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Medical Professionals

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Diagnosed With Breast Cancer: What’s Next?

The biopsy shows that you have breast cancer. In addition to the shock and emotional turmoil, a thousand questions go through your mind. “The surgeon said that he took everything out, so why do I need chemotherapy?” “What are my chances?” “Am I going to die from cancer?” “My friend only needed to take a pill, why am I not getting that?”

Not everyone diagnosed with breast cancer is treated the same because no two tumors are alike. Even after the lump in the breast is removed surgically, there is a risk of cancer growing back in the same breast or spreading to other organs, a process called metastasis. The risk of metastasis is based on a number of factors. Age, menopause, the stage of the cancer and characteristics of the tumor cells (grade, hormone receptors called ER and PR, and Her-2) all determine the risk of relapse or metastasis. Age: In general, young women tend to have more aggressive tumors and are more often treated with chemotherapy than older women. Stage: Breast cancer is staged from Stage 0 to Stage IV; Stage 0 is pre-cancerous and is also known as carcinoma in situ (DCIS or LCIS). Stage 0 cancer does not metastasize and does not require chemotherapy. Stage I is a small tumor (<2cm) confined to the breast; when the tumor has spread to the lymph nodes or if the tumor is >2cm it is Stage II. Stage III includes tumors that have spread to lymph nodes in the neck, have affected more than 4 lymph nodes, or have spread to the skin and chest wall. When the cancer has metastasized to other organs (commonly to the bones, lungs or liver), it is Stage IV. The higher the stage, the higher your risk is of relapsing; chemotherapy, hormonal therapy or both are recommended to reduce that risk. Tumor Characteristics: Certain features on the cancer cells can predict the aggressiveness of the cancer. Cancer cells are graded from I to III, grade I being the least aggressive and grade III being the most. The tumor cells are also tested for hormone receptors on the surface of cancer cells, called ER and PR (estrogen and progesterone). Tumor cells are also checked for a protein called Her-2. About 25-30% of all breast cancers are Her-2 positive. Her-2 positive patients are treated with drugs that target the Her-2 protein, such as Herceptin and Perjeta, in addition to chemotherapy.

Who Needs Chemotherapy? Even if the visible tumor is removed surgically, you may have cancer cells floating around in your system that can deposit in different parts of the body. This can happen a few months to several years later, producing metastasis. Research has shown that this risk can be reduced by giving chemotherapy for a few months. In addition, hormonal therapy and Herceptin are used in appropriate patients. After surgery, your surgeon will refer you to a Medical Oncologist who will then determine the kind of treatment you may need. Women who have very early stage breast cancer may not need any treatment and should be observed periodically. Most women with ER and PR positive tumors are treated with Tamoxifen (before menopause), or Arimidex (Anastrazole) or Femara (Letrozole) (after menopause). In addition, your medical oncologist may advise you to get chemotherapy based on the other factors mentioned above. The most commonly used chemotherapy drugs are Adriamycin, Cytoxan, Paclitaxel (Taxol), Docetaxel (Taxotere), and 5 Flurouracil (5 FU). The type of chemotherapy and duration used are also based on the risk of metastasis. Chemotherapy is given for approximately four to six months, starting about 3 to 4 weeks after surgery. Chemotherapy is often administered as an intravenous infusion. To minimize damage to the veins and to ensure proper administration, a device called a port-a-cath can be inserted below the collarbone. This is temporary and can be removed after treatment is completed. Side Effects Chemotherapy can cause nausea, fatigue, vomiting, hair loss, mouth sores, low blood countsand numbness in the extremities. These are all eversible and improve once treatment is discontinued. With the use of newer medications, nausea and vomiting can be prevented considerably.

Patient Testimonials “I thank God every day that Dr. Easaw became an oncology doctor and that I was lucky enough to have found her.” - Donna, Toms River. “Dr. Easaw took the time to answer every one of my questions and guided me to make the best decision for my Mom’s care.” - Melissa, Howell. “Dr. Easaw and her staff became an extension of my family and I feel so fortunate that she moved her office to Ocean County just when I needed her the most.” - Dorothy, Toms River. “I have been a patient of Dr. Easaw for seven years. She is a very thorough doctor who honestly cares about her patients. Every time I see her, she always takes the time to go over everything with me regarding my condition and she always has answers to any questions I have. I am very lucky to have her as my Oncologist” - Michael, Whiting, NJ

Medical Professionals

“ I was very emotional when I heard of my illness and if it wasn’t for Dr. Easaw and her staff, I honestly don’t know how I would have made it through my treatment. Dr. Easaw and her staff made my visits comforting and easier to deal with my sickness” - Julia, Lakewood, NJ “I feel that I am in very good hands, with Dr. Easaw and her staff. They excel in providing great patient care within a very difficult field. Much kudos and many thanks to them all!” - Anonymous

WithToBreast Cancer: learn more about treatment of

Next?

breast cancer or other cancers, contact Dr. Sarah J. Easaw at 732-961-0010.

October is Breast Cancer Awareness Month

Ocean Hematology & Oncology Center for Cancer & Blood Disorders

have breast cancer. In addition to the shock and emotional turmoil, a thousand The County Woman Magazine www.TheCountyWoman.com “The surgeon said that he took everything out, so why do I need chemotherapy?” “What from cancer?” “My friend only needed to take a pill, why am I not getting that?”

September/October 2018

Monmouth County Woman - September/October 2018  

The County Woman ™ is part of a nationally syndicated publication and has been around for over 31 years. There are over 371 other counties t...

Monmouth County Woman - September/October 2018  

The County Woman ™ is part of a nationally syndicated publication and has been around for over 31 years. There are over 371 other counties t...