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Combination Therapy for Breast Cancer

Research has shown that long term survival rates are increased with combination therapy when compared to any one treatment modality alone.

Treatment Modalities

The following are types of treatment modalities that can be used alone or in combination with each other as well as with surgery:

  • Systemic – these are drugs that are typically given IV so that they travel throughout the entire body, killing any cancer cells that may have broken away from the initial cancer.
  • Targeted – these are drugs that are designed to target one particular protein or component in a signaling pathway associated with cell division and tumor growth
  • Alternative – this describes a variety of methods aimed at reducing your risk for developing breast cancer as well as treating symptoms that are a result of breast cancer. These include changes in diet or lifestyle choices, traditional Chinese medicine, yoga and nutraceuticals (natural substances such as green tea, vitamin D).[1]

Timing

The timing of each treatment modality can vary but it is generally accepted that you begin chemo shortly after surgery. It may even be as little as a month after surgery, as chemotherapy immediately following surgery provides the best prognosis.[2] An alternative approach is called neoadjuvant chemotherapy, where chemotherapy is given prior to the surgery in order to shrink a tumor or treat metastatic cancer before removing the tumor. However, most breast cancer treatment modalities follow surgery.

What Does Research Show?

Research indicates that combination therapy is very effective, both at treating cancer and preventing recurrence. When trastuzumab (Herceptin, an immunotherapy drug) is combined with the chemotherapy and antimicrobial agent, paclitaxel, after doxirubucin and cyclophosphamide chemotherapy, studies showed increased survival for HER2 positive breast cancer patients.[3]

Research also shows that SERMs and aromatase inhibitors are effective alone after surgery, at preventing breast cancer recurrence. Furthermore, these drugs work well conjunction with other forms of hormonal therapy.[4] For example, aromatase inhibitors can be given after treatment with SERMs, and doing so dramatically decreases the risk of breast cancer recurrence.

Conclusion

With the many advances in breast cancer research, several treatment options have been found. The ability to fight breast cancer at every level of its development has reduced the number of patients that die from this cancer over the last several years. To determine what treatment options are available to you, both to treat your cancer and prevent its recurrence, talk to your health care team, family and loved ones and decide what is best for you.

References

1 Block, K (2009) Life Over Cancer. New York: Bantam Books.

2 Ricks, D (2005). Breast Cancer Basics and Beyond. Alameda, CA: Hunter House, Inc.

3 Romond, EH; Perez, EA; Bryant, J; Suman, VJ: Geyer, Jr., CE; Davidson, NE; Tan-Chiu, E; Martino, SM; Paik, SP; Kaufman, PA; Swain, SM; Pisansky, TM; Fehrenbacher, L; Kutteh, LA; Vogel, VG; Visscher, DW; Yothers, G; JenkinsRB; Brown, A0. Trastuzumab Plus Adjuvant Chemotherapy for Operable HER2-Positive Breast Cancer. N England Journal of Medicine, 353:1673–1684.

4 Winer, EP; Hudis, C; Burstein, HJ; Wolff, AC; Pritchard, KI; Ingle, JN; Chlebowski, RT; Gelber, R; Edge, SB; Gralow, J; Cobleigh, MA; Mamounas, EP; Goldstein, LJ; Whelan, TJ; Powles, TJ; Bryant, J; Perkins, C; Perotti, J; Braun, S; Langer, AS; Browman, GP; Somerfield, MR (2005). American Society of Clinical Oncology Technology Assessment on the Use of Aromatase Inhibitors as Adjuvant Therapy for Postmenopausal Women with Hormone Receptor–Positive Breast Cancer: Status Report 2004. Journal of Clinical Oncology, 23(3):619-629

This article was originally published on July 27,2012 and last revision and update of it was 9/2/2015.