Home' Trinidad and Tobago Guardian : December 16th 2013 Contents Scotland led a study of 1,326 patients 65 or
older with early-stage cancers whose growth
was driven by hormones.
This is the most common form of the
disease and the age group that accounts for
most cases. Half were given radiation and
half skipped it.
After five years, roughly 96 per cent of
both groups were alive, and most deaths
were not from breast cancer. About 1 per
cent of those given radiation had cancer
recur in the treated breast versus 4 per cent
of those who skipped radiation.
Doctors are unsure how to treat women
with small tumours involving the gene
that the drug Herceptin targets.
Those tumours are low risk because
they're still confined to the breast, but
high risk because the gene is thought to
make them more aggressive.
Some women get heavy-duty chemo,
including drugs that can damage the heart.
Dr Eric Winer of the Dana-Farber Can-
cer Institute in Boston led a study of 406
women given "light chemo" --- paclitaxel
plus Herceptin for 12 weeks, followed by
nine months of Herceptin alone.
More than three years later, only four
had cancer recur in the same breast, and
two had recurrences in other places.
"This is likely to become a new stan-
dard," Winer said.
The cancer conference is sponsored by
the American Association for Cancer
Research, Baylor and the UT Health Science
Tens of thousands of women each year might be
able to skip at least some of the gruelling treatments
for breast cancer---which can include surgery, heavy
chemo and radiation---without greatly harming their
odds of survival, new research suggests.
The research is aimed at curbing overtreatment,
a big problem in cancer care. Treatments help many
women beat the disease, but giving too many or ones
that aren't really needed causes unnecessary expense,
trauma and lifelong side effects, such as arm swelling
and heart troubles. Radiation can even raise the risk
of new cancers.
Several studies presented last Wednesday at the
San Antonio Breast Cancer Symposium, an interna-
tional conference on the disease, identify groups of
patients who might be able to safely forgo certain
treatments. One found that many older women can
skip radiation after surgery for early-stage tumours.
Two others suggest that surgery may not help patients
whose cancer has already spread widely. A fourth
study tested a "light chemo" combination that could
become a new standard of care.
The trend is "less and less therapy" for certain
cancer types, said one conference leader, Dr C Kent
Osborne of Baylor College of Medicine.
Breast cancer is already widely spread in 5 to 20
per cent of newly diagnosed patients, and at that
point is usually incurable. The main treatment is
chemotherapy or hormone treatments that attack
cancer throughout the body. Sometimes doctors also
remove the breast tumour in hope of prolonging sur-
vival, but this has not been put to a hard test.
Dr Rajendra Badwe, director of the Tata Memorial
Hospital in Mumbai, India, led a study of 350 women
with widely spread cancers that had shrunk after
initial chemotherapy. Half were given surgery to
remove the breast or the lump plus any cancerous
lymph nodes. The rest did not have surgery.
After about two years, 40 per cent of both groups
were alive, suggesting that medicines are enough and
that these women can be spared the ordeal of having
all or part of a breast removed.
A second study by Dr Atilla Soran of the University
of Pittsburgh Medical Center of nearly 300 women
in Turkey also suggests surgery is not helping, though
there were hints that some groups did better or worse.
Surgery seemed to help if cancer had spread just to
bone, and it appeared to do harm if it had spread
to the liver or lungs. The results also may spur interest
in a US study on the topic. Dr Seema Khan of North-
western University in Chicago has had so much
trouble recruiting participants that she lowered her
goal and may not be able to answer the question.
Most breast cancers are found at an early stage,
and many women are treated with surgery followed
by hormones or chemotherapy, plus radiation. But
cancer medicines have gotten so good at lowering
the risk of a recurrence that doctors wonder whether
the radiation is still needed. It can cause heart and
other problems, especially in older women, and three
or four weeks of daily treatments can be a burden.
Dr Ian Kunkler of the University of Edinburgh in
The trend is "less
and less therapy"
for certain cancer
types, said one
Dr C Kent Osborne
of Baylor College
body & soul
Guardian www.guardian.co.tt Monday, December 16, 2013
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