Question

Ms. Smith will be receiving chemotherapy for advanced breast cancer. She is 75 years old and
resides in a long-term care facility. Her treatment plan will include the use of the hormone
goserelin (Zoladex) and capecitabine (Xeloda), which is an antimetabolite.
a. What special monitoring might Ms. Smith require during her treatment?
b. What adjustments to Ms. Smith’s living arrangements might be required?

Answer 1

1) In the prior review, we outlined the current standard of care for monitoring treatment responses in breast cancer and discussed the many challenges associated with these strategies. We described the challenges faced in common clinical settings such as the adjuvant setting, neoadjuvant setting, and the metastatic setting. In this review, we will expand upon future directions meant to overcome several of these current challenges. We will also explore several new and promising methods under investigation to enhance how we monitor treatment responses in breast cancer. Furthermore, we will highlight several new technologies and techniques for monitoring breast cancer treatment in the adjuvant, neoadjuvant and metastatic setting.A number of modalities are used to monitor treatment response in breast cancer patients treated in the adjuvant, neoadjuvant and metastatic clinical setting. In the previous review, we outlined the current standard of care for monitoring treatment responses in breast cancer and noted many challenges associated with the current monitoring capabilities. In this review, we discuss several exciting and promising new methods under investigation to improve how we follow response in breast cancer. As previously discussed, the prevalence of breast cancer in the United States is nearly three million 1. Even more concerning is that in younger women (ages 25-39) there seems to be an increase in the incidence of distant metastatic disease at initial diagnosis 2. For most patients with metastatic disease, this represents an incurable illness and poses several challenges for providers as we balance the toxicities of treatment with helping to provide improved quality of life and overall survival. Part of providing breast cancer patients with the best quality of life is to ensure safe, inexpensive, non-invasive and accurate testing for the monitoring of treatment progress. In this review, we explore new technologies and techniques for the monitoring of breast cancer treatment in the adjuvant, neoadjuvant and metastatic setting.Axillary lymph node status serves as an important prognostic indicator in the staging of breast cancer patients.Breast exam. Your doctor will check both of your breasts and lymph nodes in your armpit, feeling for any lumps or other abnormalities.Mammogram. A mammogram is an X-ray of the breast.Breast ultrasound.Removing a sample of breastcells for testing (biopsy).Breast magnetic resonance imaging (MRI).

2)Family support and bonding.Source of money for treatment–Patients were sub-categorized into groups based on the level of difficulty as outlined below: None; costs covered by insurance,Mild; when treatment costs were met from their savings,Moderate; when funds were raised by mortgaging gold ornaments or land or selling such assets,Severe; when only personal high-interest (>36% p.a.) loans were the source; or they were not able to find the money and discontinued therapy.Decision making for the treatment (self, husband, son, daughter and others).Concern regarding the women's role and responsibilities affection toward children-schooling, employment and marriage, the health of the spouse and dependent parents.Social embarrassment.Prioritizing their personal health.Support by the family in life after cancer.