What is Chemo Brain?

The revelations about Angelina Jolie undergoing preventative mastectomies, has stirred up a great deal of interest in the whole are of breast cancer, its diagnosis and treatment and all of the things that are related to it. This brings up a very important issue and that is the issue that should all women with breast cancer be treated the same way. In effect then, does one size fit all? And the answer is no, one size does not fit all. We've really come a long way in personalizing breast cancer care in the United States and around the world, and one of the things that's helped us lead the way in this kind of personalized care are the kind of genomic tools that we have now to look at the genes of the actual breast cancer. Oncotype DX is one of those genomic tools that can be used to help understand more information about the tumor biology of the individual cancer and then to tailor the treatment to each individual patient. I've shared here before at Breast Cancer Answers, that breast cancer is a galaxy of diseases from very benign acting cancers to very aggressive cancers. A genomic tool like Oncotype DX gives us an opportunity to analyze the estrogen receptor positive breast cancers in premenopausal women and the estrogen receptor positive breast cancers in post menopausal women who may have up to one to three positive lymph nodes. In addition, a newer form of the Oncotype DX is now available for us to analyze women who have in situ breast cancer, which is the earliest type of breast cancer. Oncotype DX test for invasive breast cancers, helps us understand a couple key things. One is how aggressive is the cancer, and what are the odds that the cancer will come back over the next ten years, and that's where the recurrence score is very important. It will give us a very scientifically based estimate of the odds of the cancer coming back over the next ten years. The recurrence scores are in three categories: low risk, intermediate risk, and high risk, and as the risk goes from low to intermediate to high, then the odds of the cancer coming back over the next ten years naturally increases some. The other thing that the Oncotype DX test for invasive cancers does is it also then gives us a handle or estimate on whether someone needs chemo or not. Women who score in the low risk area of recurrence score will not benefit from chemotherapy and don't need chemotherapy. Women on the other hand who are in the high risk category, clearly do benefit from chemotherapy and one of the beauties of the Oncotype DX test is it really supports the recommendations for adjuvant chemotherapy as well as naturally needing anti-estrogen medications. Women who score in the intermediate risk with invasive cancers with a recurrence score, the individual therapy then is tailor made based on variety of other circumstances. Really exciting recently now is the newer version of the Oncotype DX, which can look at in situ breast cancer. What the validation study from utilizing this new test has shown us is that roughly 70 percent of women with in situ breast cancer actually score in the low risk category of having a recurrence in the breast, and therefore in many circumstances, may be able to avoid needing radiation therapy. So this a wonderful era that we're in right now. Genomic tools are really important in this era. No matter what your situation is, if you're newly diagnosed, or you have friends or relatives who are newly diagnosed, you really need to find out if a genomic tool like Oncotype DX is indicated in their case. The questions should be asked of the physicians providing care. The bottom line here is to empower patients to empower their family so we can end up with more tailored therapy, hopefully then less aggressive therapy. And remember please one size does not fit all.