The New Generation Breast Cancer Book by Dr. Elisa Port

Author:Dr. Elisa Port
Language: eng
Format: epub
Publisher: Random House Publishing Group
Published: 2015-09-21T16:00:00+00:00

When further treatment is needed

After my patient Susan was diagnosed, her surgery revealed that the cancer had spread to her lymph nodes and that a total of three of her twenty-one lymph nodes removed were cancerous. In Susan’s case both chemotherapy and endocrine therapy were recommended, which is quite common for women with cancer that has spread to the lymph nodes.

Like so many of my patients, Susan wanted to know more. “If the cancer was removed with surgery, why would I need additional treatment?” she asked.

I explained to Susan that her cancer had already grown over the course of months and even years before it was found. What started out as one bad cell divided into two bad cells. Two bad cells divided into four bad cells. This process of cells growing and dividing had continued until, by the time her cancer was just a centimeter (less than half an inch), there were about a billion bad cells. Some of these cells traveled to her lymph nodes, which is why three nodes with cancer were found and removed. When positive lymph nodes are found, it means that there is a higher chance that cancer cells could have taken the next step as well: escaping into the body, circulating in the bloodstream, and waiting to take up residence somewhere else, or metastasizing. If those cells did metastasize, her breast cancer would become incurable. I explained to Susan that even though she had scans of the body that thankfully were normal, these scans had limitations and could only show obvious spread, not microscopic spread. This possibility of microscopic cell escape in patients with newly diagnosed breast cancer is the reason additional medical treatment is given, and why we need medical oncologists.

Fortunately, we have many effective options for treatment, both in terms of chemotherapy and medicine, with more being developed every year through excellent research efforts. When combined with surgery, these treatments can provide excellent outcomes and prognosis for most, giving all of us reasons to be optimistic.

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