Breast Cancer Treatment and Therapy Choices

Joan Lunden’s recent battle with Stage II, triple-negative breast cancer has been an eye opener for women the world over. I am grateful to her for discussing her trials and tribulations and getting the conversation going. One aspect of her ordeal that can be discussed in detail is her treatment choices, different methods used and the timing.

Mrs. Lunden’s cancer is not only one of the aggressive varieties that responds to chemotherapy (chemo), but also needs surgical removal of the primary tumor from the breast.

Under most circumstances, this would mean that the patient undergoes surgery first to take out the primary tumor, followed by chemotherapy. This method has a solid track record and the patients have shown excellent results.

There are two major disadvantages to this:

1. Surgical wounds heal slowly and  scar badly when the patient undergoes chemo shortly after surgery
2. Depending on the tumor size and position, the surgery could leave the entire breast disfigured. The tissues get badly scarred, making the reconstruction of the breast difficult or impossible after chemotherapy

We have come across a lot of celebrities in popular culture who have opted for mastectomies (removal of the breast) and even double mastectomies (removal of both breasts) to deal with their cancer. This is a brave and very safe way of dealing with the issue. But there are many women who want to keep their breast and their figure, in spite of the cancer.

Joan Lunden is one such woman.

The doctors who helped her in managing her condition, like Dr. Ruth Oratz from New York University, gave her the option of chemo first and surgery later.

The idea was to flood the entire body and the big primary tumor with the killer chemo drugs first, so that they shrink the cancer quickly; no scars to worry about and no issues with wound healing.

After a few rounds of this kind of chemo, a very minimalistic surgery can be done to remove the tumor. Overall, the cosmetic results should be much better without risking Mrs. Lunden’s life.

This kind of ‘out of the box’ thinking is the reason why one seeks the experience of specialized oncologists and surgical oncologists. They know when to follow the beaten path and when to ignore it. If, God forbid, any of you have to deal with cancer in general or Mrs. Lunden’s particular brand of it, find an oncologist you are comfortable with and discuss all your treatment possibilities in detail. Make sure you know and understand what you are getting into and what the possible outcomes are.

Joan Lunden’s fight for herself and her family's health is a high profile example of a problem that affects millions of women each day, year round. The problem of breast cancer is also increasing in developing countries quite rapidly. It is heartening to see high profile people discuss such extremely personal issues with the public so that they can raise awareness. We wish Mrs. Lunden and her family the very best in their fight against breast cancer.