However there is also a role for the GP in supporting patients. Patients should be allocated a key worker or nurse specialist to support them through the side effects of their cancer treatment. Please discuss with the treating clinician before prescribing this SSRIs to patients taking Tamoxifen. There is some evidence to suggest that some drugs such as antidepressants paroxetine (Seroxat®) and fluoxetine (Prozac®) may decrease the efficacy of Tamoxifen, but it is still a cause for debate. After the first five years The Royal Marsden will write to the patient and their GP and confirm if the prescription should stop, continue or be switched.Įven if patients are having irregular or no periods due to breast cancer treatment, there is still the possibility of pregnancy and effective contraception is important. Anti-hormone therapy will include Tamoxifen, Letrozole and other medications such as Anastrozole (arimidex) and Exemestane. Patients with hormone sensitive cancers are prescribed antihormone tablets, also known as endocrine therapy. Women are recommended to have annual mammograms for five years, or until the patient reaches the age at which the National Breast Screening Programme starts. In many centres routine appointments are not offered but instead the patient can access the service at any time when they develop any new symptoms or concerns The side effects mimic that of the menopause and include hot flushes, nausea, mood changes, fatigue and vaginal dryness/discharge.Īround two-thirds (65%) of women diagnosed with breast cancer in England and Wales now survive their disease for twenty years or more and so issues of long term follow up in primary and secondary care are becoming increasingly important. They are often taken over extended periods of time (five years or sometimes longer) to both treat the tumour and reduce the risk of recurrence. The most common hormone treatments are Tamoxifen and Aromatase Inhibitors. About 70% of breast cancers fall into this category. In order to work, the tumour must be ER+, that is have oestrogen receptors on the surface of the cell. Hormone therapy: hormone treatments either lower the levels of oestrogen or progesterone or block their effects.Patients who have heart problems are can have relative contra-indications for Herceptin. Herceptin is given every three months for a year and side effects can include infection, hot flushes, fatigue and diarrhoea. About 15% of all breast cancers are HER2+. Cancers which test positive for the HER2 receptor can be treated with one of the most well-known targeted therapies, Herceptin. Targeted therapy: targeted drugs block the growth and spread of cancer by interfering with specific molecules on the cells’ surface.Cancers which are not responsive to hormone treatments are more likely to be treated with chemotherapy. Chemotherapy: in breast cancer, chemotherapy drugs are often given in combination to some patients.New techniques such as breath holding have been developed to minimise damage to the heart. A long-term risk of radiotherapy that is becoming increasingly apparent is damage to heart tissue, resulting in heart problems for women many years after radiotherapy treatment. ![]() These side effects can be mediated with specialist support and are often not long lasting. Generally, breast cancer patients tolerate radiotherapy well, with side effects limited to skin reactions, lymphoedema, pain and swelling. Radiotherapy: radiotherapy treatment is often given post-surgery to destroy any remaining cancer cells.The oncoplastic surgeon will discuss the patient’s options with them to ensure they receive the optimum result. Reconstruction can be immediate or delayed and use either the patient’s own tissue or implants. As more and more women survive breast cancer, the importance attached to reconstruction is greater to ensure patients achieve an optimum quality of life. Advances in surgical techniques mean that full mastectomies are less common than twenty years ago. Surgery: the two main types of surgery are lumpectomy and mastectomy.The patient’s treatment pathway will depend on a broad range of factors including its stage, immunohistochemical profile, and the patient’s general health. There are five main types of treatment for breast cancer.
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