The Empowered Patient: Research Updates
Not all doctors are diligent about keeping up to speed with current research or other cancer news. As empowered patients, it’s up to us to take charge of our own health, and this means finding out all you can about your disease. Someday – even today – you may find yourself using this information.
For women with metastatic disease
Women with hormone-responsive metastatic breast cancer are often treated with drugs to prevent their cancer from getting the fuel it needs: female sex hormones, principally estrogen and progesterone. For post-menopausal women, an aromatase inhibitor (Arimidex, Femara, Aromasin) is the current drug of choice. But often these drugs lose their effectiveness over time; the body becomes resistant to them.
Approved by the FDA in 2012 for metastatic breast cancer treatment, Afinitor (everolimus) works to reverse this resistance. In clinical trials, Afinitor combined with Aromasin doubled progression-free survival time – “one of the biggest improvements ever seen with the addition of one drug.” (Van Epps, 2012).
When cancer is found in the lymph nodes: radiation vs. surgery
A sentinel node biopsy removes several of the nodes closest to a woman’s tumor; usually these nodes are in the armpit. If cancer is found in one or more of the sentinel nodes, further surgery is often performed to remove more of the underarm nodes and prevent the further spread of cancer.
Removing underarm (axillary) lymph nodes has been shown to increase the risk of lymphedema, a serious and possibly life-threatening condition marked by swelling of the arm or trunk. A phase 3 international study, currently in progress, reveals that treating axillary lymph nodes with radiation, rather than removing them surgically, reduces lymphedema risk by up to 50% over 5 years. The study, as it continues, will track its subjects beyond 5 years.
An easier way to find clinical trials
Many women diagnosed with breast cancer are interested in participating in clinical trials – studies testing new cancer drugs or methods of treatment. Women whose cancer has spread may be looking for any possible way to slow or stop that spread; women whose cancer is under control may simply want to volunteer themselves as subjects for research.
MyClinicialTrialLocator.com is an easy-to-use online tool for finding and assessing clinical trials. The site uses government databases and information from medical research centers to provide trial information centering not just around drugs, but medical devices, procedures, and lifestyle factors like nutrition, diet, and exercise. (Garinn, 2012)
Simply go to MyClinicialTrialLocator.com; enter your type of cancer, your zip code, and how far you’re willing to travel, and the trials that fit your needs appear, complete with eligibility criteria and contact information.
Preventing metastatic breast cancer
When breast cancer spreads to other parts of the body, it’s considered incurable. With continuing treatment, some women with metastatic cancer live for years; but stage IV (metastatic) cancer is usually terminal.
Decitabine, a drug used to treat blood cancer, is showing promise in preventing early-stage breast cancer from becoming metastatic. Currrently in early trials, the drug works by turning on a type of genetic coding that prevents cancer cells from separating from the initial tumor and spreading to other parts of the body. Decitabine has been shown to prevent cancer spread in lab animals for all types of breast cancer (including triple negative) with the exception of one: invasive lobular cancer.
Researchers have also developed a test, based on that same genetic coding, which can help predict which women are more likely to see their cancer metastasize. Women with a high risk of metastasis could receive decitabine as part of their initial treatment, thus lowering that risk.
Borges, S. (2013, August 23). Pharmacologic reversion of epigenetic silencing of the prkd1 promoter blocks breast tumor cell invasion and metastasis. Retrieved from http://breast-cancer-research.com/content/15/2/R66
Garinn, J. (2013, Summer). Finding a clinical trial just got easier. Cure, 12(2), 20.
LaTour, K. (2013, Summer). Less lymphedema with radiation in early-stage breast cancer. Cure, 12(2), 16.
Van Epps, H. (2012, Fall). The estrogen effect. Cure, 11(3), 47.
Mayo Clinic (2013, August 22). Drug used for blood cancers may stop spread of breast cancer cells. ScienceDaily. Retrieved August 27, 2013, from http://www.sciencedaily.com /releases/2013/08/130822152145.htm?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed:sciencedaily/health_medicine/breast_cancer