Medical Oncology is the specialty group who advises and looks after women who require some form of adjuvant systemic therapy (drug treatment) after surgery, or before surgery in the setting of neo adjuvant therapy.
There are many different types of breast cancer and depending on what particular type you have, Professor Richard Kefford will make recommendations during the MDT meeting as to what type of adjuvant treatment you might need. The common things that will be discussed or recommended are either chemotherapy and/or so called targeted therapies, which are medications that act specifically against certain specific targets in cancer cells. Your tumour will be tested to find out what the most effective treatment for you. Chemotherapy uses drug treatment to kill any cancer cells that may have already escaped out of the breast prior to the cancer being removed. Most of the time it is not possible to know precisely whether or not this has happened, so the recommendation to use chemotherapy or not is based on results from large trials of patients who have undergone similar treatments in combination with Professor Kefford’s vast experience. Professor Kefford will explain to you the pros and cons for your particular setting as well as the combination of drugs being used, any side-effects associated with them and their duration. He is able to offer treatment at several private chemotherapy suites as well as at Westmead public hospital. There have been enormous advances in delivery of chemotherapy recently which means that for the majority of women, the side effects from chemotherapy can be well managed. Jemma Gilchrist is an experienced oncology nurse who works closely with Professor Kefford and will be able to guide you through this difficult time. Some patients will be recommended to have some form of targeted therapy, most commonly endocrine therapy (also called anti oestrogen therapy) instead of, or in addition to chemotherapy. Broadly speaking these are well-tolerated medications but for some women there can be some ongoing side effects that need to be managed. Professor Kefford will be able to advise you on how to deal with these side effects. There are a number of different tablets on the market, all which offer very similar outcomes from a breast cancer survival perspective, but each has a unique set of side effects. Sometimes it might take a trial of a few different agents to work out which drug has the least side effects for an individual.