Beating the odds in breast cancer

First, the bad news: The Philippines has the highest incidence of breast cancer in Southeast Asia. An estimated 14,000 new cases of breast cancer are expected to occur this year, according to a report by the Philippine Cancer Society.

Breast cancer is the leading cause of death among Filipino women, and about 6,000 of them are estimated to die from the disease this year.

The good news is that in the last few years there have been exciting developments in the treatment of breast cancer, the most common type of malignancy, next to lung cancer.

These include new drugs and changes in the chemotherapy treatment, a technique introduced several years ago.

Treating breast cancer usually involves more than one approach. If the cancer is detected at an early stage, the tumor can be removed by surgery.

A few weeks after surgery, additional (or adjuvant) treatment may be needed to increase the chances of a cure and reduce the chances of the cancer from coming back. Adjuvant treatment for breast cancer usually includes chemotherapy.

In the 1990s, a combination of chemotherapy known as FAC (fluorouracil, doxorubicin, and cyclophosphamide) was shown to be effective as adjuvant therapy in women who underwent surgery for node-positive breast cancer, meaning the cancer has spread to the lymph nodes. (Women with node-positive breast cancer have a higher risk of recurrence than node-negative patients.) The FAC combination became the standard of care in this group of patients.

However, a recent study published in the New England Journal of Medicine showed that replacing an older chemotherapy, fluorouracil, with a new one, docetaxel, reduced the risk of recurrence by 28 percent and the risk of death by 30 percent in patients with node-positive breast cancer.

"The TAC (Taxotere, Doxorubicin and Cyclophosphamide) combination represents an improvement from the FAC combination in the adjuvant treatment of women with node-positive breast cancer," said Dr. Antonio Villalon, a consultant medical oncologist at the Manila Doctors Hospital.

The study, conducted by the Breast Cancer International Research Group, involved 1,491 women aged 18 to 70 who had undergone surgery for node-positive breast cancer within 60 days of entry into the study. Participants were randomly assigned to receive six cycles of either TAC or FAC.

Docetaxel belongs to a newer class of chemotherapy drugs known as taxanes, which inhibits cancer cell division by essentially "freezing" the cell’s internal skeleton, which is comprised of microtubules.

Docetaxel and other chemotherapy agents should be administered only under the supervision of a qualified physician experienced in the use of anticancer treatments.

With newer medicines to fight breast cancer, patients have better odds at finally beating the disease.