Will The Nhs Fund An Unlicensed Medicine
It’s possible for your doctor to prescribe a medicine outside the uses it’s licensed for if they’re willing to take personal responsibility for this ‘off-licence’ use of treatment.
Your local integrated care board may need to be involved, as it would have to decide whether to support your doctor’s decision and pay for the medicine from NHS budgets.
Page last reviewed: 28 October 2019 Next review due: 28 October 2022
Feeling Unwell Or Tired
Many women do not feel as healthy after chemo as they did before. There is often a residual feeling of body pain or achiness and a mild loss of physical functioning. These changes may be very subtle and happen slowly over time.
Fatigue is another common problem for women who have received chemo. This may last a few months up to several years. It can often be helped, so its important to let your doctor or nurse know about it. Exercise, naps, and conserving energy may be recommended. If you have sleep problems, they can be treated. Sometimes fatigue can be a sign of depression, which may be helped by counseling and/or medicines.
Many Women With Breast Cancer Don’t Need Chemotherapy
Up to 70 percent of women with a certain type of breast cancer may not need chemotherapy, a new study finds.
Avoiding chemotherapy may come as a relief to many women who are diagnosed with breast cancer, as the treatment comes with a number of side effects, including nausea, hair loss and anemia.
The study, published yesterday in The New England Journal of Medicine, included more than 10,000 women with the same type of breast cancer: early-stage, hormone-receptor-positive, human epidermal growth factor receptor 2 -negative breast cancer. This type of breast cancer is the most common type, according to the researchers.
All of the women in the study, called the Trial Assigning Individualized Options for Treatment , or TAILORx, had their breast tumors analyzed with a molecular test. The test looks at 21 genes and then spits out a score, from zero to 100, that predicts the risk that the breast cancer will return after surgery.
The researchers were specifically interested in women who scored 10 to 25 on the test scores that fall in the range of a medium risk of the cancer returning after surgery. Women with low risk scores those below 10 don’t need chemotherapy after surgery, and instead can be treated with hormone therapy, previous studies have found. Similarly, women with high risk scores above 25 should receive chemotherapy in addition to hormone therapy.
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Stat+: Exclusive Analysis Of Biopharma Health Policy And The Life Sciences
One reason to question the findings, however, is that if pre-op chemo promotes metastasis in some patients, that might be expected to have shown up in studies of the therapy. Overall, in fact, those studies show that neoadjuvant chemotherapy does not seem to improve overall survival, as the authors of an editorial in the Journal of Clinical Oncology wrote.
Thats not as bad as decreasing survival, of course. But Einsteins Dr. Maja Oktay, a co-author of the new research, cautioned that the typical length of the studies six or so years is too short to assess the risk of metastasis, which can take more than 20 years to appear, she said. Such patients might never be flagged as having metastatic cancer, let alone having it linked to pre-op chemo decades earlier, said Aguirre-Ghiso.
On a brighter note, not all breast cancer patients have the kind of tumor microenvironment in which pre-op chemo can promote metastasis. Whether they do or not can be determined by a simple lab test, but one that is not routinely done, Condeelis said.
Serendipitously, an experimental compound called rebastinib, being developed by Deciphera Pharmaceuticals, seems to be able to block the on-ramp to the metastasis highway. In a study currently recruiting patient volunteers, the Einstein scientists are studying whether rebastinib can improve outcomes in metastatic breast cancer.
Is Immunotherapy Fda Approved
Researchers continue to look into the potential of immunotherapy, but several effective , FDA-approved drugs are now commonly used to treat certain cancers. Immunotherapy has definitely opened up more options for a lot of patients, and it is now the frontline treatment for certain patients, Batus says.
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Can Breast Cancer Develop In 6 Months
Breast cancer has to divide 30 times before it can be felt. Up to the 28th cell division, neither you nor your doctor can detect it by hand. With most breast cancers, each division takes one to two months, so by the time you can feel a cancerous lump, the cancer has been in your body for two to five years.
Is Chemo The First Course Of Treatment
But chemo is not always the first course of treatment. These days, a cancer diagnosis doesnt have to mean chemo and the nausea, vomiting and hair loss most people think of, says Susan Budds, NP, a nurse practitioner who specializes in cancer at Rush. In fact, sometimes chemo takes a back seat to other treatments that may have milder side
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What Is The Alternative To Chemo Therapy
TLDR: Chemotherapy is a very abrasive and tiring treatment option for cancer which is why many people choose alternative options. There are plenty of clinically proven alternatives to chemotherapy including immunotherapy and targeted medicines just to name a few. Choosing the right chemotherapy alternative will depend on the specific type of cancer you have.
The diagnosis of cancer is not easy for anyone to handle, and often, dealing with the treatment can be even more tiresome than the disease itself. When it comes to the treatment options available for cancer, chemotherapy is the most prominent as its widely used and recommended by doctors all across the world.
Chemotherapy is administered by way of an anti-cancer medication cocktail that is designed to either reduce symptoms, cure the disease, or prolong the life of the patient. The Chemotherapy process utilizes these various cancer-fighting drugs to inhibit the growth of new cancer cells directly.
However, chemotherapy is also known for killing healthy cells, which can lead to a wide range of adverse side effects. Thanks to advancements in technology and science, there are alternative options for chemotherapy available.
What is the best alternative to chemotherapy?
Here are some of the most common alternative treatments to chemotherapy:
What Is The Survival Rate Of Breast Cancer Patients Without Chemotherapy
Among those who did not have chemotherapy, the five-year survival rate without distant metastasis was 94 percent. For those who did have chemotherapy, the rate was 1.5 percent higher. Study authors concluded that about 46 percent of women with breast cancer who are at high clinical risk of recurrence may not need chemotherapy.
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Menstrual Changes And Fertility Issues
For younger women, changes in menstrual periods are a common side effect of chemo. Premature menopause and infertility may occur and could be permanent. If this happens, there is an increased risk of heart disease, bone loss, and osteoporosis. There are medicines that can treat or help prevent bone loss.
Even if your periods stop while you are on chemo, you may still be able to get pregnant. Getting pregnant while on chemo could lead to birth defects and interfere with treatment. If you have not gone through menopause before treatment and are sexually active, its important to discuss using birth control with your doctor. It is not a good idea for women with hormone receptor-positive breast cancer to take hormonal birth control , so its important to talk with both your oncologist and your gynecologist about what options would be best for you. When women have finished treatment , they can safely go on to have children, but it’s not safe to get pregnant while being treated.
If you think you might want to have children after being treated for breast cancer, talk with your doctor soon after being diagnosed and before you start treatment. For some women, adding medicines, like monthly injections with a luteinizing hormone-releasing hormone analog, along with chemo, can help them have a successful pregnancy after cancer treatment. To learn more, see Female Fertility and Cancer.
Chemotherapy Can Cause Side Effects
Chemotherapy not only kills fast-growing cancer cells, but also kills or slows the growth of healthy cells that grow and divide quickly. Examples are cells that line your mouth and intestines and those that cause your hair to grow. Damage to healthy cells may cause side effects, such as mouth sores, nausea, and hair loss. Side effects often get better or go away after you have finished chemotherapy.
The most common side effect is fatigue, which is feeling exhausted and worn out. You can prepare for fatigue by
- asking someone to drive you to and from chemotherapy
- planning time to rest on the day of and day after chemotherapy
- asking for help with meals and childcare on the day of and at least one day after chemotherapy
There are many ways you can help manage chemotherapy side effects. For more information, see the section on side effects.
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The Benefits Of Chemotherapy
Chemotherapy is a group of medications that can kill cancer cells and is recommended for several types of cancer. It is very effective, and may be used on its own or combined with other treatments. For example, your oncologist may recommend a round of chemotherapy to shrink your tumor before surgery.
Cancer cells tend to multiply quickly and replicate much faster than healthy cells. For this reason, chemotherapy targets fast-growing cells. The main drawback to chemotherapy is that it cannot differentiate cancer cells from healthy cells. Therefore, normal cells are also destroyed in the process. This is why chemotherapy has so many possible side effects.
When developing your treatment plan, your oncologist aims to find the dose of chemotherapy that kills cancer cells while trying to spare as many healthy cells as possible. Fortunately, normal cells are able to recover from chemotherapy, but it may take time. Cancer cells, on the other hand, are not able to recover from chemotherapy.
What Does Triple Negative Mean In Terms Of Breast Cancer
Normal breast cells have receptors that respond to hormones such as estrogen and progesterone, which allows them to grow and regress in response to the hormone level. Hormone receptors may or may not be present in breast cancer. About two-thirds of breast cancers are positive and contain these receptors like normal breast cells do. These are less aggressive cancers that are less likely to need chemo and are often treated with hormone therapy and surgery. Radiation may or may not be needed.
HER2/neu , is a protein molecule that has a role in cell proliferation in normal cells. In some breast cancers, this protein is overly produced or positive. For HER2-positive tumors, there a specific medication that targets this protein.
Triple-negative breast cancers are not positive for estrogen receptors, progesterone receptors or HER2 protein. Since these targets are absent in triple-negative breast cancer, chemotherapy is needed, Sun says. Triple-negative breast cancer is often very sensitive to chemotherapy, which, despite the side effects, is an effective treatment that can save lives. Because this is an aggressive cancer, treatment is aggressive also. But there are several ways we can address it.
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Will I Need Chemotherapy
Not everyone with early breast cancer will be recommended chemotherapy. Whether or not it is recommended for you will depend on your individual situation. Factors the doctors consider include the pathology of your breast cancer the risk of the cancer coming back or spreading to other parts of the body your general health and your preferences. Your medical oncologist will discuss whether chemotherapy is the right treatment for you and which combinations of medications are most appropriate.
Some aspects of your type of breast cancer can influence whether chemotherapy is recommended for you. Your surgeon or medical oncologist may talk to you about genomic tests. Genomic tests can help predict the likelihood of an individual cancer recurring and can provide information to help you decide whether you may benefit from chemotherapy or some other breast cancer treatments.
Your doctor may talk to you about genomic tests currently available, including:
Why Chemotherapy Might Not Be Suitable For You
Some cancers are very sensitive to chemotherapy. So it can work very well for them.
But some types of cancer don’t tend to respond well to chemotherapy. In that case, your doctor isn’t likely to suggest it as a treatment for you.
Chemotherapy can be a difficult treatment to have, and you need to be well enough to have it. Some people worry they may be too old to have chemotherapy.
No one is automatically too old. But older people may have other health issues that make them more likely to get severe or long term side effects.
Some treatments can put a strain on organs such as the heart. Doctors make sure you are fit enough by checking your heart, lungs, kidneys and liver before starting treatment.
They look at the benefits and risks of any treatment when deciding your treatment plan, and will discuss this with you.
Cancer and its Management
J Tobias and D Hochhauser
Wiley Blackwell, 2015
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Do Oncologists Lie About Prognosis
Oncologists often do not give honest prognostic and treatment-effect information to patients with advanced disease, trying not to take away hope. The authors, however, find that hope is maintained when patients with advanced cancer are given truthful prognostic and treatment information, even when the news is bad.
New Developments In Cancer Research
Progress in the field.In recent years, advancements in research have changed the way cancer is treated. Here are some recent updates:
Uterine cancer.Women who use chemical hair straighteners frequently could have a higher risk of developing uterine cancer than women who have never used the products, according to new findings from a national study that has followed nearly 34,000 U.S. women for more than a decade.
Breast cancer.A new study suggests surgery may not always be necessary for all breast cancer patients. A small early-stage clinical trial found that a carefully selected group of patients who responded remarkably well to chemotherapy could skip surgery altogether.
Cancer vaccines.For a long time, the promise of cancer vaccines that would protect healthy people at high risk of cancer has only dangled in front of researchers. Now, though, encouraging animal data and preliminary studies in human patients are making some doctors feel optimistic.
Rectal cancer.A small trial that saw 18 rectal cancer patients taking the same drug, dostarlimab, appears to have produced an astonishing result: The cancer vanished in every single participant. Experts believe that this study is the first in history to have achieved such results.
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.
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What Types Of Breast Cancer Should Be Treated With Chemotherapy
Almost all women with HER2-positive cancers still need some amount of chemotherapy. And women with triple-negative tumors still need a relatively intensive course of chemotherapy, Dr. Lustberg says.
Chemotherapy may also be used to treat certain larger HR-positive cancers that have spread to lymph nodes, even if the tumor is estrogen-positive. “Specialized testing can determine which of these breast cancers will benefit from chemotherapy,” Dr. Lustberg says. Because of the personalized therapy made possible by these predictive biomarkers, the use of chemotherapy in lymph node-negative and lymph node-positive HR-positive cancers has decreased in recent years, with excellent clinical outcomes.
Things You Didn’t Know About Chemotherapy
If your doctor says you need chemotherapy, your thoughts may turn to outdated notions of what’s involved. Like a lot of folks, you may picture days on end in the hospital, hooked up to an IV drip. The truth is there are lots of ways to get chemo, including pills and even skin creams. And the side effects aren’t the same for everyone.
Learn these surprising chemo facts, and you’ll be better prepared for what’s ahead.
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Ovarian Ablation Or Suppression
In women who have not yet experienced the menopause, oestrogen is produced by the ovaries.
Ovarian ablation or suppression stops the ovaries working and producing oestrogen.
Ablation can be done using surgery or radiotherapy. It permanently stops the ovaries from working and means you’ll experience the menopause early.
Ovarian suppression involves using a medicine called goserelin, which is a luteinising hormone-releasing hormone agonist .
Your periods will stop while you’re taking it, although they should start again once your treatment is complete.
If you’re approaching the menopause , your periods may not start again after you stop taking goserelin.
Goserelin comes as an injection you have once a month.
An Integrative Approach To Fighting Cancer
Kerry Witzeman was just 53 years old when her doctor informed her that she had bladder cancer. After removing a tumor the size of a golf ball from her bladder, her urologist delivered the shocking news that she would need to have her bladder removed and continue with a standard cancer treatment. Not wanting to undergo surgery or chemotherapy, Kerry and her husband researched naturopathic cancer care. What they discovered could benefit all people whose doctors have told them that invasive surgery and chemotherapy that will make them weak and sick is their only hope.
The problem with chemotherapy is that it destroys the immune system, leaving it weak and vulnerable to future attacks. It may hold off the progression of cancer for a short time. However, this is little comfort considering that many cancers return more aggressively after a period of remission. Immune modulation kills cancer cells while simultaneously helping to strengthen the patients immune system. It is the first step in an integrative approach to overcoming cancer for good.
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