A group of 19 of the nation's leading cancer centers has published a new version of its breast cancer treatment guidelines for doctors.
Not all doctors agree with the new guidelines, but some are optimistic about them. The medical world is ever changing as new drugs come along and survival rates are increasing dramatically.
One local Oncologist, Dr. John Nanfro, is doing his research and is encouraged by what he sees.
"There are newer chemotherapy drugs coming to the market. A drug called Alipta and other drugs that are being tested to see if you can continue to improve on survival.”
In the past, tumor size was the first factor doctors would consider when deciding if chemotherapy or other treatments would help women after surgery. Now many doctors first consider the tumors hormone status.
That means doctors evaluate whether the tumor is estrogen receptor or progesterone receptor positive.
Women whose tumors are ER or PR positive are likely to benefit from hormone therapy, according to Dr. Nanfro.
"In breast cancer women who are estrogen progesterone positive, they basically are treated with hormonal agents. But the original drug was Tamoxifin and now we've come into a new class of drug called Aromatase inhibitors.”
The new research also recommends doctors look at whether the tumor expressed too much of HER-2 protein. In the past women whose cancers were HER-2 positive had a less favorable outlook. But new studies have shown those cancers are now responding to treatment with Herceptin a man made anti-body that attacks HER-2.
"Before we would reserve the drug Herceptin, which is an anti HER-2 drug, would reserve for women who had recurred and were HER-2 positive. Now the latest data is for HER-2 positive should be treated with chemo up front followed by Herceptin for one year. The survivals were drastically improved by doing that."
The new guidelines still stress the importance of tumor size when deciding on chemotherapy.