Researchers Explore Alternatives to Surgery, Chemotherapy, and/or Radiation for Localized Breast Cancer (dateline February 25, 2002)
Women who are diagnosed with localized breast cancer, cancer that has not spread past the breast, typically undergo surgery and either chemotherapy or radiation as treatment for their disease. However, a new study finds that drug therapy (typically tamoxifen and/or other drug therapies) may be a viable option for these women. In a newly published study, women who were initially treated with drug therapy did not have as fast a response to treatment as those who underwent surgery, chemotherapy or radiation. However, overall survival and the time it took the cancer to spread to other areas of the body was similar among the women, regardless of whether they initially received drug therapy or standard surgery, chemotherapy, or radiation. Since drug therapy is associated with fewer side effects and less inconvenience than standard therapies, the researchers suggest it as reasonable option for some breast cancer patients.
To conduct their study, Dr. S.M. Tan of the City Hospital of Nottingham, England and his colleagues followed 108 women who had been diagnosed with locally advanced breast cancer. Of the 108 women, 52 received initial drug therapy and 56 women received "multimodal therapy," which typically consisted of surgery and radiation or chemotherapy. The women who received drug therapy were given either tamoxifen (brand name, Nolvadex) if they were post-menopausal or tamoxifen and goserelin (brand name, Zoladex) if they were pre-menopausal. Once the breast cancer was found to have progressed in the women on drug therapy, they then received surgery, radiation, or chemotherapy.
Dr. Tan and his team found that the women who initially received multimodal therapy (surgery, chemotherapy, or radiation) did fare better than the women who initially received drug therapy. That is, the women who received multimodal therapy achieved a faster rate of response to treatment than the women who received drug therapy. Furthermore, 80% of the women who received drug therapy eventually needed surgery, chemotherapy, or radiation.
Though the results of the study do not appear as though drug therapy is beneficial to women with locally advanced breast cancer, Dr. Tan and his colleagues argue that there is no data to confirm whether a rapid response to treatment (as seen among the women who received multimodal therapy) is significant when it comes to disease progression and the patients overall chances of survival.
Obviously, the study did not find that drug therapy is a better option than the standard surgery, chemotherapy, or radiation that is typically used on breast cancer patients. However, the study did find that survival rates were similar among the women in the study, regardless of whether they were treated with multimodal therapy or the initial drug therapy. The researchers did note that drug therapy was more effective in women who had estrogen-receptor positive breast cancers (roughly 80% of breast cancer cases are estrogen-receptor positive). Therefore, these women may wish to consider whether the physical and emotional effects of surgery, chemotherapy, and/or radiation are worth undergoing these treatments from the start, or whether an initial regimen of drug therapy may be easier to handle.