Treatment for DCIS (Ductal Carcinoma in Situ) & its Recovery, Prevention & Coping

DCIS (ductal carcinoma in situ) can be successfully treated and in most cases the tumor is removed surgically to avoid any chance of recurrence.

Some of the commonly used treatment procedures for DCIS (ductal carcinoma in situ) are:

• Simple mastectomy.
• Radiation therapy and lumpectomy.

There are some other treatment options like:

• Lumpectomy and use of drug tamoxifen.
• Lumpectomy only.

There are two types of surgical treatments available for treatment of DCIS (ductal carcinoma in situ). You have to choose between the breast-conserving surgery (lumpectomy) or breast-removing surgery (mastectomy).

• Lumpectomy for Treating DCIS (ductal carcinoma in situ): In this surgical treatment method for DCIS (ductal carcinoma in situ), the affected tissue of the breast is removed completely along with some part of the surrounding tissue. Usually with the amount of tissue removed one does not require breast reconstruction. It is one of the most popular treatment options and is followed by radiation therapy. However when compared to Mastectomy, the chances of recurrence is more with Lumpectomy while survival rate is same for both. However in case of older women in is better to go with lumpectomy alone, lumpectomy plus tamoxifen therapy, or no treatment at all.
• Treating DCIS (ductal carcinoma in situ) Using Mastectomy: This surgical treatment for DCIS (ductal carcinoma in situ) involves more than just the removal of affected breast tissue but areole and nipple too and even underarm lymph nodes in some cases. After the surgery, the shape of the breast can be restored with breast reconstruction if required. In the recent times this method has gained more popularity as it is equally effective.

Usually Lumpectomy is sufficient to treat DCIS (ductal carcinoma in situ), while mastectomy is used for following cases:

• If DCIS (ductal carcinoma in situ) is affecting a large area of the breast then lumpectomy is not sufficient to treat DCIS (ductal carcinoma in situ) completely and mastectomy may be required.
• If there are more than one areas of breast affected with DCIS (ductal carcinoma in situ) which is referred as multifocal or multi-centric disease then mastectomy is the more suitable option.
• If the abnormal cells of DCIS (ductal carcinoma in situ) are observed near the edge (margin) of the tissue specimen then it is a possible indication that the abnormality has spread across a larger area of the breast. Thus in such case lumpectomy is not sufficient to treat DCIS (ductal carcinoma in situ) and mastectomy is the only solution for removal of affected tissue.
• Lumpectomy is always followed by radiation therapy. However in few situations radiations may be harmful for the individual and thus in such cases mastectomy is the only solution. Such situation can arise if someone develops side effects like systemic lupus erythematosus on exposure to radiation or if DCIS (ductal carcinoma in situ) is diagnosed after first trimester of pregnancy.
• Also if the individual has a preference for mastectomy as compared to lumpectomy like if someone wants to avoid radiation.

Usually in the surgical treatment of DCIS (ductal carcinoma in situ), lymph nodes are not removed unless doctor feels that abnormal cells have spread beyond the breast and is affecting the lymph nodes.

Radiation Therapy involves exposing the breast to the high energy radiations like X-rays as they can kill abnormal cells and avoid the reoccurrence of the DCIS (ductal carcinoma in situ) after surgery. Usually external beam radiation therapy is used for the treatment of DCIS (ductal carcinoma in situ).

However radiation therapy is not always necessary especially in case of low grade DCIS (ductal carcinoma in situ). Low grade refers to a situation when only a small part of tissue is affected can be safely removed with lumpectomy.

Estrogen is a hormone that can boost the spreading of abnormal cells and promotes growth of tumor. Tamoxifen is a drug that suppresses the action of estrogen and is effective against hormone receptor positive cancers.

Tamoxifen does not work as a treatment for DCIS (ductal carcinoma in situ) but it can be used as a post therapy after surgical removal of the affected tissue of the breast to prevent reoccurrence of any cancer or spreading to other breast in future.

Usually the use of tamoxifen is not necessary in case of mastectomy as there is very little chance of recurrence of DCIS (ductal carcinoma in situ) in mastectomy. Moreover tamoxifen is only effective in avoiding DCIS (ductal carcinoma in situ) to affect other breast. Refer to your doctor to know about the advantages and disadvantages of use of tamoxifen in your case.

A follow-up care is usually required after the surgery for DCIS (ductal carcinoma in situ) and radiation therapy and then your doctor will prepare the right plan for you. In case of mastectomy followed by breast reconstruction, you would need to visit doctor regularly to let the doctor analyze your healing. If you are on some hormonal therapy like tamoxifen then it can continue for 5 years or so and during all that period your doctor would need to see you for monitoring the situation.

The duration and the frequency of follow-up care plan can vary from one individual to another. However the minimum follow up for DCIS (ductal carcinoma in situ) will include:

• A checkup and physical exam after every six months till 5 years and then after at an interval of 1 year as long as doctor recommends.
• A mammogram with a frequency of 1 year following the surgical treatment for the period as recommended by doctor.

The recovery period/ healing time is not fixed and can vary from one woman to another as there are many factors like type of treatment, level of abnormalities etc… that determines the recovery period for DCIS (ductal carcinoma in situ). Consult your doctor for the exact recovery time.

There is no exact way to prevent DCIS (ductal carcinoma in situ). Cancer is still a subject of lot of research and so far we have only found success in understanding what happens in any type of cancer but the root cause of cancer is not yet known. DCIS (ductal carcinoma in situ) is also one of the very early stages of the breasts cancer and as far as we do not know about the root cause, it is impossible to define any preventive measures.

As DCIS (ductal carcinoma in situ) or any other type of cancer occurs due to abnormalities in the cells, we can ensure that we stay healthy. The key to a good health is proper diet, good sleep and excising regularly. The diet must contain fresh vegetables and fruits to avoid any deficiency or disorder in the body. Also sleeping at right time is necessary to allow the body to relax and gather energy for the next working day. Exercising or physical activities also keep our body moving and away from the diseases such as DCIS (ductal carcinoma in situ). At the most we can do is to follow a healthy routine and diet unless we find exact prevention methods of DCIS (ductal carcinoma in situ).

It can be very disturbing as well as frightening for a woman to be diagnosed with DCIS (Ductal Carcinoma in Situ). However one can cope up with the situation. Here are some coping tips:

• One of the best ways to fight and cope with DCIS (ductal carcinoma in situ) is by understanding the disease so that you can take better care of yourself. Talk to your doctor about the disease and learn about your pathology tests. Try to gather information about DCIS (ductal carcinoma in situ) from authentic sources like National Cancer Institute so that you can fight your fears. In this way you will be in a much better condition to choose the right treatment.
• Try to find support from your friends and relatives and support groups for proper coping with DCIS (ductal carcinoma in situ). Do not cut off yourself as it will make things worse. Share your feelings, fears and anxiety with your close friends and family. You can also seek help from medical social worker or talk to a counselor. You can also find lot of strength by joining the support group where you can spend time with more women going through the same things and learn how to cope up with it.
• It is true there is not you can do much about your medical condition. But you can ensure that you take proper care of yourself both mentally and physically so that you stay away from any other health issues. Always include high nutritious food like fruits, whole grains and vegetables in your diet. Try to make a routine of exercising daily

Give yourself enough time to sleep to wake with lots of energy and freshness. Find ways to cope up with the stress.

So far there are no alternative treatments in the form of medicines are available for treatment of DCIS (ductal carcinoma in situ). However medicines are useful in coping up with the side effects of the surgery like anxiety. Women can feel anxiety when they are diagnosed with DCIS (ductal carcinoma in situ) as one straight away thinks that it will end their life soon. However it is not so and in fact anxiety makes it harder to lead a normal life including sleeping and other routine activities.

Following things are helpful in coping up with anxiety:

• Aromatherapy.
• Exercise.
• Massage.
• Yoga.
• Tai chi.
• Meditation.
• Techniques for relaxation like guided imagery.
• Music therapy.
• Hypnosis.

The prognosis or outlook for DCIS (ductal carcinoma in situ) is good. It is good to be diagnosed with DCIS (ductal carcinoma in situ) as it is the earliest stage of breast cancer and in this stage it is highly treatable. Thus on being diagnosed with DCIS (ductal carcinoma in situ), the treatment can be started immediately before it can cause complications or spread out further. Researchers are still trying to understand some of types of DCIS (ductal carcinoma in situ) that are very risky and can easily spread to other parts or may even recur in future after treatment. The best part is that it is completely treatable and the survival rate is almost 100%.

DCIS (ductal carcinoma in situ) is a type 0 breast cancer and thus it is actually one of the types of cancer. It is a complicated medical situation and cannot be treated at home. There are no medicines or home remedies that can be used for treatment. However the researchers are trying to understand the nature and cause of the cancer.

Once a woman is diagnosed with DCIS (ductal carcinoma in situ), a lot will change in the routine as you will be thinking about the diagnoses and cancer too often.

However, a life style changes can help you cope up with DCIS (ductal carcinoma in situ) both mentally and physically.

• Changing Your Diet is a good lifestyle change for DCIS (ductal carcinoma in situ): Some of the food items are recognized as being especially harmful for the body and can even promote the cancer cells. Since obesity features in the risk factors for breast cancer, it is necessary to avoid food items that are rich in high saturated fats. Some of the researches also suggest that consumption of meat can also promote DCIS (ductal carcinoma in situ) and thus it must be avoided.
• Exercise and Physical Activities can be a major lifestyle change for handling DCIS (ductal carcinoma in situ). It is necessary to exercise regularly are many research have shown that the risk of cancer can be reduced by 40% in case of woman who exercise in a routine way.
• Avoiding the Usage of Antibiotics is a suggested lifestyle change for DCIS (ductal carcinoma in situ). Antibiotics are often helpful in fighting against the foreign bodies and restricting their growth. Unfortunately it can also promote the growth of abnormal cells in body. Thus the use of antibiotics increases the risk of breast cancer or DCIS (ductal carcinoma in situ) in woman. It is recommended to try and avoid it as much as possible.
• Getting proper quality sleep is also a great way to avoid illnesses. Some of the studies have revealed that women who work in night shifts have a very high risk of developing DCIS (ductal carcinoma in situ) or breast cancer and in absence of proper sleep, the situation can get worse.
• Managing stress through various methods is a good lifestyle change for DCIS (ductal carcinoma in situ). It is normal to feel stressed once you are diagnosed with DCIS (ductal carcinoma in situ) but one needs to make necessary changes in lifestyle to fight stress as it can make it harder to deal with the treatment and medications. Also it can interfere with your sleep and other routine activities. To cope up with the stress, the best way is to talk about the condition with your family and friends. Go out and meet other people. Talk to your doctor about your condition. Take help of a counselor if required.

Also Read:

• DCIS (Ductal Carcinoma in Situ): Causes, Symptoms, Diagnosis, Complications