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Most Women With Early Onset Breast Cancer Don’t Need Chemotherapy (New Report)

Some convention cancer treatments are completely ineffective with certain cancers. The majority of immediate risk breast cancer patients can forgo chemotherapy.

by Alanna Ketler

A report which was recently released, outlined how the conventional treatment method for various kinds of cancer, like chemotherapy, is actually completely ineffective for a large portion of those women suffering from breast cancer.

Perhaps the most exciting part of this new report is that it has brought this information to the mainstream and finally, might open up a discussion in regards to alternative treatment methods for cancer treatment.

The results, which were released Sunday, are likely to bring down the use of chemotherapy for the disease.

The findings came from the largest breast cancer treatment trial ever conducted. It showed that the majority of patients who have an intermediate risk of cancer recurrence, around 65,000 women annually in the United States alone, can completely avoid chemotherapy altogether.

“We have been waiting for these results for years,” said Allison Kurian, an oncologist at Stanford University who was not involved in the trial. “They are going to change treatment and remove uncertainty for women making decisions.”

The same study, conducted over the course of a decade has also confirmed that patients at a low risk, determined by a genetic test of their tumors can forgo chemotherapy.

The combined total from the two groups make up about 70 percent of women diagnosed with a common type of breast cancer. This means that over 85,000 women a year can completely forgo chemotherapy treatment, and that is just in the United States alone.

Many women, and other cancer patients have been already opting out of chemotherapy based on their own research. Now, experts say that they can have confidence in those decisions. Others, may opt to change their treatment methods based on the results from the study.

This type of cancer is driven by hormones, has not yet spread to the lymph nodes and does not contain a protein called HER2. After surgery, patients generally receive endocrine therapy, which is designed to block the cancer causing effects of the hormones.

Chief medical and scientific officer of the American Cancer Society, Otis Brawley, said the trial made a good example of “precision medicine” and it would save many women from unneeded and potentially damaging chemotherapy.

The Study

The results came from a trial called TAILORx, which was designed to help doctors to be more precise when treating early stage breast cancer. Starting in 2006, the trial enrolled more than 10,000 women in the United States and five other countries who were diagnosed with early-stage breast cancer and followed their progress through post surgery treatment.

The most recent results were published at the annual meeting of the American Society of Clinical Oncology in Chicago and were published in the New England Journal of Medicine.

The tumors of the patients involved in the study were analyzed using a test called Oncotype DX, which is able to examine the activity of 21 genes to predict the risk of recurrence over a 10 year period. Previous studies have already made it clear that women with low scores could skip chemotherapy and those with the high scores were more suitable.

The big outstanding question was: What should women with mid-range scores get? Such patients have been in “the gray zone, and we haven’t known what to tell them,” Kurian said.

In order to find the answer researchers assigned more than 6700 women with intermediate scores, between 11 and 25 to two groups. After surgery one group received endocrine therapy only and the other was treated with both endocrine and chemotherapy.

After the two year follow up, the showed that the majority of patients who did not receive chemotherapy were doing as well as the ones who did.

An exception was the women who were aged 50 or younger, those who received a score of 16 and over got a “substantial” benefit from the chemotherapy and should consider it, according to lead author of the study, Joseph Sparano, associate director for clinical research at the Albert Einstein Cancer Center and oncologist at the Montefire Medical Center in New York.

From the Washington Post,

Phyllis Laccetti, a 58-year-old night nurse at Montefiore, was diagnosed with cancer in her right breast in 2007. She had a lumpectomy, followed by a mastectomy, and had a recurrence score of 12 or 13, which put her in the middle range. She enrolled in the ­TAILORx trial and was relieved to be randomly assigned to the group that did not get chemotherapy. She got only tamoxifen.

Because of her work as a nurse, she was familiar with chemotherapy’s sometimes harsh effects. She also watched her brother and sister — who died of thyroid cancer and leukemia, respectively — suffer through chemotherapy treatments.

“They were sick all the time,” she said. “My brother was so sick that he’d be saying, ‘I can’t do this anymore,’ and it was the same thing with my sister.”

Laccetti’s cancer has not returned.

Alternative Treatment?

Hopefully, this new research that is coming to the surface is confirming what many have been coming to realize on their own — there are many other options to treat cancer. We have covered many of these alternatives extensively and they deserve to be brought to the limelight so that these methods can get the funding they need for in depth scientific study.