Which First-Line Breast Cancer Therapy Is Right for Me.
Knowing where to turn next with your breast cancer treatment can be a tough decision. But understanding the different types of therapies can help ensure you know what’s best for you.
Hormone and targeted therapies.
The first-line treatment for advanced hormone receptor-positive (estrogen receptor-positive or progesterone receptor-positive) breast cancer is usually hormone therapy.
Tamoxifen is generally the first option for premenopausal women. If you’re post-menopausal, you’ll likely try letrozole (Femara) or fulvestrant (Faslodex) first.
Side effects of hormone therapy vary with each drug, but can include:
*hot flashes and night sweats.
*loss of sex drive.
Hormone therapies can also increase your risk of blood clots, stroke, and bone loss.
Two targeted therapies for postmenopausal women with advanced hormone receptor-positive/HER2-negative breast cancer are:
*Palbociclib (Ibrance), which is used in combination with an aromatase inhibitor. Side effects may include nausea, mouth sores, hair loss, fatigue, and diarrhea. This medication may raise your risk for infection.
*Everolimus (Afinitor), which is used in combination with exemestane (Aromasin). It’s generally reserved for use after letrozole or anastrozole (Arimidex) have failed to control the cancer. Side effects can include shortness of breath, cough, and weakness. This medication can increase the risks of infection, high blood lipids, and high blood sugar. Careful monitoring of the blood is necessary.
Targeted therapies for HER2-positive breast cancer include:
*ado-trastuzumab emtansine (Kadcyla).
Some of these may be more effective when used in combination with chemotherapy.
Most hormonal and targeted therapies are available in pill form.
If side effects get overwhelming, or your cancer continues to progress while taking hormonal or targeted therapy, changing drugs is a good strategy. If you’ve already done that and cancer is still progressing, you may have to switch to chemotherapy alone.
Chemotherapy drugs are designed to kill fast-growing cells, which is why they’re so effective in destroying cancer. But there are other fast-growing cells in your body that can be damaged in the process, including:
*cells in your bone marrow that help form blood.
*cells in your mouth, digestive tract, and reproductive system.
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