Treatment

Treatment

Breast cancer treatment option is chosen based on its type, grade, stage, size and hormone sensitivity. Women mostly undergo surgery to remove breast cancer as well as chemotherapy, hormone therapy or radiation. 

Unlike in the past, innovative treatment processes are now available so patients with breast cancer have a survival rate of over 90% in the 5-year span. 

All treatment innovations presented here are available at Vejthani Hospital in Bangkok as we strive to offer the best cancer care to our clients.

Here are the things that make cancer care at Vejthani Hospital stand out from other institutes in the country. (hyperlink to why choose Vejthani page)

Breast cancer surgery

Surgeries performed to treat breast cancer:

• Lumpectomy. This surgery removes the breast cancer and some tissues surrounding it. Indicated for smaller tumor but if performed in a larger tumor, chemotherapy should be done prior to surgery to facilitate tumor shrinkage and remove it easily.
• Mastectomy.  The surgery removes all breast tissues.
• Sentinel node biopsy. The sentinel lymph nodes are removed in this procedure and sent to pathology for examination under a microscopic to check for cancer type. The sentinel lymph node is believed to be the first lymph node which breast tumor spread to. The procedure is done by injecting a dye to detect which lymph node to remove. Once laboratory test results to cancer-free lymph nodes, there is no need to remove other lymph nodes.
• Axillary lymph node dissection. If sentinel lymph node biopsy results positive for cancer, the surgeon will recommend removing all or most of the underarm lymph nodes group.
• Contralateral prophylactic mastectomy or removing both breasts. If there is a strong family history of breast cancer, some women will opt to remove the breast with cancer as well as the other breast that is healthy. Although, some may not develop cancer on the healthy breast, it would be best to consult your doctor for best recommendations.
• Breast reconstruction is also possible after breast cancer surgery and you may be referred to a plastic surgeon to discuss your options.

Radiation therapy

This is the use of high-energy rays or particles to treat the disease. It is done by killing tumor cells or inhibiting their growth and duplication. Years of study by radiation oncologists have led to the widespread use of effective, tolerable doses of radiation. It may be used in more advanced breast cancer to control the disease or to treat symptoms such as pain. 

Chemotherapy

The use of specific drugs to kill cancer cells. This medication usually administered orally or intravenously. Chemotherapy enters the bloodstream and travels throughout the body. The treatment is most commonly used to decrease risk of recurrent tumor after surgery, shrink breast cancer after surgery when the tumor is large or inflamed, and control metastatic breast cancer which has spread to other organs in the body.

Hormone therapy

The change of hormonal environment in your body, impacts the growth and behavior of some breast cancers. If your breast cancer produces one of the hormone receptors estrogen receptor (ER) or progesterone receptor (PR) then hormonal therapy is effective in treating early-stage, metastatic or advanced breast cancer and help preventing a recurrence.

Targeted therapy drugs

Targeted Therapy is a medication for cancer that has been developed to be exceptionally precise. Meaning, it will specifically target cells that have a mutated receptor or targets the receptor that has the primary mechanism of developing cancer. This leads to obtaining a good result of the treatment and a positive response to medications.

Doctors may recommend this treatment if the breast cancer has metastasized to other locations of the body. Targeted therapy medications include monoclonal antibodies, antibody-drug conjugates and kinase inhibitors.

Treating Cancer under the Concept of Precision Medicine

Precision medicine is a more targeted approach to cancer treatment, and the concept takes patients’ data into account as much as possible. One of the causing factors of breast cancer is genetic mutations and mutations in different genes can have implications for cancer treatment. Genetic mutations can vary between individuals, and certain mutations may make cancer cells respond to specific treatments. Understanding the genetic profile of a person’s cancer can help determine suitable treatment options and optimize the effectiveness of the drugs. This is where Vejthani incorporates the use of Cancer Avatar or Cancer Organoid.  

Cancer Avatar or Cancer organoid involves the collection of cancer tissues from the patient, which are then cultured in the laboratory to cultivate cells that closely resemble the cancer cells present in the patient’s body. These cultivated cancer cells serve as an accurate representation of the patient’s cancer. Subsequently, these representative cancer cells are tested with various types of cancer treatments to assess their response before administering a specific treatment to the patient. 

Generally, the gene mutations that occur in breast cancer are BRCA1 and BRCA2. Doctors also test if the cancer has a positive receptor to HER2. The treatments are then administered based on the type of gene mutations. To achieve the most effective treatment outcome, it is essential to run complete genetic testing. Although only two genes tend to mutate, 30 genes have the possibility for mutations in breast cancer. With limited genomic profile information, it could be challenging to select the best treatment for the patient. In that case, trying all different kinds of drugs on the patient to see which has the best responsiveness would be an experiment and leads to multiple side effects. Therefore, cancer research has invented a revolutionary course of treatment for cancer known as Cancer Avatar or Cancer Organoid. It plays a significant role in selecting the most effective treatment for breast cancer.  

Immunotherapy

Immunotherapy is a type of cancer treatment that relies on the function of the patient’s immune system. Typically, the immune system keeps monitoring and destroying all of the foreign substances, such as germs or cancer cells. However, it cannot detect cancer cells sometimes. Immunotherapy helps to boost the effectiveness of the immune system to detect and fight against the cancer. Nevertheless, the oncologist will choose and plan the proper treatment that will suit with individual patient, depending on the type and stage of the cancer, as well as the patient’s overall health conditions.

Immunotherapy uses checkpoint inhibitors to target specific proteins called checkpoints that regulate the immune system’s response to prevent overactivity and maintain self-tolerance. These checkpoint proteins, such as PD-1 (programmed cell death protein 1) and CTLA-4 (cytotoxic T-lymphocyte-associated protein 4), can sometimes be exploited by cancer cells to evade the immune system.

Checkpoint inhibitors block the interactions between these checkpoint proteins and their corresponding receptors on immune cells, allowing the immune system to recognize and attack cancer cells more effectively. By releasing the brakes on the immune system, checkpoint inhibitors help unleash a stronger immune response against cancer, leading to improved outcomes for some patients. They have shown promising results in the treatment of various cancers, including melanoma, lung cancer, bladder cancer, and many others.

Cancer treatment At Vejthani Hopsital is adminstered under the concept of Precision Medicine, we use the messenger RNA (mRNA) technology to produce personalized cancer vaccines to enhance the treatment outcomes. Messenger RNA (mRNA) technology has shown great promise in the field of personalized cancer vaccines. The use of mRNA for cancer treatment involves creating a vaccine that is tailored to an individual patient’s specific tumor.

It’s important to note that while mRNA-based cancer vaccines show promise, they are still in the early stages of development and research. Clinical trials are ongoing to evaluate their safety and efficacy in different types of cancer.