I think the different chemo treatments for breast cancer confuse people. I recently was contributing to a thread in one of my support groups, and thought I would help everyone out by posting a really quick summary of the most common chemos for BC.
Here is how the drugs break down:
Antimetabolites interfere with DNA and RNA growth by substituting for the normal building blocks of RNA and DNA.
eg. 5-fluorouracil (5-FU)
Anthracyclines are anti-tumor antibiotics that interfere with enzymes involved in DNA replication.
eg. doxorubicin (Adriamycin®), epirubicin
Alkylating agents directly damage DNA to prevent the cancer cell from reproducing.
eg. cyclophosphamide
Mitotic inhibitors stop mitosis (cell division) or inhibit enzymes from making proteins needed for cell reproduction.
eg. paclitaxel (Taxol®) and docetaxel (Taxotere®)
So, they basically try to attack the cancer cells during different phases of the cell reproductive cycle, and using different mechanisms. This way if one isn’t overly effective, the other will take up the slack. If they mix drugs, they can also minimize side effects, because they can use smaller amounts of each drug. If they used only anthracyclines, for example, they would damage your heart. If they used only Taxol, they would fry all of your nerves. This way, you have some minor effects of each, but not enough to cause catastrophic damage.
The best way to picture it is as a classic battle. First they send in air support to do some carpet bombing, then they send in the infantry and cavalry on the ground. Once they’ve cleared out the majority of the cancer, they send in the snipers to finish off any stragglers. I know that’s violent, but it’s the closest analogy I can think of
I think doctors are like generals - they tend to all have the same weapons in their arsenal, but each one likes to come up with their own battle plan. To be honest, I think number of treatments are fairly directly related to the stage and grade of the disease (more treatments for more aggressive cancers) but the order of the drugs doesn’t really matter. You can send in the carpet bombers at the beginning or at the end - either way, the cancer cells get blown up!
Researchers have reduced breast cancer metastasis to bone using an experimental agent to inhibit ROCK, a protein that was found to be over-expressed in metastatic breast cancer. In a study in mice, the team of researchers from Tufts University School of Medicine, the Sackler School of Graduate Biomedical Sciences at Tufts, and Tufts Medical Center report that inhibiting ROCK, or Rho-associated kinase, in the earliest stages of breast cancer decreased metastatic tumor mass in bone by 77 percent and overall frequency of metastasis by 36 percent. The results suggest that ROCK may be a target for new drug therapies to reduce breast cancer metastasis.
The last couple of days have been gloomy here in Edmonton, with colder weather rolling in and wintery grey skies hovering low overhead. It’s already getting dark by supper time, which makes me just want to curl up in bed. Evie doesn’t feel the same way though (nor does my boss), so I’m still getting up in the early morning dark to start my days. Even the vitamin D doesn’t seem to be helping.
It’s days like these when I find it hard to stay positive. My mind wanders to scary places, worrying about things I can’t control. So - how to cheer up?
Stupid horror movies from the 80s - campy, cheesy and hilarious (what would have given me nightmares before my little cancer adventure now cracks me up)
I’m part of a cancer discussion board on Ravelry, and some of the other members are second-time cancer fighters because of earlier radiation treatments. Here’s hoping the latest radiation findings can keep that from happening in the future…
Researchers at the University of Pittsburgh School of Medicine and the National Cancer Institute (NCI), part of the National Institutes of Health, may be hot on the heels of a Holy Grail of cancer therapy: They have found a way to not only protect healthy tissue from the toxic effects of radiation treatment, but also increase tumor death. The findings appear today in Science Translational Medicine.
ScienceDaily (2008-12-31) – Women who have a high level of insulin have a higher risk of developing breast cancer than women who have a lower level of the hormone.
This supports the diet that I was talking about last week. Sadly, this means fewer treats for me, but maybe it’s a drug-free way to slow down or prevent recurrence. I guess I can manage with fewer brownies.
ScienceDaily (2009-08-17) — Researchers have discovered a chemical that works in mice to kill the rare, aggressive cells within breast cancers that can seed new tumors. These cells, known as cancer stem cells, are thought to enable cancers to spread — and to reemerge after seemingly successful treatment. Although work is needed to determine whether this chemical holds promise for humans, the study shows that it is possible to find chemicals that selectively kill cancer stem cells.
After doing extensive research into gluten- and dairy-free, low-sugar diets for my husband, who suffers from multiple sclerosis, I stumbled across the following research. I was planning on following the diet anyway, in solidarity and just for general health reasons, but this study suggests that there may be direct benefits to preventing recurrence.
Reuters Health Friday, July 10, 2009
NEW YORK (Reuters Health) - The amount of carbohydrates a woman eats, as well as the overall “glycemic load” of her diet, impact her chances of developing breast cancer, Swedish researchers report.
The concept of glycemic load is based on the fact that different carbohydrates have different effects on blood sugar. White bread and potatoes, for example, have a high glycemic index, which means they tend to cause a rapid surge in blood sugar. Other carbs, such as high-fiber cereals or beans, create a more gradual change and are considered to have a low glycemic index.
Dr. Susanna C. Larsson of Karolinska Institute in Stockholm and colleagues analyzed data on 61,433 women who completed “food frequency” questionnaires in the late 1980s.
Over the course of about 17 years, 2952 women developed breast cancer and, according to the investigators, glycemic load “was significantly positively associated with risk of overall breast cancer.” Women with higher glycemic load diets were more apt to develop breast cancer.
In addition, carbohydrate intake, glycemic index and glycemic load were all positively associated with risk of a certain type of breast tumor - namely, estrogen receptor (ER)-positive/progesterone receptor (PR)-negative breast cancer.
Women with the highest “glycemic index diet” had a 44% increased risk of developing ER+/PR- breast cancer compared to women with the lowest glycemic index diet.
Women in the highest category of “glycemic load” had an 81% increased risk of ER+/PR- tumors, and those with the highest carbohydrate intake had a 34% increased risk, compared to those in the lowest groups.
The investigators speculate that high-glycemic load diets may boost breast cancer risk by increasing concentrations of insulin and sex hormones in the body, which may contribute to the development and spread of breast cancer cells.
The findings support the benefits on breast health of a diet high in healthy “low glycemic index” foods.
SOURCE: International Journal of Cancer, July 2009.
“Fewer women in the United States are dying from breast cancer, but disparities in death rates still exist between whites and blacks, a new report shows.
Deaths from breast cancer have dropped more than 2 percent each year since 1990. And in the past decade that decline in deaths has been shared by black, Hispanic and white women. But black women still have a 40 percent higher death rate from breast cancer than white women, according to the report, Breast Cancer Facts & Figures 2009-2010, released Wednesday by the American Cancer Society.
“The breast cancer death rate continues to decrease since the 1990s in U.S. women because of improved treatments and increased mammography screening rates,” said Dr. Ahmedin Jemal, strategic director for cancer surveillance at the American Cancer Society.
The death rate from breast cancer peaked in 1989, Jemal said. “The most recent data from 2006 shows the breast cancer death rates have dropped nearly 30 percent,” he said. “That’s very good news.”
When this data is translated into the number of women with breast cancer who did not die, some 130,000 lives were saved, he noted.”
One of the things that scares IBC patients about their diagnosis is the possibility of metastasis. A new study out of Oxford highlights the mechanism by which cancer cells can migrate into the brain. As it turns out, a specific molecule on the outside of cancer cells allows them to stick to the blood vessels in the brain. If they can find a drug to deactivate this molecule, it could prevent brain metastases. One less place for the zombie cancer hordes to hide (I hope)!
