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Three Week Radiation Therapy as Effective as Five Weeks for Early-stage Breast Cancer E-mail
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Early-stage breast cancer patients who receive a more intensive course of radiation to their whole breast over three weeks is as effective as the standard, less intensive five-week whole breast radiation and offers patients more convenience at a lower cost, thereby providing a better quality of life, according to a randomized, long-term study presented September 22, 2008, in the plenary session at the American Society for Therapeutic Radiology and Oncology's 50th Annual Meeting in Boston.

The cost of this shorter treatment, called accelerated hypofractionated whole breast irradiation, is two-thirds of the cost of the standard whole breast radiation. It is also less expensive then other new approaches such as partial breast irradiation.

"There has been renewed interest in hypofractioned whole breast irradiation, due to the potential radiation advantages, patient convenience, quality of life and lower costs. However, long-term effects were a potential concern," Timothy Whelan, M.D., lead author of the study and a radiation oncologist at the Juravinski Cancer Centre at McMaster University in Hamilton, Ontario, Canada, said. "We were surprised that the risk of local recurrence and side effects for women treated with accelerated whole breast irradiation was so low even at 12 years. Our study shows that this treatment should be offered to select women treated with early-stage breast cancer."

Many women with early-stage breast cancer are able to undergo breast conserving therapy to keep their breast after treatment. Typically, this means they first have surgery to remove the cancer (called a lumpectomy) followed by a course of radiation therapy to kill any cancer cells that may remain. The standard whole breast radiation therapy treatment takes approximately 15 minutes every day, Monday through Friday, for five weeks.

Between April 1993 and September 1996, researchers randomly assigned 1,234 women to be treated with either accelerated whole breast irradiation or standard whole breast irradiation. These women were followed for 12 years to determine if accelerated whole breast radiation was as effective as the standard breast cancer treatment. At 10 years after treatment, breast cancer returned locally in 6.2 percent of breast cancer patients treated with the accelerated radiation therapy, compared to 6.7 percent for those patients treated with standard therapy. Both groups of patients also had a good or excellent cosmetic outcome from the radiation treatments.

"This shorter treatment may not be for everyone, however, I would encourage women whose breast cancer is caught early to talk to their oncologist to see if they are a good candidate for this shorter therapy," Dr. Whelan added.

For more information on radiation therapy for breast cancer, visit http://newswise.com/articles/view/544332/www.rtanswers.org.

About Cancer

Cancer (medical term: malignant neoplasm) is the general name for a group of more than 100 diseases in which a group of cells display uncontrolled growth (division beyond the normal limits), invasion (intrusion on and destruction of adjacent tissues), and sometimes metastasis (spread to other locations in the body via lymph or blood). These three malignant properties of cancers differentiate them from benign tumors, which are self-limited, do not invade or metastasize. Most cancers form a tumor but some, like leukemia, do not. The branch of medicine concerned with the study, diagnosis, treatment, and prevention of cancer is oncology.

Cancer cells can spread to other parts of the body through the blood and lymph systems. Most cancers are named for the organ or type of cell in which they start - for example, cancer that begins in the colon is called colon cancer; cancer that begins in basal cells of the skin is called basal cell carcinoma.

Cancer types can be grouped into broader categories. The main categories of cancer include:
  • Carcinoma - a cancer which is derived from the lining cells, or epithelium, of an organ. There are 4 major types of epithelium in the body (Glandular, squamous, transitional, and pseudostratified). Some types are only found in a few select organs such as the lung (pseudostratified) or urinary bladder (transitional). Carcinomas can arise from any of these epithelial types. For example, breast carcinoma is most commonly derived from the lining cells of the milk producing glands. A carcinoma with a glandular growth pattern is an adenocarcinoma. Common adenocarcinomas include prostate, colon, and breast. A carcinoma with a growth pattern resembling the squamous lining cells is termed a squamous cell carcinoma. Common squamous cell carcinomas are found in the esophagus and skin. However, any of these organs may have either type of carcinoma arising from it, although these latter diagnoses are exceedingly rare.
  • Central nervous system cancers - cancers that begin in the tissues of the brain and spinal cord.
  • Leukemia - cancer that starts in blood-forming tissue such as the bone marrow and causes large numbers of abnormal blood cells to be produced and enter the blood.
  • Lymphoma - a cancer derived from the white blood cells that are present in the lymphoid tissues of the body. These sites most commonly include the lymph nodes and spleen. However, lymphomas may arise from any organ and body site.
  • Sarcoma - cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue.

Today, millions of people are living with cancer or have had cancer. The risk of developing most types of cancer can be reduced by changes in a person's lifestyle, for example, by quitting smoking, limiting time in the sun, being physically active, and eating a better diet. Half of all men and one-third of all women in the US will develop cancer during their lifetimes. 

Although doctors often cannot explain why one person develops cancer and another does not, research shows that certain risk factors increase the chance that a person will develop cancer. Nearly all cancers are caused by abnormalities in the genetic material of the transformed cells. These abnormalities may be due to the effects of carcinogens, such as tobacco smoke, radiation, chemicals, or viruses, bacteria, and certain hormones. Other cancer-promoting genetic abnormalities may be randomly acquired through errors in DNA replication, or are inherited, and thus present in all cells from birth. Other common risk factors for cancer include:
  • Growing Older
  • Family history of cancer
  • Poor diet, lack of physical activity, or being overweight
  • Alcohol

About Breast Cancer

Breast cancer is a malignant (cancerous) tumor that starts from cells of the breast. The disease occurs mostly in women, but men can get breast cancer too. In the U.S., it affects one in eight women. There are many types of breast cancer, though some of them are very rare. Sometimes a breast tumor can be a combination of these types and to have a mixture of invasive and in situ cancer.  The most common types of breast cancer are:
  • Ductal carcinoma in situ (DCIS): This is the most common type of non-invasive breast cancer (85 - 90% of all cases). DCIS means that the cancer is only in the ducts. It has not spread through the walls of the ducts into the tissue of the breast. Nearly all women with cancer at this stage can be cured. Often the best way to find DCIS early is with a mammogram.
  • Lobular carcinoma in situ (LCIS): This condition which occurs in approximately 8% of all cases, begins in the milk-making glands but does not go through the wall of the lobules. Although not a true cancer, having LCIS increases a woman's risk of getting cancer later. For this reason, it's important that women with LCIS to follow the screening guidelines for breast cancer.
Less common are: 
  • Inflammatory breast cancer (IBC): This uncommon type of invasive breast cancer accounts for about 1% to 3% of all breast cancers. Usually there is no single lump or tumor. Instead, inflammatory breast cancer (IBC) makes the skin of the breast look red and feel warm. It also gives the skin a thick, pitted appearance that looks a lot like an orange peel. Doctors now know that these changes are not caused by inflammation or infection, but by cancer cells blocking lymph vessels in the skin. The breast may become larger, firmer, tender, or itchy. IBC is often mistaken for an infection in its early stages. Because there is no defined lump, it may not appear on a mammogram, which may make it even harder to catch it early. It usually has a higher chance of spreading and a worse outlook than invasive ductal or lobular cancer.
  • Paget's disease of the nipple. Paget's disease of the nipple or breast is a rare type of breast cancer, which can occur in women and men. It shows up in and around the nipple, and usually signals the presence of breast cancer beneath the skin. Most cases are found in menopausal women, but can also appear in women that are as young as 20.  Early stages symptoms include redness, scaly and flaky, and  mild irritation of  nipple skin. Advanced stages may include: tingling in nipple skin, very sensitive skin on the nipple, burning or painful nipple skin, ooze or bloody discharge from the nipple (not milk), itchiness that doesn't respond to creams, nipple retraction (pulls into the breast), scaly rash on areola skin, and/or breast lump beneath the affected skin.
There are also many other less common types of breast cancer, such as:
  • a lump or a thickening in the breast or in the armpit. Note Most breast lumps are benign (be-nine); that is, they are not cancer. Benign breast tumors are abnormal growths, but they do not spread outside of the breast and they are not life threatening. But some benign breast lumps can increase a woman's risk of getting breast cancer. Most lumps turn out to be caused by fibrocystic (fi-bro-sis-tik) changes. Cysts are fluid-filled sacs. Fibrosis is the formation of scar-like tissue. Such changes can cause breast swelling and pain. The breasts may feel lumpy, and sometimes there is a clear or slightly cloudy nipple discharge.
  • a change of size or shape of the mature breast
  • fluid (not milk) leaking from the nipple
  • a change of size or shape of the nipple
  • a change of color or texture of the nipple or the areola, or of the skin of the breast itself (dimples, puckers, rash)
  • a discharge from the breast

 

 

 
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