When you receive your pathology results from your biopsy and/or your surgery, you’ll find out whether the cancer has sneakily been using your very own biochemistry to fuel its growth. If this is the case, it ‘luckily’ provides you with another treatment tool to show the cancer the door. Results that come back as negative for all receptors (oestrogen, progesterone and HER2) are known in the business as triple-negative cancer (i.e. ER-/PR-/HER2-) and hormone or herceptin treatment would not be effective.
Herception and HER2+ cancer
A positive result for the HER2 testing means that the over-expression of HER2 proteins in cell membranes cause the cells to multiply even more rapidly and uncontrollably than normal. HER2 positive cancer is usually more aggressive in nature but can also be treated using a drug called Herceptin (Trastuzumab) that binds to HER2 proteins in breast cells stopping them from wreaking so much havoc. Herceptin is given via infusions (into the vein) either alongside chemotherapy or as a stand-alone treatment.
Hormone sensitive cancers and hormone therapy
Hormone sensitive cancer can be partial to either oestrogen (ER+) or progesterone (PR+) or both (ER+/PR+). It is most common for breast cancer to be oestrogen receptor positive and blocking the production or uptake of this is how hormone treatment works. Tamoxifen or Armidex are usually given to us young folk and are taken daily in tablet form usually for a period of 5 years or more. They work by blocking the oestrogen receptor sites on breast tissue cells (like a plug in a hole) so that only very limited amounts of oestrogen can bind to cells, and the fuel supply is cut off.
All being well, if you intend to try for a family before 5 years after your diagnosis, you may instead be prescribed Zoladex (goserelin acetate). This is a lutenising-hormone releasing agonist (in plain English that means it tricks your body into temporarily stopping the production of oestrogen). Its given by a rather painful, but thankfully rather quick, monthly injection into the flab of your abdomen. It can be stopped easily and the effect is usually quickly reversed so you see your periods return within a few months. In some cases you may be on Tamoxifen or Armidex and Zoladex at the same time – it all depends upon your unique treatment regime and circumstances.
While this all gives you a further device to rain right on cancer’s parade, it doesn’t come without its fair share of side-effects. Your periods will stop and with that comes your very own temporary menopause and its side effects. Night sweating, insomnia, joint-pain, mood swings, loss of libido and hot flushes will probably all show up at some point during hormone treatment. Its not pleasant but the treatment really works – what more is there to say?