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Healthcare Delivery

HER2 Breast Cancer and how to handle the diagnosis and treatment

Breast cancer is one of the most common cancers affecting women, but did you know that there are various types of breast cancers. One such type is HER2-positive breast cancer, in which the breast cancer cells have more HER2 receptors (a particular protein found on the surface of cells) than normal breast cells.

About 1 of every 5 breast cancers is detected to be HER2-positive breast cancer. HER2-positive breast cancer is considered aggressive because it grows and spreads quickly.

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Knowing as much as you can about your breast cancer type helps you best work with your doctor/physician/oncologist to optimize treatment. HER2 status testing is done on a biopsy sample taken from the tumour. There are two ways to test HER2 status: Immunohistochemistry (IHC) that measures the amount of HER2 protein in the cancer cells and Fluorescence in situ hybridization (FISH) that looks at the number of copies of the HER2 gene in the cancer cells. The FISH test helps confirm the diagnosis and guide treatment.

 

The type of breast cancer is important to guide your doctor to plan appropriate cancer treatment. Treatment for HER2-positive cancer tends to be less responsive to hormonal treatment. This could be because HER2-positive breast cancer tends to be more aggressive than other types of breast cancer. However, treatments that specifically target HER2 are effective. Drugs that specifically block HER2 to stop the growth of cancer cells are called HER2-targeted therapies. Examples of these drugs include trastuzumab, lapatinib, pertuzumab, and ado-trastuzumab emtansine.

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When educating yourself about HER2-positive breast cancer, explore online resources and patient related information. Experienced survivors can provide both information and support. Be sure your oncologist is also knowledgeable and up-to date on research developments, and don’t be afraid to seek a second opinion.

 

 

 

Iamher2.com is a one-of-a-kind initiative from Sorento Healthcare Communications Pvt Ltd, to provide support to HER2 positive breast cancer patients. The initiative is a completely unbiased support service which will help HER2 positive breast cancer patients and their caregivers to get encouraged in opting for the right treatment for their condition. IamHER2 helps patients with an ecosystem of resources to facilitate expert opinion, affordable testing, counselling, chat with other survivors, and treatment along with all the other ancillary services required like counselling, nutrition, psychological support etc.

About the author

rasika

Dr Rasika Bhat

Dr Bhat is Senior Manager – Medical communication solutions heads a team of medical content writers and editors and responsible for developing medical communication strategy and knowledge initiatives for continuous medical education. She has about 10 years of experience in clinical practice and medical communications. She has been associated with social initiatives namely iamHER2 (for HER2 positive patients) and pollution smokers (air pollution and lung cancer)

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Healthcare Delivery Public Health

5 tips to manage constipation due to breast cancer chemotherapy

Chemotherapy is one of the treatment options that offer hope to many women with breast cancer. But it can also cause some unwanted side effects ranging from hair loss and constipation, to more serious complications. Accepting a diagnosis of breast cancer is difficult enough, and to add to that, the side effects related to its treatment can sometimes further demotivate patients.

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Healthcare Delivery Public Health

How can we tackle the issue of Breast cancer in India ?

 

In my last post I wrote about the looming challenge that breast cancer poses for the Indian women. If you have not read that piece please click here for the link.

To find answers to these questions i started looking at the various components of the Healthcare ecosystem to see what they were doing to tackle the issue.

As always I start with the Government.

The Government in India has achieved several significant milestones in the healthcare space. They eradicated small pox in the 70’s and finally eradicated polio recently. Currently the Govt is on a war footing to tackle Measles. But when it comes to breast cancer the government has done little. With around 130,000 cases per year the number is far lower than the ones from other diseases like Tuberculosis and hence the general lack of interest in that area.

Most of the Government efforts have gone around providing diagnostic equipment and helping set up radiotherapy centers. India today has 300 full fledged radiotherapy centers. While the WHO guidance is to have one center per  million people. In addition the state governments do run campaigns and have one off events. There has been a lot of talk on the Public – Private partnerships, but nothing has come out of it. Currently certain state governments have been more active. One such example is Punjab which has shown more interest in cancer detection.

The Healthcare Insurance industry in India has not been active in this area either. With many corporate programs, the Insurance firms have a great opportunity to create products just for women but till now there has been nothing concrete that has been done.

But the Medical Devices industry has been active and are on the fore front of the work against breast cancer.

According to Rekha R the marketing manager for Oncology, Philips Healthcare, medical devices firms have been active in this area. The Philips Healthcare strategy is based on three key fronts.  On the first leg they have the Philips Innovation Center (PIC) that works on technology to reduce the exposure to radiotherapy. As the only way to detect the condition is to use self examination followed by a mammogram, the PIC tends to work with technology like Microdose Mammography. In pursuit of this facet Philips acquired the Swedish firm Sectra that has the technology to reduce scatter and reduce the scan time.

The second pillar rests on generating this awareness among general practitioners and other specialists. They are made aware that there is technology can reduce risk which scanning for cancer and they should recommend patients to be aware of the technology available for preventive screening.

The third pillar is around educating women. In the end self examination is the first step and there is no way that any steps can be taken against breast cancer without the women becoming aware of the self examination methods and their need to do the same.

Also Philips invests a lot of effort in continuing medical education for  doctors and also hold technical webinars for them. there are also programs called ‘Catch them young ‘ which trains freshly graduated doctors.

In the next issue of this series I will talk about a unique program called Asha Jyoti and also reflect on the work done by the Pharmaceutical sector in this area.

 

As always comments and suggestions are welcome.

 

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Healthcare Delivery Public Health

Why breast cancer could be a big looming challenge for India ?

Cancer.

The very word strikes terror in the hearts of patients and physicians alike.

But often we consider cancer as a problem of the west and one that does not really affect India. Except for tobacco related cancer, there is hardly any public outreach program either from the Government or the private health sector.

India has almost 3-4 million cancer patients. The number could be much higher as the detection mechanisms in India are almost not present. 70% of these cancer patients come in at stage 3 or 4 where the prognosis is very bad.  Almost a million cancer are detected annually and the number of cancer patients in India could be around 7 million in the next couple of years.

Women though less prone to tobacco related cancer are more prone to Cervical and breast cancer. These two types account for almost 80 % of cancers in women. Every year almost 130,000 cases of breast cancer are detected in India and according to the Indian Medical Association the situation will get worse.

Rural women are more affected as the cancer is detected at a much later stage. The increase in awareness and education has also resulted in the rise of the cases from 54,000 ten years ago to 130,000 today. Almost 30,000 women would die due the breast cancer every year, which is a sad statistic as breast cancer is not terminal. If detected at early stages can be dealt with effectively. Incidentally October was breast cancer awareness month and a series of events were held in India to take stock of the situation. Overall there were some key reasons why the situation was getting worse in India.

Some of the reasons for increase in the cases detected include

1) Awareness and education

2) Late marriages and pregnancies

3) Use of contraceptives

4) Hormonal imbalances

5) Stress and change in life style

 

Not surprisingly Bangalore has emerged as the breast cancer capital of India. Bangalore has an incidence of 36.6 per lakh cases. Thiruvanathapuram and Chennai follow closely and these figures are also an indication of higher awareness in these cities.

The real challenge is to get women to take charge of their lives and get serious about screening. High risk categories are advised to undergo screening once every 2 years especially after the age of 38. Those in high risk include women who have an incidence of breast cancer in their family.

A good example in news was the extreme step taken by actress Angelina Jolie who got her breasts removed once she realized that she was in the high risk category. Her mother it seems had been diagnosed with breast cancer and she had a 80 % chance of developing the condition herself.

So what can we do as a nation?

In the next part of this series I will discuss what can the various parts of the healthcare ecosystem do to combat breast cancer in India.

As always views, suggestions and comments are welcome.