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
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
used frequently after conservative breast surgery, invasive tumour
growth, lymph node involvement and metastases. It is used locally.
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
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,
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.
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
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.