Friday, February 27, 2015
FAIRFIELD-SUISUN, CALIFORNIA
99 CENTS

Breast cancer treatments continue to advance

By
From page B5 | November 09, 2013 |

Breast cancer afflicts up to 1 million people worldwide annually, including 230,000 cases in the United States.

Tragically, up to 40,000 deaths occur each year in our country due to breast cancer, which remains the number one cause of overall mortality in women between ages 40 and 49.

Film star Angelina Jolie chose to undergo prophylactic bilateral mastectomies upon learning that she was at high risk of the disease due to an inherited gene mutation called BRCA1, which is also linked to ovarian cancer.

Genetic screening tools that identify those at risk for cancer are emerging, and playing a larger role in prevention of cancer. For example, I gather that Angelina Jolie is now considering further surgery to prevent ovarian cancer also linked to the BRCA1 gene. Preventing cancer is an optimal strategy. But how about patients who are diagnosed with breast cancer? What can we offer them?

Treatment of breast cancer requires a multidisciplinary approach. A primary care physician will coordinate care with other specialists. Oncologists, radiologists and surgeons play pivotal roles. About 5 percent of patients will be diagnosed with disease that is widespread, a condition referred to as “de novo metastatic” disease.

Some patients present with localized disease, but subsequently develop recurrences that may metastasize. A large part of the initial evaluation of a cancer patient involves an effort to achieve diagnostic precision with respect to tumor size, microscopic characteristics of the tumor and more arcane characteristics, including presence or absence of estrogen or progesterone receptors.

If a cancer is staged in a manner that suggests localized disease with limited potential for spread, so-called “breast-conserving” treatments might be an option. In patients with larger tumors with more ominous pathological characteristics, mastectomy may be necessary.

Oncologists are experts at “staging” cancers and recommending the best treatments. Chemotherapy, radiation treatments, surgical reconstruction and treatment of depression may all play a role.

The American Society of Clinical Oncology recommends discussion of risks versus benefits of specific therapies. For example, chemotherapy may adversely impact fertility in patients of child-bearing age. Treatment must be tailored to achieve maximum benefits with the fewest possible side effects.

Since some tumors appear to be stimulated by hormones such as estrogen, some medications block receptors of these naturally occurring bodily compounds. Examples of estrogen-receptor modulators include tamoxifen, and newer agents called aromatase-inhibitors are broadening the therapeutic options with respect to this class of drugs. Clinical trials demonstrate decreases in cancer recurrence in selected patients treated with these medications.

Metastatic disease is more challenging to treat, although chemotherapeutic agents have been employed that may markedly improve survival. Treatment of breast cancer consists of more than just eradicating the disease. For example, we have agents that stimulate white blood cell production, red blood cell production, and we can treat complications of the disease, including infections and pain.

Palliative care remains a cornerstone of assisting patients and families struggling with this condition. There is more to practicing medicine than curing diseases, and management of breast cancer may require sensitivity to a wide array of psychosocial dynamics.

Every patient is unique. Although widespread breast cancer may decrease median survival rates to months or years in some patients, others soldier on for many years with the assistance of active treatment interventions.

We do not entirely understand the way the body’s immune system may resist recurrences of cancer. Moreover, the National Institutes of Health continues to sponsor clinical trials designed to improve treatments for cancer.

Many malignancies that were previously fatal, including a number of leukemias and lymphomas, are now curable in some cases. Therefore, I remain optimistic that we will continue to make strides in treating breast cancer.

Scott T. Anderson, M.D., Ph.D. ([email protected]) is clinical professor of medicine, UC Davis. This column is informational, and does not constitute medical advice.

Scott Anderson

LEAVE A COMMENT

Discussion | No comments

The Daily Republic does not necessarily condone the comments here, nor does it review every post. Read our full policy

  • Recent Articles

  • Enter your email address to subscribe and receive notifications of new posts by email.

  • .

    Solano News

     
    Fairfield mayor ready to share a whale of a tale

    By Amy Maginnis-Honey | From Page: B1, 2 Comments

     
    Nonagenarian recounts life as spy in World War II

    By Amy Maginnis-Honey | From Page: B1

     
     
    Republican women to hear about immigration reform

    By Amy Maginnis-Honey | From Page: A3, 1 Comment

    2-day event will focus on bullying prevention

    By Amy Maginnis-Honey | From Page: A3, 1 Comment

     
     
     
    Wolk to chair committee on state’s wine industry

    By Kevin W. Green | From Page: A4

     
    Kaiser offers Capoot scholarships

    By Bill Hicks | From Page: A4

    Fairfield police log: Feb. 25, 2015

    By Susan Hiland | From Page: A12

     
    Suisun City police log: Feb. 25, 2015

    By Susan Hiland | From Page: A12

    .

    US / World

    Llamas on the loose trends on Twitter

    By The Associated Press | From Page: A2

     
    Two inured in hazmat explosion

    By The Associated Press | From Page: A4

    No charges yet for train crash truck driver

    By The Associated Press | From Page: A4

     
    Not guilty plea for suspect in Hollywood exec murder

    By The Associated Press | From Page: A5

     
    After 67 years of marriage, couple dies holding hands

    By The Associated Press | From Page: A5

    Missing 400-year-old Italian books found in California

    By The Associated Press | From Page: A5

     
    Sacramento man pressured to remove swastikas

    By The Associated Press | From Page: A5, 3 Comments

    Feds: 3 accused in Islamic State plot vocal about beliefs

    By The Associated Press | From Page: A6

     
    Saudi man convicted of conspiracy in ’98 US embassy bombings

    By The Associated Press | From Page: A7

     
    Panel: Use new meningitis vaccines only for outbreaks

    By The Associated Press | From Page: A7

     
    House GOP weighs new approach on Homeland Security

    By The Associated Press | From Page: A7

    Vandalism in Arizona shows the Internet’s vulnerability

    By The Associated Press | From Page: A7

     
    Prosecutor: Mom craved attention, poisoned child with salt

    By The Associated Press | From Page: A7

    Ukraine, rebels start pulling back heavy weapons in the east

    By The Associated Press | From Page: A10

     
    ‘Jihadi John’ raised in UK, studied computers, reports say

    By The Associated Press | From Page: A10

    Militants abduct more Christians, smash ancient artifacts

    By The Associated Press | From Page: A10

     
    .

    Living

    Community Calendar: Feb. 27, 2015

    By Susan Hiland | From Page: A2

     
    Today in History: Feb. 27, 2015

    By The Associated Press | From Page: A2

    Horoscopes: Feb. 27, 2015

    By Holiday Mathis | From Page: A9

     
    I’m worried about how my wife’s erratic behavior is affecting our kids

    By Kathy Mitchell and Marcy Sugar | From Page: A9

    .

    Entertainment

    Week in preview Feb. 27-March 5, 2015

    By Amy Maginnis-Honey | From Page: B1

     
    Custom dress Lupita Nyong’o wore at Oscars reported stolen

    By The Associated Press | From Page: B2

    Conan O’Brien takes his show to Cuba for a special hour

    By The Associated Press | From Page: B2

     
    Review: Smith, Robbie pour on the charm in sharp ‘Focus’

    By The Associated Press | From Page: B2

    AP Exclusive: Redmayne lends voice to “Thomas & Friends”

    By The Associated Press | From Page: B3

     
    ABC’s Sawyer does prime-time prison special

    By The Associated Press | From Page: B3

    Q&A: Writer-director-actor Mark Duplass is a busy guy

    By The Associated Press | From Page: B3

     
    Actor Will Patton charged with DUI in native South Carolina

    By The Associated Press | From Page: B3

    Entertainment Calendar: Feb. 27, 2015

    By Susan Hiland | From Page: B4

     
    Tea Leoni in a happy state as star of ‘Madam Secretary’

    By The Associated Press | From Page: B5

    Graceland brings Elvis back to his Las Vegas home

    By The Associated Press | From Page: B6

     
    TVGrid

    By Daily Republic Syndicated Content | From Page: B6

    .

    Sports

    LeBron scores 42, Cavs beat Warriors for 18th win in last 20

    By The Associated Press | From Page: B7

     
     
    A’s begin baseball’s mandatory domestic violence training

    By The Associated Press | From Page: B7

    Earthquakes set to open new MLS stadium

    By The Associated Press | From Page: B7

     
    LeBron not happy colleges recruiting 10-year-old son

    By The Associated Press | From Page: B8

    IOC member, once critical of Rio, now sees ‘great progress’

    By The Associated Press | From Page: B8

     
    Judge rules for Peterson, opening door for reinstatement

    By The Associated Press | From Page: B8

    Herman survives windy day; McIlroy stumbles at Honda Classic

    By The Associated Press | From Page: B8

     
    Roberts, NBA writers open discussion over locker room access

    By The Associated Press | From Page: B8

    IOC relaxes rule on athletes and sponsors during Olympics

    By The Associated Press | From Page: B8

     
    Nevada gambling regulators sign off on Olympic betting

    By The Associated Press | From Page: B8

    Video shows Hernandez dancing near gas pump before killing

    By The Associated Press | From Page: B8

     
    Kings’ Collison to have surgery, re-evaluated in 3-6 weeks

    By The Associated Press | From Page: B8

    AP source: 49ers to bid to host college football title game

    By The Associated Press | From Page: B8

     
    Bulls say Rose to have surgery on Friday

    By The Associated Press | From Page: B8

     
    NASCAR back on track for extra day of testing in Atlanta

    By The Associated Press | From Page: B8

    No word on possible MLB discipline for Angels star Hamilton

    By The Associated Press | From Page: B8

     
    Giants closer Casilla hit on shin during batting practice

    By The Associated Press | From Page: B8

    .

    Business

    Volkswagen Jetta is a pleasure to live with, not just to gawk at

    By Washington Post | From Page: C1 | Gallery

     
    5 things to know about ‘net neutrality’

    By The Associated Press | From Page: A1

    Regulators approve tougher rules for Internet providers

    By The Associated Press | From Page: A1

     
    Strong reliability scores should help Buick brand’s rebirth

    By The Associated Press | From Page: C2

    Nissan executive known as ‘father of the Z’ dies at 105

    By The Associated Press | From Page: C2

     
    Applications for US jobless aid rise to 313,000

    By The Associated Press | From Page: B11

    Google looks for more revenue from ads in Android app store

    By The Associated Press | From Page: B11

     
    Walmart CEO wading through mounting issues

    By The Associated Press | From Page: B11

    Pew study: Americans still stressed despite improved economy

    By The Associated Press | From Page: B11

     
    Facebook allows users to ‘fill in’ gender option

    By The Associated Press | From Page: B11, 1 Comment

    Medical marijuana passes tough first hurdle in Utah

    By The Associated Press | From Page: B11

     
    .

    Obituaries

    Donald Grimm

    By Nancy Green | From Page: A4

     
    .

    Comics

    Zits

    By Daily Republic Syndicated Content | From Page: A8

     
    Blondie

    By Daily Republic Syndicated Content | From Page: A8

    Baldo

    By Daily Republic Syndicated Content | From Page: A8

     
    For Better or Worse

    By Daily Republic Syndicated Content | From Page: A8

    Sally Forth

    By Daily Republic Syndicated Content | From Page: A8

     
    Dilbert

    By Daily Republic Syndicated Content | From Page: A8

    Peanuts

    By Daily Republic Syndicated Content | From Page: A8

     
    Beetle Bailey

    By Daily Republic Syndicated Content | From Page: A8

    Pickles

    By Daily Republic Syndicated Content | From Page: A8

     
    Garfield

    By Daily Republic Syndicated Content | From Page: A8

    Frank and Ernest

    By Daily Republic Syndicated Content | From Page: A8

     
    Baby Blues

    By Daily Republic Syndicated Content | From Page: A8

    B.C.

    By Daily Republic Syndicated Content | From Page: A8

     
    Get Fuzzy

    By Daily Republic Syndicated Content | From Page: A8

    Rose is Rose

    By Daily Republic Syndicated Content | From Page: A8

     
    Wizard of Id

    By Daily Republic Syndicated Content | From Page: A8

    Cryptoquote

    By Daily Republic Syndicated Content | From Page: A9

     
    Bridge

    By Daily Republic Syndicated Content | From Page: A9

    Word Sleuth

    By Daily Republic Syndicated Content | From Page: A9

     
    Sudoku

    By Daily Republic Syndicated Content | From Page: A9

    Crossword

    By Daily Republic Syndicated Content | From Page: A9