Personalized treatment is already here - in the form of treatment protocols depending on the test results for various kinds of cancers, including breast cancer. Early detection will play a greater role in assuring that treatments hit the cancer cells hard while leaving healthy tissues alone. One of the great sources of trouble with chemotherapy and radiation is that they were often unfocused and hit healthy cells and cancer cells alike. Cyberknife surgery has reduced radiation damage to healthy cells while blasting cancer cells with higher and more focused dosages, minimizing side effects.
Gene therapy may be the next wave of treatment, evaluating the cancer cells protein structure and blocking or attacking certain pathways to strictly kill those cancer cells, wherever they may be lurking in the body:
Within just a few years, the technology may be available to sequence an individual tumor's genes and find out exactly what pathways need blocking, says Raymond DuBois, provost of M.D. Anderson Cancer Center in Houston and president of the American Association for Cancer Research. Theoretically, that means drugs could be much better matched to patients. That kind of matching is only occasionally available now. Beyond Herceptin, Gleevec has proved very effective at blocking signals that encourage cell replication in certain leukemia patients with a specific chromosomal defect. Lung cancer drugs Tarceva and Iressa target the cell-growth receptor EGFR; for reasons not yet fully understood but most likely involving mutations in EGFR, they work better in some patients than in others.Another area of research is in cancer stem cells:
Just as healthy adult stem cells in the body's organs produce cells for renewal and repair, the thinking goes, a small fraction of the cells in a single tumor manufacture tumor cells like little factories. Chemotherapy and radiation may seem to make a person cancer free when they actually leave the factories untouched to crank up production again later. Researchers have reported finding stem cells in leukemias and myelomas, as well as in breast, brain, pancreatic, and other tumors. Whether the cells are true stem cells or simply cells that have mutated to possess the stem-cell-like power of self-renewal is up for debate; either way, those properties are likely controlled by unique pathways that might be singled out and targeted.Certain drugs are already finding usage to prevent metastases, including osteoporosis drugs to combat metastatic breast cancers from spreading to bone. Immunotherapy will also play a role in cancer treatment in coming years.
Cancer is no longer the death sentence that it was once considered, and I'm tremendously thankful for that. For those who are now learning that they or a loved one has cancer, the best advice I can give is to get the doctors advice and learn about the disease and treatment options once the specific diagnosis is made. If you try to research a course of treatment online before knowing the specific diagnosis, you can work yourself in to a ball of knots because of the staggering subtle differences in cancer subtypes and treatment options depending on the stage and location.
Once you have a specific diagnosis you need to talk to a doctor you feel most comfortable with. If you're risk adverse or want a more aggressive approach, you need to find doctors who are of like-mind. I'd also suggest getting a second opinion, which in big cities like New York, Boston, Los Angeles, or Chicago are not a problem even when dealing with rare cancers or presentations, but could be an issue elsewhere. In that case, consider that some hospitals and medical centers around the country will review case files remotely and provide diagnostic and treatment options.
Also, don't overlook family support and peer support groups, whether they're online or local. Just remember that the information they provide may not be the best for your own situation.
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