Non-Small Cell Lung Cancer
Pancreatic Cancer
Metastatic Breast Cancer
Ovarian Cancer
About GEMZAR
Resources
Important Safety Information
Prescribing Information
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Diagnosis and Staging

"Diagnosis" is what your healthcare team does to recognize whether or not you have metastatic breast cancer, based on its outward signs and symptoms. "Staging" is a description of how far the cancer has spread, described as stages I through IV.

Both the diagnosis and staging of metastatic breast cancer is a multistep process that is required in order for you and your healthcare team to make decisions about treatment.

Diagnostic Tests
Staging
Your Healthcare Team
Treatment Options

Diagnostic Tests
Getting tested regularly for breast cancer improves your chances for early detection. The screening tests described below can help find cancer early:

  • Breast self exam
    A technique that can aid in the detection of early tumors, particularly those that might develop between annual mammograms and clinical breast exams. Monthly self-exams help you become familiar with how your breasts normally look and feel. This can help you recognize changes, such as thickening, lumps, spontaneous nipple discharge, dimpling, or puckering.1

    Don't be overly worried if you think you feel a lump. Breast tissue naturally has a lumpy texture, and this lumpiness is more noticeable in some people than in others. If you feel the lumpiness throughout your breast, it is probably just the normal breast tissue and not something to be concerned about. If, however, you discover a new lump that feels different from the rest of your breast — one that is firmer or different from what you have felt before — you should have it checked by your healthcare team.1
  • Clinical breast exam
    A physical examination done by physicians, nurse practitioners, and other trained medical staff, who check the appearance and feel of the breasts and underarm for changes.

    The American Cancer Society recommends that women in their 20s and 30s should have a clinical breast exam as part of a routine health exam at least once every three years. Women over the age of 40 should have a yearly clinical breast exam.1
  • Mammogram
    Uses x-rays to create an image of the breast, and may detect tumors that can't be felt. A mammogram is generally considered to be the best screening method available. It can detect a tumor in an early stage, when it can be most effectively treated.

    Yearly mammograms are recommended for women 40 years and older.1
  • Ultrasound
    Uses high-frequency sound waves to produce images on a viewing screen. Ultrasound is the best way to find out if something discovered through a physical exam or mammography is solid (a "benign fibroadenoma") or fluid-filled (a "benign cyst"). An ultrasound does not, however, indicate whether a solid lump is cancerous.2

Additional Tests
Having a breast lump or an abnormal area show up on a mammogram is not unusual. When one is detected, additional testing is then necessary to make sure that the lump or abnormal area is not cancerous. Often, cancer can be ruled out with additional mammograms or other imaging techniques, such as ultrasound.2

Only about 1 in 5 American women who have biopsies are diagnosed with cancer.2

If cancer can't be ruled out, you will need to have a biopsy to remove and examine cells or tissue from the breast.2 The idea of having a biopsy can be frightening, but it is important to remember that most women who get biopsies don't have breast cancer. Nevertheless, biopsies are important because if cancer is detected, you can be treated right away.

If your healthcare team determines that you have breast cancer, you may have additional tests to see if it has spread to other parts of your body. Some of these tests include:

  • Chest x-ray
    Usually is the first test performed to detect breast cancer. An x-ray is a two-dimensional picture that can help locate a tumor in the breast.
  • CT and MRI scans
    These tests are conducted by two different machines that show three-dimensional images of your body. Computerized tomography (also called "CT") and magnetic resonance imaging ("MRI") images, or "scans," produce highly detailed pictures that are like slices of your body. These can help determine the size, shape, and location of a cancerous tumor.

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Staging
When a diagnosis of cancer is made, the cancer is classified into a particular "stage." This indicates how far the cancer has progressed, and is an important tool in choosing the best treatment. The stage of a cancer is determined by examinations and tests on the tumor, lymph nodes, and organs.

The breast cancer stage is one of the most important factors in making an outlook ("prognosis") of your recovery, of the chance of the cancer coming back, or of it spreading to other organs. The earlier the stage is at diagnosis, the better the prognosis is for getting rid of the cancer.

The following table summarizes the four main stages of breast cancer and the 5-year survival rate for each stage:

Stages of Breast Cancer

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Your Healthcare Team
Metastatic breast cancer is a serious disease that is usually treated by a team of healthcare professionals with different specialties. Members of a healthcare team might include a surgeon, radiation oncologist, medical oncologist, radiologist, pathologist, oncology nurse, and social worker, among others. Not everyone with metastatic breast cancer should receive the same treatment. Your particular medical situation will determine the type of treatment you receive.

Each person's journey with cancer is different. Your own experience will depend on the stage of the cancer and other factors such as your general state of health and your treatment goals. You should talk openly with your healthcare team about your cancer stage and prognosis, and how they affect your treatment options.

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Treatment Options
There are two broad categories of breast cancer treatment.

  • Local therapy
    Treats only a local area, including the breast and lymph nodes around the breast, and involves techniques such as surgery and radiation.4
  • Systemic therapy
    Goes beyond a local region to treat the whole body or system, and includes chemotherapy and hormone therapy.4
    • "Neoadjuvant therapy" is given before surgery, and is designed to shrink a large tumor enough to make surgical removal easier and make breast-saving surgery possible.4
    • "Adjuvant therapy" is given after surgery, and is used to kill any remaining undetected cancer cells and prevent the cancer from coming back.4

Because every situation is unique, treatment options may vary. However, treatment of metastatic breast cancer generally involves a systemic therapy such as chemotherapy or hormone therapy. Other treatment options may include additional surgery, radiation, or the use of other drugs that may provide symptom relief. The therapy you receive to fight your disease depends on your physical condition, progression of the disease, options available to you, and your own choice.

Women diagnosed with metastatic breast cancer generally receive therapy with a treatment regimen of chemotherapy.

Chemotherapy
Chemotherapy is any treatment involving the use of drugs to kill cancer cells. Cancer chemotherapy may consist of single drugs or combinations of drugs. It can be given through a vein, injected into a body cavity, or delivered orally in the form of a pill. Chemotherapy is different from surgery in that the cancer-fighting drugs circulate in the blood to parts of the body where the cancer may have spread; it can kill or eliminate cancer cells at sites far from the original cancer.5

The initial treatment of metastatic breast cancer is called "first-line" therapy. If the cancer continues to grow with first-line therapy or returns after first-line therapy, additional treatment, called "second-line" therapy, may be given. If the tumor continues to grow after second-line therapy, the next therapy is called third-line therapy, and so on.

Clinical trials have been performed and reviewed by the FDA on each of these options to determine their effectiveness and safety. As you and your healthcare team consider options for cancer treatment, it is important to carefully consider the results of clinical trials and the side effects of all available therapies.

GEMZAR is used in combination with the chemotherapy drug paclitaxel to treat the metastatic form of breast cancer.

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Let's explore how GEMZAR can help.

References:

  1. American Cancer Society. How Is Breast Cancer Found? Available at:
    http://www.cancer.org/docroot/CRI/content/….
    Accessed March 4, 2008.
  2. American Cancer Society. If Breast Cancer Is Suspected. Available at:
    http://www.cancer.org/docroot/CRI/content/….
    Accessed March 4. 2008.
  3. American Cancer Society. How Is Breast Cancer Staged? Available at:
    http://www.cancer.org/docroot/CRI/content/….
    Accessed March 3, 2008.
  4. American Cancer Society. How Is Breast Cancer Treated. Available at:
    http://www.cancer.org/docroot/CRI/content/….
    Accessed March 4, 2008.
  5. American Cancer Society. Chemotherapy. Available at:
    http://www.cancer.org/docroot/CRI/content/….
    Accessed April 14, 2008.


About GEMZAR

GEMZAR is indicated in combination with cisplatin (another type of chemotherapy) for the first-line treatment of patients with locally advanced (stage IIIA or stage IIIB) or metastatic (stage IV or cancer that has spread) non-small cell lung cancer for whom surgery is not possible.

GEMZAR is indicated in combination with carboplatin (another type of chemotherapy) for the woman with ovarian cancer that has returned at least 6 months after the patient had finished platinum-based therapy.

GEMZAR in combination with paclitaxel is approved by the FDA for the first-line treatment of patients with metastatic breast cancer after they have received another type of chemotherapy called an anthracycline, unless their medical condition did not allow them to receive an anthracycline.

GEMZAR is indicated as a single agent (given alone) as the first-line treatment for patients with locally advanced (stage II or stage III when surgery is not an option) or metastatic (stage IV) adenocarcinoma of the pancreas. GEMZAR is also indicated for patients previously treated with 5-FU (another type of chemotherapy).

Important Safety Information

GEMZAR may not be appropriate for some patients.

If you are allergic to GEMZAR, tell your doctor you should not receive it. GEMZAR can suppress bone marrow function. There have been rare reports of serious kidney or liver toxicity with GEMZAR treatment, sometimes fatal. Serious lung toxicity has also been reported, sometimes fatal. If you think you are pregnant, are planning to be pregnant, or are nursing, please tell your healthcare team. GEMZAR may harm your unborn or nursing baby.

If you have had prior kidney or liver problems or impairment, please tell your healthcare professional. GEMZAR may not be right for you. GEMZAR has not been shown to work in children. Tell your doctor if you are taking other medicines, including prescription and nonprescription medicines, vitamins, or herbal supplements.

There is a risk of side effects associated with GEMZAR therapy. The most common side effects are low blood cell counts (red blood cells, white blood cells, and platelets); fever; infection; hair loss; tiredness; nausea, vomiting, constipation, and diarrhea; rash; shortness of breath; muscle aches; and numbness or tingling in your toes or fingers. These are not all of the side effects of GEMZAR. If you have any side effect that bothers you or that doesn't go away, be sure to talk with your healthcare professional. Call your healthcare professional right away if you have fever or chills. These symptoms could mean you have an infection.

You will have regular blood tests before and during your treatment with GEMZAR. Your doctor may adjust your dose of GEMZAR or delay your treatment based on the results of your blood test and on your general condition.

For more information about all of the side effects of GEMZAR, please talk with your healthcare team, see the complete Prescribing Information, or call 1-800-545-5979.

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