC: Inflammatory breast cancer doesnt have a lump that a surgeon can remove easily. Chemotherapy often is the first treatment for IBC.

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Foods That Affect Cyp Enzymes

Cytochrome P450 enzymes are molecules that the metabolism and absorption of chemotherapy drugs into the blood.

Certain foods can

common effects of chemotherapy include fatigue, nausea, and mood changes.

For this reason, a person should avoid activities that are mentally or physically taxing. This includes strenuous work or exercise.

If I Have Invasive Breast Cancer Do I Have To Have A Mastectomy

TO SHAVE OR NOT TO SHAVE Your Head Before Starting Chemo

Mastectomy is one treatment for invasive breast cancer, but it isnt required in all cases, Tran says, especially now. Which treatments your doctor recommends and the order in which theyre given depend on several factors.

For example, she says, You and your doctor may decide that the best option for you is to undergo chemotherapy first. Chemotherapy can shrink the tumor and melt part of it away, so it is small enough to be managed with a lumpectomy instead of a full mastectomy.

If surgery is the best choice for you, new advancements for breast-conserving surgery and mastectomy with reconstruction can offer alternatives that preserve your appearance and self-image, such as oncoplastic breast reduction, nipple-sparing mastectomy, aesthetic flap closure and other techniques.

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Engage In A Calming Activity

Its possible that you may experience many different feelings during chemotherapy, such as anxiety, sadness, or anger. Doing a calming activity may help you to cope with these feelings when they occur. Some examples include:

Why Your Decisions Matter

In the past, doctors sometimes made decisions without talking with patients. Today, the situation is different. Your health care team wants to know your concerns and answer your questions. They also believe that you have the right to make your own decisions. Working with your health care team to make a treatment plan can help you feel more in control.

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When Chemotherapy Is Used

Chemotherapy may be used if cancer has spread or there’s a risk it will.

It can be used to:

  • try to cure the cancer completely
  • make other treatments more effective for example, it can be combined with radiotherapy or used before surgery
  • reduce the risk of the cancer coming back after radiotherapy or surgery
  • relieve symptoms if a cure is not possible

The effectiveness of chemotherapy varies significantly. Ask your doctors about the chances of treatment being successful for you.

Questions To Ask Your Doctor About Chemotherapy

Whatâs The Norm?

Patients are sometimes reluctant to ask questions, but I tell my patients that any question is an important question when it comes to their cancer care. Oncologists deal with cancer every day, but it’s all new to the patient. Getting your questions answered will help you make informed decisions about your care.

Think about your questions before your appointment. Write them down and bring them with you. I also recommend bringing a family member or friend to take notes during the appointment because its easy to get overwhelmed by information.

Here are some questions to consider asking your doctor about chemotherapy:

  • What drug or drugs are you recommending?
  • Whats the goal of this treatment?
  • How long will I be on it?
  • How do I receive it?
  • How often do I have to come in? Can someone come in with me?
  • If Im taking this drug at home, where do I store it? How often do I take it? What if I forget to take it?
  • What are the potential side effects? Are you going to give me anything ahead of time to deal with them?
  • Am I likely to have long-term side effects from this drug?
  • Who do I call if Im at home and I have a question?
  • What kind of support is there to help me through this treatment?
  • Is there any support for my caregivers?

If you think of more questions after your appointment, call back and ask them.

If you start chemotherapy and your experience is different from what you expected, talk to your care team. They may be able to make changes that help you.

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