Targeted therapy- the most significant innovation in breast cancer treatment

Breast cancer is the most highly diagnosed cancer in women worldwide but in Africa, Uganda inclusive, it comes second after cervical cancer.

Although breast cancer is thought to be a disease of the developed world, almost 58% of deaths occur in less developed countries.

Dr. Gerald Mutungi who heads the Non-Communicable Diseases (NCDs) department at the ministry of health, says cancer is responsible for 5% of all the deaths that occur in Uganda's hospitals, a number too big to be taken lightly.

But in recent years, new treatment options have surfaced, bringing with them both enthusiasm and optimism.

Treating cancer

Dr. Jackson Orem, a physician, medical oncologist, researcher and Director of the Uganda Cancer Institute, says once diagnosed with breast cancer, there are two approaches to treating the condition which is local treatment and systemic treatment.

The local treatment means treating the tumor without affecting the rest of the body using surgery or radiotherapy whereas systemic treatment involves using drugs.

Dr. Orem explains that systemic treatment is preferred when cancer has spread to other parts of the body.  It targets cancer cells using drugs in circulation.

Drugs used in systemic treatment can be given by mouth or put directly into the bloodstream.

Dr. Orem explains there are three categories of systemic drugs for breast cancer which include chemotherapy, hormone Therapy and the more recent innovation called targeted therapy.

He says the most significant innovation in treatment of breast cancer was the introduction of targeted therapy using a drug called Trastuzumab (Herceptin) which is an artificial immune system protein. It can be given alone or with chemotherapy.

Also a new study by Dr. Joseph Sparano, who helps direct clinical research at the Albert Einstein Cancer Center in New York City found that majority of women with an early form of a common breast cancer, may be able to skip chemotherapy, depending on the results of a comprehensive gene test.

The study of nearly 7,000 women found that use of the already available gene test (Oncotype DX gene test) could pinpoint those women who needed chemotherapy, and those who did not.

Researchers and experts say the findings could be a game-changer in breast cancer care.

Preparing for treatment

Dr. Orem says when diagnosed with breast cancer, your treatment must be discussed in a care team that can provide you with options weighing benefits and risks or side effects of treatment.

He explains the treatment team should comprise of different types of doctors. They include a breast surgeon, surgical oncologist, radiation oncologist, medical oncologist, plastic surgeon or reconstructive surgeon.

Other specialist on the team may include nurses, psychologists, nutritionists, social workers, and other health professionals.

He says typically, the treatment plans are based on the type of breast cancer, its stage, and any special situations. The treatment plan depends on other factors including overall health and preferences of the patient.