Women hear advances in breast cancer research

Special to the Green Valley News

“Everything you’ve learned today is because patients were involved in clinical trials,” said Dr. Rachel Swart, who spoke Saturday about advances in breast cancer research.

About 350 breast cancer survivors, some wearing head scarves indicating chemotherapy, attended a three-hour program at the Arizona Cancer Center at the University of Arizona to learn the latest advances to prevent recurrence of breast cancer.

Recurrence is the return of cancer following initial treatment and is a fear many survivors live with. The highest risk of recurrence is in the first five years following diagnosis. However, the risk is different for each person and depends on several factors — size of tumor, cancer grade, whether it has spread to the lymph nodes, how many nodes are involved and the hormone receptor status of the tumor.

Seven female Arizona Cancer Center oncologists and professionals addressed the crowd with knowledge, experience and empathy. With improved and less radical surgery and treatments, moderator Dr. Alison Stopeck said there are currently 2.5 million breast cancer survivors in the United States.

Food enhances health

Cyndi Thomson, Ph.D., a dietitian and nutritional counselor, said it’s important to eat colorful vegetables (yellow, orange, green leafy and cruciferous vegetables such as broccoli, Brussels sprouts, cabbage, cauliflower, rutabagas, radishes, turnips and watercress) plus whole grains and foods with fiber vs. fiber supplements.

“You’re in control,” she said. “People are passionate about their food but are uninformed. When your pant or dress size goes up, pay attention. Self monitor, notice what you’re eating and get active.”

Importance of activity

Jennifer Bea, Ph. D., said women who are active have an average 43 percent reduction in recurrence.

“Walking is your best friend. Walking three hours a week at 2.5 miles per hour helps with the quality of life,” she said.

“Being active must be something you enjoy — dancing, swimming, riding a bike or walking. Start slow and build gradually.”

Dr. Joanne Jeter said it’s important to identify and manage genetic risk factors.

She said Hispanic women face a higher risk of breast cancer than the general population; Jewish women of Ashkenazi descent, those who have ancestors from Germany, Poland, Lithuania, Ukraine and Russia, have a higher incidence of specific mutations increasing the risk of developing breast and ovarian cancer.

Jeter said many women are hesitant about genetic testing believing it will cause discrimination in health insurance coverage. A new HIPPA-related law protects against genetic discrimination, she said.

“Approximately 12 percent of women in the U.S. will develop breast cancer ... know your family history,” she said.

Advances in surgical oncology

“The mastectomy is the oldest form of breast cancer therapy. The medical profession has come a long way since the early 1900s, when the very disfiguring Halstead radical mastectomy was done along with removal of lymph nodes,” surgical oncologist Dr. Julie Lang said.

Current treatment for early-stage breast cancer is a lumpectomy and radiation, which Lang said is equal to the results of a full mastectomy and overall survival today.

If a mastectomy is recommended the more modern method doesn’t affect the pectoral muscle and, if chosen, reconstructive surgery may be done at the time of surgery or at a later date.

Lang said since the 1990s when the sentinel node dissection biopsy was introduced the need for more invasive therapy has been greatly reduced.

The diagnostic procedure is used to determine if the cancer has spread to auxiliary lymph nodes under the arm and only requires the removal of one to three nodes.

Hormonal therapy

About two-thirds of breast cancers are related to estrogen, said Dr. Leona Downey.

“Tamoxifen acts as an estrogen antagonist in the breast; it also helps improve bone density. Aromatase inhibitors reduce estrogen production in postmenopausal women. They are approved for treating both early and advanced breast cancer in post menopausal women.”

She said breast cells may develop resistance to therapies.

To test the efficacy of a new drug some patients may be referred to take part in a clinical trial, which are held at Comprehensive Cancer Clinics such as the Arizona Cancer Center.

Swart said most clinical trials do not use placebos, and patients chosen to participate should be comfortable with their doctor and should ask a lot of questions.

Clinical trials include a team of doctors, nurses, social workers, psychologists and other health care professionals who monitor the participant carefully during the trial and stay in touch after the trial is completed.

Three clinical trials for breast cancer are under way at AZCC.

Benefits of participating include patients playing an active role in their own health care, gaining access to new research treatments before they are widely available, obtaining expert medical care at leading health care facilities and helping others by contributing to medical research. Information: www.clinicaltrials.gov.

Ellen Sussman is a freelance writer in Green Valley. Contact her at ellen2414@cox.net.