Follow-up care and adjuvant therapy
Follow-up care and adjuvant therapy begins after surgical removal of the tumour. Regular follow-up checks are important in order to evaluate the healing process. Together with the oncologist, you will decide on any follow-up treatments such as chemotherapy, hormone therapy or radiotherapy.
The oncologist decides on the necessary adjuvant treatment and medication based on the size of the tumour, the patient’s age, whether the axillary lymph nodes are affected, and the biological and microscopic features of the cancer cells. This may involve chemotherapy and/or less arduous hormonal therapy. For very large tumours or in the rare case of inflammatory breast cancer, a course of medication may be necessary before the first operation, to reduce the size of the tumour before the surgery can go ahead.
In most cases, a course of chemotherapy is undertaken using cytostatic agents. Cytostatics stop the cancer cells from dividing and multiplying; thereby inhibiting the growth of the cancerous tumour, as the drugs destroy the malignant, fast-growing cells. Chemotherapy is normally used as an adjuvant/post-operative treatment. The medication is administered for several days in a row. Then, after a break, a new treatment cycle commences. Normally several treatment cycles will be required. The course usually involves an individually determined combination of different medications. Unfortunately, chemotherapy takes its toll on the body and is associated with some unpleasant side effects (hair loss, nausea, fatigue etc.). An increasing number of pharmaceutical companies are currently working on new approaches to cancer research. For example, certain antibody therapies based on monoclonal antibodies provide new treatment options and fewer side effects for a specific group of women.
Hormonal therapy is currently used in some cases as an adjuvant treatment for breast cancer and to treat metastasis. The aim is to inhibit the growth-promoting effect of the female hormone, oestrogen, on the cancer cells. Aromatase inhibitors are also used to treat advanced tumour growth with metastases.
Breast-conserving surgery necessarily includes local radiotherapy of the residual mammary gland and possibly the lymph drainage system, depending on how far the tumour has spread. In rare cases and at an advanced stage of cancer, radiotherapy may also be carried out after a mastectomy. Radiotherapy takes a period of five weeks. During this time, clearly demarcated areas of skin undergo intensive radiation therapy for a few minutes at a time. This radiotherapy may cause some skin irritation.
Psychological support for individuals with breast cancer
Following a diagnosis of breast cancer, almost all affected women have to face a multitude of frightening thoughts and feelings. Confirmation of the disease is often experienced as a massive blow. The woman’s normal life and her future goals seem suddenly thrown into question. Individuals may experience fear of returning to everyday life and self-consciousness in dealing with other people. Doubt about the effectiveness of the treatment and fear of the disease spreading are frequently recurring feelings. It is common to experience periods of hopelessness and depression, but also moments of hope and an intense appreciation of life. Talking about the disease openly and seeing a psychological counsellor can help women come to terms with the situation. Our centre works with experienced and sensitive psychologists and psychiatrists and can put you in touch with a suitable specialist upon request.
Talking to other people affected by breast cancer
The role of the woman’s doctor is to accompany her through the treatment and to address her concerns. Family life may come under particular strain. It is not just the woman with breast cancer who is affected – her entire family may be shaken by the diagnosis. Many patients also feel the need to meet with other women who are facing a similar experience. You can make contact with other affected individuals via our clinic.