Hormone therapy
Hormone therapy — perhaps more properly termed hormone blocking therapy — is often used to treat breast cancers that are sensitive to hormones. Doctors sometimes refer to these cancers as estrogen and progesterone receptor positive cancers.

Hormone therapy can be used after surgery or other treatments to decrease the chance of your cancer returning. If the cancer has already spread, hormone therapy may shrink and control it.

Treatments that can be used in hormone therapy include:

• Medications that block hormones from attaching to cancer cells. Tamoxifen is a type of drug called a selective estrogen receptor modulator (SERM). SERMs act by blocking any estrogen present in the body from attaching to the estrogen receptor on the cancer cells, slowing the growth of tumors and killing tumor cells. Tamoxifen can be used in both pre- and postmenopausal women.
• Medications that stop the body from making estrogen after menopause. Called aromatase inhibitors, these drugs block the action of an enzyme that converts androgens in the body into estrogen. These drugs are effective only in postmenopausal women. Aromatase inhibitors include anastrozole (Arimidex), letrozole (Femara) and exemestane (Aromasin).
• Surgery or medications to stop hormone production in the ovaries. In premenopausal women, surgery or medications can shutdown hormone production in the ovaries.

Side effects of hormone therapy vary according to which medication you receive, but typically include menopausal symptoms, such as hot flashes, vaginal dryness, decreased sex drive and mood changes. Side effects of aromatase inhibitors include joint and muscle pain, as well as an increased risk of bone thinning (osteoporosis).

Targeted drugs
Targeted drug treatments attack specific abnormalities within cancer cells. Targeted drugs approved to treat breast cancer include:

• Trastuzumab (Herceptin). Trastuzumab targets a protein called HER2 that helps some breast cancer cells grow and survive. If your breast cancer cells make too much HER2, trastuzumab may help block that protein and cause the cancer cells to die.
• Bevacizumab (Avastin). Bevacizumab is a drug designed to stop the signals cancer cells use to attract new blood vessels. Without new blood vessels to bring oxygen and nutrients to the tumor, the cancer cells die. Bevacizumab is approved for breast cancer that has spread to other areas of the body.
• Lapatinib (Tykerb). Lapatinib targets the HER2 protein and is approved for use in advanced breast cancer. Lapatinib is reserved for women who have already tried trastuzumab and their cancer has progressed.

Side effects of targeted drugs depend on the drug you receive. Targeted drugs can be very expensive and aren't always covered by health insurance.

Clinical trials
Clinical trials are used to test new and promising agents in the treatment of cancer. Clinical trials represent the cutting edge of cancer treatment, but they're often unproven treatments that may or may not be superior to currently available therapies. Talk with your doctor about clinical trials to see if one is right for you.

Examples of treatments being studied in breast cancer clinical trials include:

• New combinations of existing drugs. Researchers are studying new ways of combining existing chemotherapy, hormone therapy and targeted therapy drugs. Testing new combinations may help determine if certain breast cancers are more susceptible to specific combinations.
• Bone-building drugs to prevent breast cancer recurrence. In early 2009, a study reported adding a bone-building drug to hormone therapy treatment after surgery for premenopausal women reduced the risk of breast cancer recurrence. The drug used in the study, zoledronic acid (Reclast, Zometa), is a type of drug called a bisphosphonate that's used to treat bone loss (osteoporosis) and other bone diseases. The group of women who received zoledronic acid experienced fewer cancer recurrences than did the group that didn't receive the drug during the study, which lasted four years. Doctors are awaiting the results of other studies of zoledronic acid before widely recommending this treatment.
• Using higher doses of radiation over a shorter period of time on a smaller portion of the breast. Researchers are studying partial breast irradiation in women who've undergone lumpectomy. Partial breast irradiation involves higher doses of radiation aimed at only a portion of the breast, rather than the entire breast. Radiation used in partial breast irradiation can come from a machine outside your body or it can come from tubes or catheters placed within the breast tissue.

Alternative medicine

No alternative medicine treatments have been found to cure breast cancer. But complementary and alternative medicine therapies may help you cope with side effects of treatment when combined with your doctor's care.

Alternative medicine for fatigue
Many breast cancer survivors experience fatigue during and after treatment that can continue for years. Doctors aren't sure what causes cancer-related fatigue and it can persist despite treatment. When combined with your doctor's care, complementary and alternative medicine therapies may help relieve fatigue. Ask your doctor about:

• Gentle exercise. If you get the OK from your doctor, start with gentle exercise a few times a week and work your way up to more if you feel up to it. Consider walking, swimming, yoga or tai chi.
• Managing stress. Take control of the stress in your daily life. Try stress reduction techniques such as muscle relaxation, visualization and spending time with friends and family.
• Relaxation strategies. Balance activity with periods of relaxation. Try listening to music, writing in a journal, meditating or taking a warm bath.