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.
By Amy Engeler
On September 2 of last year, Tomomi Arikawa left her office door open as she slipped out to her two o'clock sonogram appointment. She expected to return shortly — the imaging center was just across town from her office at ABC News, where she was a story editor for 20/20. At her gynecologist's urging, Tomomi was going to have a tender lump in her right breast checked out. The lump felt squishy, like a piece of Bubble Wrap, not like a hard kernel or a marble or any of the objects tumors...
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."