Source: The New York Times
By Gina Kolata
The feeling of a small lump on her breast, which turned out to be malignant, terrified Dr. Sima Dosi who thought she would have to undergo chemotherapy. But she manged to avoid it. She was one of the women who benefited from a revolutionary treatment of these types of cancers.
Many patients have benefited from the use of these drugs not only because they have not undergone the pain of chemotherapy, but also because they now have a significantly increased life expectancy
Until recently, chemotherapy was the mainstay of breast cancer treatment. Today genetic tests can indicate which patients will benefit from it. At the same time there are a wide range of drugs, such as estrogen inhibitors and drug cocktails that destroy tumors by targeting proteins on their surface. Consequently, many cancer specialists are now opting out of chemotherapy treatments when possible.
Every year thousands of women avoid chemotherapy treatment, which is accompanied by side effects such as hair loss, nausea, fatigue, damage to the heart and nerves of the limbs. A similar reduction in chemotherapy has been reported in the treatment of other cancers, such as lung cancer, but with less success. Dr. Lisa Carey, a breast cancer oncologist at the University of North Carolina, says the new approach "is a wonderful, new world."
Thirty years ago, guidelines from the National Cancer Institute for the treatment of breast cancer required chemotherapy in 95% of cases. This doctrine was gradually changed with the advent of the anti-cancer drug Herceptin, which targets a tumor surface protein that is detected in 30% of patients. It was initially co-administered with chemotherapy reducing the chances of recurrence by 50% and the risk of death by 30%, regardless of the dosage and composition of the chemotherapy. Subsequent studies have shown that its administration, together with another anti-cancer drug, is effective without the addition of chemotherapeutic regimens.
Many patients have benefited from the use of these drugs not only because they have not undergone the pain of chemotherapy, but also because they now have a significantly increased life expectancy. Similar results have been recorded in the treatment of lung cancer, where about 25% of patients can be treated with targeted drugs by avoiding chemotherapy, while there is a significant increase in life expectancy of patients with advanced lung cancer.