The earliest recorded evidence of cancer was breast cancer, and it can be traced back to ancient Egypt. More than 3000 years later, with the expansion of modern medicine, various methods have been developed to combat various diseases, including cancers. While there isn’t a true cure for cancer, various treatments and managements have been discovered that could improve symptoms, prolong life-expectancy, detect them at an early stage and possibly prevent the worsening of the condition.
When the normal regulation of cell growth is impaired and abnormal cells start forming. If these cells form lumps or growths, they are referred to as a tumour. Tumours become cancerous when they develop secondary growth, spread and affect other parts of the body or its functions. Just like how not every tumour is cancerous, not all cancers develop from a tumour.
Breast Cancer and Chemotherapy
Not everyone with breast cancer will benefit from chemotherapy. Depending on the stage and type of the cancer, some may only require surgical removal. Types of chemotherapy can be categorised according to its purpose.
- Adjuvant Chemotherapy. This refers to chemotherapy given after surgery, as part of the management plan to ensure complete removal of remaining cancerous cells that might not be removable by means of surgery.
- Neoadjuvant Chemotherapy. This course of chemotherapy is given prior to surgical removal of the cancerous tumour. Its purpose is to shrink the size of the tumour to allow a less invasive surgical procedure, reducing the risk of complications associated with a larger operation.
- Chemotherapy for Metastasis. In this situation, the cancer has spread (metastasise) to other parts of the body and surgical methods are not possible. Chemotherapy will provide a treatment to different parts of the body affected by the spread.
- Palliative Chemotherapy. As its name suggests, this course or courses of chemotherapy will be given not as a curative option but for the relief of symptoms to improve quality of life.
The Red Devil
The strongest chemotherapy drug is Doxorubicin, also known as the ‘Red Devil’. It is used to treat a range of solid cancers (cancers caused by tumours) including breast cancer, as well as blood cancers like leukaemia and lymphomas. Its name came about due to its bright red colour and the strong accompanying side effects along with its vesicant properties.
Doxorubicin belongs to the drug class called Anthracyclines. This medication is usually given via the bloodstream (intravenously), and works by blocking the enzyme topoisomerase-2, which slows or stops the growth of cancerous cells. As with most chemotherapy medications, it is usually given as a course of several cycles, and sometimes in conjunction with other chemotherapy agents according to the treatment needs.
The most common side effects of Doxorubicin are alopecia (hair loss), nausea and vomiting. Apart from that, the medication may cause a temporary change in colour of urine to a bright red colour for a day or two after each administration.
A rare but serious side effect is cardiotoxicity, which is toxicity to the heart. As such, patients with existing heart diseases may not be able to benefit from this chemotherapy medication as it will exacerbate and worsen them. Patients on this treatment will be advised to keep a lookout for any possible symptoms of heart failure which are but not limited to shortness of breath, swelling (oedema) of the ankles and legs, unexplained tiredness and unexplained sudden weight gain.
Those on Doxorubicin may also experience skin sensitivity and will need extra protection against the Sun. If patients have been previously treated with radiation therapy, the previously exposed area of skin may develop a sunburn-like reaction.
not all these serious side effects may occur. The healthcare team will always weigh the benefits against the possible side effects of any management plan for each individual patient. Some patients will highly benefit from these strong medications and may be cured after persevering through the treatment course.
Every management plan for any disease should always consider the treated patient’s opinions, preference and comfort apart from their best interest. A good understanding of the disease, its progression, treatment plans and monitoring will allow better participation and compliance for the best individualised management plan. Discuss all your questions (Soalan) with your trusted physician to aid your understanding and to make informed decisions about your care plan.