Breast cancer is the most common malignancy among women in Israel. But the survival rates here are among the highest in the world, thanks to the quality of early detection and treatment. 20 important facts to know about breast cancer care at Rambam.
1.Breast cancer is the most common form of cancer among Israeli women. Some 4,500 women are diagnosed with the disease annually. 2.The average age of diagnosis in Israel is 60, and has remained stable over the past several years. 3.About one quarter of Israeli women diagnosed with breast cancer are under age 50. 4.In light of advances in diagnosis and treatment, breast cancer survival rates in Israel are among the highest in the world. 90% of women diagnosed today will be alive 5 years after their diagnosis. 5.Rambam takes a multidisciplinary approach to treating breast cancer, starting with detection (mammography, ultrasound and MRI), biopsy and pathological testing to determine an optimal treatment plan, followed by surgical, radiation and other treatments according to the molecular characteristics of their tumor. 6.At Rambam’s Breast Cancer Unit (BCU), an interdisciplinary team of breast surgeons, imaging specialists, plastic surgeons, oncologists, radiation specialists, and geneticists devises the treatment strategy for each new patient. This may start with surgery, followed by chemotherapy and radiation treatments, or begin with chemotherapy and only afterwards surgery. 7.Upon admission to the BCU, new patients meet with the treating physicians for an explanation of their treatment plan, followed by a meeting with a coordinating nurse for further explanations on the course of treatment – how the drugs are administered and what to do at each stage. The coordinating nurse also provides emotional support, help with decision-making, explanations about treatment side effects, and setting appointments as necessary. 8.The BCU social workers meet with every new patient, providing emotional support as well as information about their eligibility for social benefits. The BCU also offers psychological care for whoever wants it. 9.The BCU is an active participant in dozens of leading clinical studies investigating advanced breast cancer treatments. Some involve treatment and others are observational. 10.The BCU clinical research coordinators consult with patients to help determine if they are eligible for clinical trials, with the opportunity to receive the most advanced treatments available. 11.During the early 2000s, several dozen patients at Rambam’s BCU took part in two groundbreaking clinical trials for Herceptin, a drug that targets cancer characterized by an overexpression of the HER2 receptor. They benefitted from its life-saving effects 5-6 years before its official release. 12.Biological drugs, alone or in combination with hormonal treatments, offer new promise for treating breast cancer. With relatively mild side-effects, biological drugs enable patients to maintain their quality of life while receiving this advanced treatment. The effects of hormonal treatments generally last for one year, but with the addition of biological drugs, this effective period can be doubled. And because biological drugs are administered orally, patients don’t need to make frequent hospital visits. 13.One of the most recent and innovative studies at the BCU is with a new controlled-release chemotherapy drug that affects only the tumor and its metastasized growths. The drug is encased in a material that only releases it at its tumor target, preventing the side effects normally associated with chemotherapy. 14.Another BCU study is testing drugs employing radium 223 in combination with hormonal treatments for patients with breast cancer that has spread to the bones. The drug targets the tumor itself, with few side effects. 15.Even for patients with triple negative breast cancer (estrogen, progesterone and HER2 receptor negative), there are new developments: Enzalutamide, an anti-androgen drug already used to treat prostate cancer, is now being investigated to determine its beneficial effects for this type of breast cancer. 16.Many triple negative tumors are found in women who carry the BRCA1 and BRCA2 mutation, which puts them at a higher risk of developing breast and ovarian cancer. New biological drugs that block the protein PARP are now available, and their effectiveness compared to chemotherapy is under study. 17.Another study is showing that patients with a low body mass index are much more likely to suffer from toxic effects of chemotherapy. The first stage of the study was performed in the US and it has now been expanded to Israel for women over 65. The study points to the benefit of increasing body mass through physical activity. 18.The BCU holds workshops for women recovering from breast cancer, with guidance on how to cope with side effects that occur after treatments, follow-up testing and to lifestyle recommendations after recovery.
Medical Consultant Dr. Georgeta Fried Director, Breast Unit Oncology Section Rambam Health Care Campus
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