Progress Towards the Cure: Breast Cancer Research Roundup

PJ Hamel Health Guide
  • Breast cancer research is constantly providing health-care professionals with new data on which to base treatment and prevention recommendations. Here’s this month’s news, and how it might affect you.

     

    New hope for prospective moms

    A younger woman undergoing chemotherapy for breast cancer often faces a devastating situation: the very drugs that can save her life can also prevent her from ever bearing children.

     

    Which do you take a chance on – your life, or your fertility?

     

    Now, a drug sometimes used to prevent breast cancer recurrence in pre-menopausal women has shown promise in another arena: preserving fertility after chemotherapy.

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    Many women experience “ovarian death” as a result of chemo; they go into menopause, permanently losing their fertility. In older women, those who’ve already had their children, this is bothersome, though ultimately not serious. But for younger women, those looking forward to becoming moms, it can be the end of a dream.

     

    Goserelin (Zoladex) causes temporary shutdown of the ovaries, and helps prevent breast cancer recurrence in younger women with hormone-positive disease by controlling the production of cancer-feeding estrogen. A recent study sponsored by the National Institutes of Health indicates that this temporary ovarian shutdown also seems to protect women from undergoing premature menopause – thus preserving their fertility.

     

    While further study is needed – this first trial included only women with hormone-negative breast cancer – Zoladex may one day give hope to young women who want to survive breast cancer – and also become mothers.

     

    Is there a better choice than tamoxifen?

    Women with hormone-receptive breast cancer are typically treated, long-term, with drugs that prevent any remaining cancer cells from obtaining the estrogen they need to grow.

     

    For pre-menopausal women, the gold-standard drug for over 30 years has been tamoxifen. Post-menopausal women are typically prescribed an aromatase inhibitor (AI) – Aromasin, Femara, or Arimidex.  

     

    An analysis of two international trials, presented recently at the annual meeting of the American Society of Clinical Oncology (ASCO) in Chicago, indicate that Aromasin might be more effective at preventing recurrence than tamoxifen in pre-menopausal women – so long as the drug is paired with ovarian suppression via drugs, radiation, or surgery (i.e., the patient is put into menopause).

     

    Questions remain. Does this new protocol extend life? Would pairing tamoxifen with ovarian shutdown produce the same result? In addition, menopause has a variety of unpleasant side effects, some serious: bone loss and heart problems have both been linked to the reduction of circulating estrogen resulting from menopause.

     

    For now, tamoxifen remains the long-term hormone therapy of choice for pre-menopausal breast cancer survivors. But continuing studies may one day make Aromasin the better choice.

     

    Deadly combination: BRCA carriers + smoking

  • Women who carry damaged versions of the BRCA2 gene (one of two “breast cancer genes”) are at high risk for breast cancer – up to 70% lifetime risk, compared to the 12% lifetime risk of the average woman. A recent international study indicates that these women, if they also smoke, are twice as likely to be diagnosed with lung cancer, as well.

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    About 2% of people of European descent worldwide carry this mutated gene. And while little research on the connection between genetics and lung cancer has thus far been carried out, the BRCA2 link is the strongest yet discovered.

     

    What does this mean for you? If you’re a BRCA2 carrier, it’s simple: don’t smoke. Or if you do, realize you’re doubling your risk of lung cancer.

     

    Can a blood test predict cancer recurrence?

    One of the most exciting reports to come out of ASCO’s annual meeting May 29-June 2 in Chicago is one concerning a new test that seems to reliably predict which breast cancer survivors will have a recurrence, and which won’t.

     

    A circulating free DNA test (cfDNA) looks for “tumor-specific mutations” (mutations known to cause cancer) in the blood plasma of women diagnosed with breast cancer. In the study, researchers checked the level of these mutations in breast cancer survivors before treatment began; and directly after treatment concluded.

     

    Before treatment, all women showed similar levels of mutations. After treatment, some women were mutation-free; while others continued to show mutations. Of those exhibiting mutations, 80% went on to suffer a recurrence; while none of the women without mutations had a recurrence.

     

    In addition, the level of mutations continued to grow over time in the women who eventually had a recurrence of their disease, leading researchers to believe that these mutations are, indeed, a reliable indicator of the presence of cancer.

     

    The study authors caution that results are still too new to be 100% conclusive; it’ll take years to see how many women eventually have a cancer recurrence, whether or not their initial cfDNA test revealed mutations.

     

    But if and when this simple blood test becomes a regular part of every survivor’s labs, it may go a long way to determining which women could relax their defenses; and which should be extra-vigilant when checking for signs of recurrence.

     

    Sources

     

    Fox, M. (2014, June 1). Breast Cancer Gene Also Causes Lung Cancer. NBC News. Retrieved June 1, 2014, from http://www.nbcnews.com/health/cancer/breast-cancer-gene-also-causes-lung-cancer-n118871

     

    Kelly, J. (2014, June 9). Blood Test Predicts Breast Cancer Relapse. Medscape Multispecialty. Retrieved June 10, 2014, from http://www.medscape.com/viewarticle/826423?src=rss

     

    Pollack, A. (2014, May 30). Drug Saves Fertility for Women With Cancer. The New York Times. Retrieved June 3, 2014, from http://www.nytimes.com/2014/05/31/business/drug-could-protect-fertility-in-breast-cancer-patients.html?_r=0

     

    Steenhuysen, B. J. (2014, June 1). Study may open new options for younger women with breast cancer. Yahoo! News. Retrieved June 1, 2014, from http://news.yahoo.com/study-may-open-options-younger-women-breast-cancer-113115124--finance.html

Published On: June 22, 2014