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Breast Cancer
New Options
Increased funding is fueling new developments for diagnosis, treatment and prevention.
Increased funding is fueling new developments for diagnosis, treatment and prevention.
Breast cancer cases nationwide have tripled in the past 30 years, and the disease is now striking patients in their 20s and 30s instead of late 50s or older. That might be because women are more diligent about looking for it, says Jane Torres, founder and president of the Florida Breast Cancer Research Coalition.
DOING HER HOMEWORK: "I spent days and days and days at the University of Miami library trying to get as informed as possible to understand what doctors were saying, ask the right questions and play a role in my treatment," says Jane Torres, founder and president of the Florida Breast Cancer Research Coalition.One in every seven or eight women will be diagnosed with breast cancer at some point -- including an estimated 211,240 this year nationwide and 13,430 in Florida, according to the American Cancer Society. It's the most common type of cancer among women. And it can strike men too. This year 1,690 U.S. men are expected to get breast cancer.
Although death rates have been decreasing, breast cancer this year will claim the lives of 40,410 women and 460 men. It's surpassed only by lung cancer as the most deadly cancer among women.
Increased research funding is producing new developments for diagnosis, treatment and even prevention, says Torres, herself a survivor of breast cancer in 1994. Federal funding for breast cancer research has climbed from less than $90 million in 1991 to more than $800 million.
In diagnosis, the mammogram is still the gold standard, but it's not 100% reliable. More people are turning to MRIs as an added precaution, Torres says.
In treatment, clinical trials all over the country and Florida are helping forge new alternatives. At the Mayo Clinic in Jacksonville, oncologist Edith Perez has been studying the effects of combining chemotherapy and a monoclonal antibody, the drug trastuzumab, known as Herceptin. The treatment has dramatically decreased incidences of recurrence and death.
In a process known as antiangiogenic therapy, researchers in Boston and Indiana have shown that a combination of bevacizumab, known as Avastin, and the chemotherapy drug paclitaxel, known as Taxol, slows the progress of cancer that has spread from the breast to other parts of the body.
In other clinical trials, researchers are looking at preventing recurrence with a low-fat diet and studying the use of aromatase inhibitor drugs that block tumor growth by lowering the amount of estrogen in the body.
Prevention is perhaps the biggest challenge in breast cancer research. "If we can't figure out what causes it, we can't figure out what prevents it," Torres says. Advocates are pushing for studies of environmental factors such as food, plastics and pesticides, along with studies of psychological factors such as stress.
Resources
American Cancer Society: cancer.org
Florida Breast Cancer Coalition Research Foundation: fbccrf.org
National Cancer Institute: nci.nih.gov
National Center for Complementary and Alternative Medicine: nccam.nih.gov
American Society of Clinical Oncology: asco.org
Association of Cancer Online Resources: acor.org
Cancer Care Inc.: cancercare.org
Download a 72-page guide called "Breast Cancer: Treatment Guidelines for Patients" at nccn.org. In the Patients section, click on Patient Guidelines and then Breast Cancer.
Techniques and Treatments
Sentinel Lymph Node Biopsy
During surgery, surgeons inject a radioactive substance and/or a blue dye near a tumor to identify the "sentinel" lymph nodes that drain the tumor area. The node is tested to see if cancer cells have spread there while the patient is still sedated; the results dictate how a lumpectomy or mastectomy proceeds.
High-Dose Chemotherapy with Stem Cell Transplant
Chemotherapy-damaged cells are replaced with immature blood cells that were removed from the blood or bone marrow of the patient before the chemotherapy process and stored for later intravenous infusion. Studies have not proved this works better than traditional chemotherapy.
Monoclonal Antibodies
Laboratory-produced antibodies, or proteins that respond to foreign cells in the body, are used to prevent cancer cells from growing or spreading. These can be infused alone into the patient or with cancer drugs or radioactive materials. They also can be used as a complement to chemotherapy. The drug trastuzumab, or Herceptin, is a monoclonal antibody that blocks HER2, a protein that transmits growth signals to cancer cells.
Source: National Cancer Institute, www.nci.nih.gov
