Adjuvant therapy options

A variety of therapeutic treatment options are currently under discussion, and in some cases being evaluated very differently. This is particularly true of alternative forms of therapies, such as immune therapy. For this reason, we shall confine ourselves here to looking at radiotherapy, chemotherapy and hormone therapy.

Radiotherapy
Radiotherapy is used pre- as well as postoperatively. When applied before the operation (pre-operatively) it serves to reduce or to stop the growth of a tumour. After the operation (post-operatively) the aim of adjuvant radiotherapy is to eliminate any remaining cancer cells in the breast or the scar tissue. Radiotherapy, which uses ionising radiation, is
currently used frequently after conservative breast surgery, invasive tumour growth, lymph node involvement and metastases. It is used locally.
Radiotherapy begins approximately 3 weeks after surgery, when the healing process of the wound is well advanced. Nowadays, as a rule, the treatment is divided into a large number of single doses, and can last for about 5 - 6 weeks with up to 5 radiotherapy sessions per week. The affected area of skin is extremely sensitive during this time, and should be treated only with an approved medicated powder.
These days, the radiotherapy dose and the area to be irradiated can be calculated individually with the aid of computer tomography. This means that the possibility of side effects, such as burns, can be reduced relatively effectively.

Chemotherapy
The aim of chemotherapy is to inhibit the growth of tumour cells and to destroy them, using cytostatic agents. It, too, can be employed pre- and postoperatively. These cytostatic agents also inhibit cell division, preventing metastases.
Chemotherapy can, for example, be used when other forms of treatment, such as radiotherapy or hormone therapy, are not sufficient and the tumour cells have already spread into the body.
Side effects such as nausea, hair loss, etc, are possible with this treatment. However, these can in some cases be influenced for the better by the individual combination of products, a change in the drug dose or combination, and the administration of anti-emetics for nausea and vomiting.

Hormone therapy
Some breast tumours are known as hormone receptor-positive tumours, i.e. they have grown under the influence of hormones such as oestrogen. After breast surgery, these patients may also receive hormone treatment to counteract hormone production in the body.
One option is the administration of so-called anti-oestrogens. These bind to the oestrogen receptors in the tumour cells thereby preventing oestrogen from affecting tumour growth.
Today, a wide variety of preparations are available for hormone therapy. The administration of aromatase inhibitors, for example, inhibits the formation of oestrogens. Progestogens are also used; they, too, have an anti-oestrogenic effect.