Treatment Options
There are three primary avenues for treating cancer – medical oncology, radiation oncology and surgical oncology. Some individuals only need one, while others may need all three modalities to fight their cancer. At Columbia St. Mary’s, we offer the most advanced technologies in treating cancer in all three arenas and work together as a team to ensure that our patients' treatment plans incorporate everything that is needed for the best possible outcomes.
While our commitment to advanced technology sets us apart, you’ll find the real difference resides in the people who work on your Columbia St. Mary's team. We are here to help you in your battle against cancer by providing a compassionate team of integrative oncology specialists.
Medical Oncology
Medical oncology includes chemotherapy, hormone therapy, immunotherapy and other pharmaceutical services. All of these treatments kill cancer cells and/or alter their ability to grow and form new cells. While the type, frequency and duration of medical oncology treatments depend on individual needs, all treatment is overseen by an expert medical oncologist and a team of oncology certified nurses.
Chemotherapy
Chemotherapy may be recommended as a breast cancer treatment option.
Chemotherapy is available intravenously or as a pill and has two primary
functions: to eradicate early stage tumors and to shrink an advanced
tumor in preparation for surgical removal. There are a variety of
chemotherapy drugs that are administered either individually or combined
as part of a regimen that you and your doctor will discuss based on what
would work best for you and your specific type of cancer.
Chemotherapy cycles typically last between 14 and 28 days with periods
of rest in between to allow the body to recover.
Hormone Therapy
Some breast cancers have hormone-receptors, which means they use your
body’s estrogen to fuel their growth and reproduction. In these cases,
lowering a patient’s estrogen levels is necessary to combat the cancer
and prevent it from spreading and/or returning. There are three primary
ways this is done.
Immunotherapy
Sometimes, cancer develops when the immune system stops functioning
properly. In those cases, doctors can actually use your body’s own
immune system to fight the cancer.
Radiation Oncology
Columbia St. Mary’s radiation oncology program is accredited by the
American College of Radiology. They are one of only 12 such accredited
programs in the state.
Radiation oncology is the use of high-energy, penetrating waves or
particles such as X-rays or gamma rays, to destroy cancer cells and keep
them from reproducing. This treatment requires a radiation oncologist,
radiation therapist, dosimetrist and medical physicist to work together
to create and deliver a treatment plan customized to the size, location,
and specificity of each individual’s cancer.
Radiation treatment plans are created through the use of a specialized
Computerized Tomography (CT) scanner. This state-of-the-art method
creates a 3D image of your internal anatomy, allowing your cancer team
to pinpoint the location and size of your tumor as accurately and
precisely as possible. This is a critical first step in any breast
cancer treatment plan.
We offer the full spectrum of radiation therapy services and the most
advanced technology including: Stereotactic Body Radiation Therapy
(SBRT), the Trilogy™ Stereotactic System, conventional external beam
radiation treatments, radioactive implants (brachytherapy), Intensity
Modulated Radiation Therapy (IMRT), and more.
Partial Breast Irradiation
For years, radiation treatment of the whole breast has been the standard
treatment option – and it’s been successful in preventing breast cancer
recurrence. But at Columbia St. Mary’s, we also offer partial breast
irradiation. This treatment option achieves similar results in less time
and targets the tumor site and surrounding area with external beam
radiation or internal brachytherapy. In addition, targeted radiation
greatly reduces the exposure of healthy tissue to radiation.
Image-Guided Radiation Therapy (IGRT)
Imaging such as fluoroscopy, ultrasound or CT are utilized prior to
daily treatment. This gives the radiation oncologist real-time updates
of the tumor location and increases the accuracy of the treatment.
Stereotactic Radiosurgery (SRS)
SRS is a highly effective treatment option for smaller, well-defined
tumors. Using extremely accurate image-guided tumor targeting, SRS
delivers one or more high doses of radiation with minimal damage to
surrounding healthy tissue.
Intensity Modulated Radiation Therapy (IMRT)
IMRT utilizes hundreds of tiny radiation beams to deliver a single dose
of radiation. By using so many delivery devices, IMRT is able to
increase the radiation dose to the areas that need it and reduce
radiation exposure to specific sensitive areas of surrounding normal
tissue.
3D Modulated Radiation Therapy (3DMRT)
3D treatment is much like IMRT in that both treatment options utilize
highly-targeted radiation applications in order to reduce exposure of
healthy tissue. Previous radiation treatments have been able to match
the height and width of the targeted tumor, but 3D treatment allows us
to match the specific shape, further reducing damage to the surrounding
tissue.
Respiratory Gating
Tumors in the breast can often be difficult to target accurately with
radiation due to the movement caused by the patient’s breathing. In the
past, doctors were forced to broadly target the entire region, which
would invariably include healthy tissue. Now, however, respiratory
gating allows doctors to map the movement of the tumor and only deliver
radiation as the tumor passes through a precise, predetermined window.
This is particularly important for cancer of the left breast, where
excess radiation could affect the heart.
Surgical Oncology
Most women who have breast cancer will need to do undergo surgery as part of their treatment plan. Our team of board certified, dedicated surgeons are key members of the multidisciplinary team, working with the patients to decide the best method for removing cancer. They specialize in oncologic surgery and are highly skilled in breast surgical procedures, including: minimally invasive techniques, palliative surgery, and neo-adjuvant treatments as well as traditional methods.
Lumpectomy
In a lumpectomy, the entire tumor itself is removed (with minimal
healthy breast tissue). The goal is to remove all signs of cancer while
preserving as much of the breast as possible.
Mastectomy
A mastectomy is the surgical removal of some or all of the breast
tissue. There are several different types.
Partial Mastectomy: In a partial mastectomy, a portion of the
breast is removed – such as a quarter of the tissue as in a
quadrantectomy – in order to eliminate the cancer. The removal of some
of the chest muscles is sometimes necessary as well.
Skin-Sparing Mastectomy: For women who intend to have breast
reconstruction, a skin-sparing mastectomy is the best treatment option.
This procedure removes the breast tissue, nipple, areola and lymph node
but preserves the breast skin.
Simple Mastectomy (total mastectomy): This surgery entails
removal of the breast, nipple and areola but preserves the major chest
muscles and lymph nodes.
Modified Radical Mastectomy: This procedure entails the removal
of the breast, nipple, areola and axillary lymph nodes (in the
underarm), but leaves the major chest muscles intact.
Lymphadenectomy
If your cancer has spread to your lymph nodes (this occurs in about 40
percent of breast cancer patients), you will need to have them removed
as well. They can either be removed at the same time as your tumor or at
a later date.
Reconstruction
Breast reconstruction can either be done at the same time as your mastectomy or after your treatment is finished. Our plastic surgeon utilizes groundbreaking, innovative procedures for optimal cosmetic results. There are many options when it comes to breast reconstruction. Dr. John Yousif, plastic surgeon, can help you decide which option is best for you. Click here for Dr. Yousif's locations and contact information.