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Once the cancer has been surgically removed, the oncologist, a specialist in cancer medicine, may recommend radiation to destroy any remaining breast cancer cells. Radiation stops cancer cells from dividing. It works especially well on fast-growing tumors. Unfortunately, it also stops some types of healthy cells from dividing. Healthy cells that divide quickly, such as those of the skin and hair, are most affected. This is why radiation can cause fatigue, skin problems, and alopecia (hair loss).
Breast cancer surgery may be followed by chemotherapy, even when it is diagnosed in the earliest stages. Chemotherapy is administered either orally or by intravenous injection. It is usually administered in cycles: anticancer agents are given, followed by a period of time for recovery. Treatment time ranges from four to nine months.
There may be significant side effects with some types of chemotherapy, including nausea and vomiting, temporary hair loss, mouth or vaginal sores, fatigue, weakened immune system, and infertility. Advances in chemotherapy, especially regimens for early breast cancer, use medications that cause fewer side effects.
The growth of some breast cancer cells may be slowed by the antiestrogen drug tamoxifen. Administered orally, tamoxifen travels throughout the bloodstream, affecting all cells in the body. Treatment with tamoxifen continues at least two years, and often as long as five years. Research suggests that tamoxifen may lower the risk of breast cancer recurrence by between 25–35%. Side effects of tamoxifen may include a slightly higher risk of endometrial cancer (cancer of the lining of the uterus). The risk increases if the drug is taken for more than five years. Other side effects include menopause-like symptoms such as weight gain, hot flashes, and mood swings.
Other possible hormone treatments include the use of progestins, estrogens, and androgens. In rare cases, the surgeon may suggest oophorectomy (surgical removal of the ovaries) in pre-menopausal women as a way of eliminating the main source of circulating estrogen, which can boost the growth of some breast tumors.
Stem cell treatment may be used to treat advanced breast cancer. Treatment involves removing stem cells from the patient's bone marrow or blood, and administering very high doses of chemotherapy or radiation to kill cancer cells. Since these high doses of chemotherapy also kill healthy white blood cells, patients are left extremely vulnerable to infection. When the stem cells are replaced, they restore the body's ability to combat infection.
Author Info: Barbara Wexler, The Gale Group Inc., Gale, Detroit, Gale Encyclopedia of Nursing and Allied Health, 2002
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