Oct 28, 2008 9:42 am US/Eastern
HealthWatch: The Truth About Chemotherapy
NEW YORK (CBS) ―
During this Breast Cancer Awareness Month, CBS 2 HD wants to tell its viewers about something that can help women with one of the most difficult treatment decisions they'll have to face.
Dr. Max Gomez has some information on whether or not to undergo chemotherapy after surgery.
It's a genetic test. But not for the breast cancer genes you may have heard about. Rather it looks at a whole series of genes in the tumor itself to help predict the likelihood that a cancer will come back and how much of a difference chemotherapy would make.
Dr. Gomez tells you what you need to know:
You'd never know it looking at her but Elizabeth Belson is a breast cancer survivor. She was diagnosed after her first mammogram at just 40-years-old.
"When I did get the final news, I let out a big cry," said Belson.
Her initial treatment options were pretty clear cut; a lumpectomy, followed by radiation. But now she had to make a really tough choice, whether also having chemotherapy would lower her risk of recurrence enough to warrant the side effects.
"Toxicity, possibility of going into menopause, again depending on which formula I would've taken," said Belson.
Fortunately Elizabeth had help in making her decision. It's a test called Oncotype-Dx that actually takes her own tumor and analyzes it for activity of 21 genes. The result gives the breast cancer patient a range for her personalized risk that her cancer may come back.
"It can separate the patient's tumor out into three categories. Low risk, high risk and broad intermediate category," said Dr. Stephen Malamud of Beth Israel Cancer Center.
Elizabeth found herself on the low end of the intermediate range, with a lifetime risk for recurrence of about 13 percent. Other studies have shown that adding chemo to her treatment wouldn't improve her chances all that much.
"With aggressive chemotherapy one would be able to push that down to about 8-10 percent. And is that incremental improvement of 4-5 percent over 10 years. Could it be worth the investment?" said Dr. Malamud.
On the other hand, women in a high risk category could substantially reduce their risk, while those in the low risk group would benefit little. Elizabeth decided that dropping just a few percentage points would be her best decision.
"After heavy consideration it didn't warrant those few percentage points less. It didn't warrant my doing the chemotherapy," she said.
The Oncotype-Dx test is applicable to women like Elizabeth, whose lymph nodes were clear and her tumor estrogen receptor positive, which means the cancer was being fueled by the female hormone. Those are the women who have the toughest choice about whether or not to have chemotherapy.
(© MMIX, CBS Broadcasting Inc. All Rights Reserved.)
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