For many women diagnosed with breast cancer, the disease doesn't make them feel ill. It's the treatment -- surgery, radiation, and, most of all, chemotherapy. Coping with side effects that range from nausea and fatigue to mouth sores and premature menopause can make four, six, or eight months of treatment seem like a lifetime.
And for many women, side effects can linger long after breast cancer treatment is over. What's more, some, such as low blood counts or nausea and vomiting so extreme they can't be controlled, can delay the next treatment, possibly making it less effective.
Procedures used for determining the stage of breast cancer should be modified for pregnant women to avoid radiation exposure to the fetus. Nuclear scans cause fetal radiation exposure. If such scans are essential for evaluation, hydration and Foley catheter drainage of the bladder can be used to prevent retention of radioactivity. Timing of the exposure to radiation relative to the gestational age of the fetus may be more critical than the actual dose of radiation delivered. Radiation exposure...
As scientists research new treatments for breast cancer, they're also studying new "treatments for the treatments," new ways to prevent or reduce some of the most debilitating side effects of cancer therapies.
New Drug Controls Nausea One of the most common (and awful) side effects of many types of chemotherapy is nausea and vomiting. It leaves many women exhausted, dehydrated, and sometimes so distressed that they want to stop chemotherapy altogether. Some women are so affected by chemotherapy nausea that, even years later, they find themselves searching for a bathroom or a bucket at the mere sight of their oncologist.
Now, a new drug is helping many more women get through chemotherapy nausea-free. Emend, approved by the FDA in 2003, works differently than many of the other standard anti-nausea medications used with chemotherapy. It blocks "substance P," a chemical substance that transmits nausea and vomiting signals to the brain. It's effective at staving off "delayed-onset" nausea, which hits 24 to 48 hours after a chemotherapy dose and can last as long as five days. In studies, Emend kept about 20% more patients nausea-free for up to five days following chemotherapy.
In late 2004, Memorial Sloan-Kettering Cancer Center in New York made Emend part of its standard regimen of drugs for women undergoing breast cancer chemotherapy. "It's very well tolerated and very effective," says Andrew Seidman, associate attending physician in the Breast Cancer Medicine Service at Sloan-Kettering.
"It doesn't replace other anti-nausea drugs, but rather works well in combination with them. With these other medications alone, patients still had the potential for breakthrough nausea two or three days after treatment. Since we've made the change, I think we're doing an even better job at managing nausea."