Dr. Sunil Gandhi, Cancer & Blood Disease, 10/02/12 - Pink Paper Day

I recently saw a 65-year-old patient. She had a screening mammogram in November 2011. A six-month follow up was recommended. The repeat mammogram and ultrasound of the breast showed a suspicious mass.

She underwent a biopsy of the mass. Unfortunately, it showed breast cancer.

She needed surgery to remove the breast cancer. Her choices were to remove the whole breast or remove the cancerous lump and have radiation therapy to the remaining breast later. She elected the latter option.

Her surgeon did a sentinel lymph node biopsy. It is the first lymph node(s) to which cancer cells are most likely to spread from a primary tumor. A surgeon injects a radioactive sub­stance, a blue dye or both near the tumor to locate the position of the sentinel lymph node.

The sentinel lymph node biopsy procedure allows for the removal of one to a few lymph nodes, saving a bigger axillary lymph node dissection procedure (like in my patient) in many patients. The smaller lymph node procedure helps patients lower the risk of lymphedema (swelling of the arm) and decreases arm mobility and range-of-motion problems.

Her cancer had spread to one lymph node. Thus her cancer was stage II-A. Such patients benefit from chemotherapy. Chemotherapy is the use of drugs to kill cancer cells, usually by stopping the cancer cells’ ability to grow and divide. Systemic chemotherapy is delivered through the bloodstream to reach cancer cells throughout the body. Medical oncologists like me prescribe chemotherapy.

Studies have conclusively shown that it improves the chance of cure.

Chemotherapy may be given on many different schedules, depending on what worked best in clinical trials for that specific type of chemotherapy. It is usually given once every few weeks for a total five to six months. It is usually given in the vein.

The side effects of chemotherapy depend on the individual and the drug and the dose used, but they can include fatigue, hair loss, risk of infection, nausea and vomiting, loss of appetite and diarrhea.

These side effects usually go away once treatment is finished. These drugs cause short-term side effects, but in the long term it helps the patient a lot.

My patient just started the treatment and she will need it for almost six months. It may cause some side effects in the short run, but in the long term, it will help my patient a lot. There is a saying: “No pain, no gain.”

Dr. Sunil Gandhi is a hematologist and oncologist. He is volunteer medical adviser of the Citrus Unit of American Cancer Society. Write to 521 N. Lecanto Highway, Lecanto, FL 34461, email sgandhi@tampabay.rr.com or call 352-746-0707.