A roadmap for patients: Understanding breast cancer diagnosis and navigating treatment choices

Rachita’s life took an unexpected turn when the possibility of breast cancer loomed large. Fear and uncertainty gripped her, like so many others facing a potentially life-changing diagnosis. However, Rachita didn’t let fear dictate her journey. After several conversations with her doctor, she chose to face it head-on and underwent the necessary tests and treatments while discovering that healing goes beyond the physical battle —it’s a profound transformation within. While she is better now and embracing the new normal, the fear of recurrence creeps in occasionally. Breast Cancer Recurrence: Understanding the Odds Dr Ullas Batra, Co-director, Dept of Medical Oncology, Rajiv Gandhi Cancer Institute and Research Centre, Delhi said that receiving a breast cancer diagnosis is a life-altering moment, but what can be even more challenging is the possibility of recurrence. Research indicates that there is a significant risk of recurrence, ranging from 30% to 60%, within a decade of the initial breast cancer diagnosis, he said, adding that a pressing concern in India is the substantial delay that patients experience in accessing healthcare services, leading to over 60% of breast cancer diagnoses occurring at advanced stages, typically stage II or stage III. This is concerning because the stage at which breast cancer is first detected can significantly impact the likelihood of recurrence or metastasis, he added. Citing an example, he said that individuals with Stage III breast cancer are at a greater risk of experiencing recurrent breast cancer compared to those with Stage I or Stage II diagnoses. Despite considerable progress in improving breast cancer survival rates over the years, the fear of relapse and the prospect of life after metastasis continue to weigh heavily on the minds of many. The Breast Cancer Treatment Landscape Breast cancer is an escalating global concern, particularly among women as they age. In 2020, a WHO study revealed a staggering 2.3 million new cases, accounting for a significant 11.7% of all cancer types diagnosed. Dr Batra said that in most cases, a patient diagnosed with breast cancer undergoes a combination of medical and surgical treatment. In contrast to a few years ago, there are now multiple treatment modalities available for the management of breast cancer, he added. Medical treatment includes chemotherapy, radiation therapy, endocrine therapy, and advanced adjuvant therapies among others. With innovative treatments coming to the forefront, it is essential to consider the long-term value plan when choosing the right treatment option for oneself through discussions with one’s doctor. While discussing a plan of action, it is vital to evaluate the risks, benefits, and potential side effects of the available treatments. This will help empower patients to analyse and choose the course of action that aligns best with their individual circumstances and preferences. For instance, research indicates that when combined with conventional hormonal therapies, advanced treatments have proven highly effective in combatting cancer. Furthermore, in the event of a cancer recurrence or metastasis, these advanced therapies have demonstrated their capacity to enhance patients’ quality of life. Your healthcare provider can tailor a treatment plan that aligns with your individual needs and preferences only when they have a comprehensive understanding of your condition. In recent times, access to these treatment options has also become easier for breast cancer patients. For example, oral chemotherapy is now included in many corporate health insurance schemes. Deciding Between Traditional vs Advanced Therapies Traditionally, chemotherapy has been employed as the initial line of defence post-surgery for patients diagnosed with breast cancer. A concern with traditional treatments like chemotherapy could attack the cells of the entire body. Therefore, while it may manage cancer, chemotherapy can also impact an individual’s quality of life due to common side effects, which include nausea, infections, anaemia, hair loss, fatigue, and recurrence. On the other hand, we have recently witnessed the introduction of targeted advanced therapies.  A reason why innovative advanced therapy options are increasingly becoming more popular is that they yield better results with fewer side effects. This type of therapy helps block the replication of cancer cells, preventing the formation of new ones. This significantly helps reduce the risk of recurrence while avoiding the side effects that come along with chemotherapy alone. It can be daunting to make treatment decisions. With the right treatment plan, one can lead a fulfilling life even post-diagnosis. To have the best chance at combatting breast cancer, patients should prioritize their follow-up care and adhere to the treatment plan, as well as be consistent with prescribed care. Additionally, the importance of regular breast cancer screening cannot be overstated, as it is a cornerstone of early detection. Early detection substantially enhances the likelihood of a full recovery, mitigates the burden of treatment, and reduces the associated costs.