San Antonio Breast Cancer Symposium 2014: Get Help Understanding How the Research Affects You
Every December thousands of researchers and medical professionals from all over the world pour in to San Antonio, Texas, for the San Antonio Breast Cancer Symposium (SABCS). They share their findings about breast cancer and its treatments in technical, medical language, which will be translated into every day language for consumers in a flood of news reports. Swimming through that flood is a challenge. How can you tell if any of the San Antonio news is relevant to you?
Most of us will need to rely on our doctors to help us sort it out. Here is why.
Much of the news is relevant to small sub-groups of breast cancer patients. It used to be that all you needed to know was the hormone receptor and Her2 status of your tumor. Much of the new research deals with characteristics of tumors that aren’t even being tested in most doctor’s offices. Breast cancer is a collection of diseases, not just one, so a research report that sounds promising in a headline may not be for you. Several of the presentations dealt with the usefulness of tamoxifen, ovarian suppression, and other hormonal ways of treating breast cancer, but they may have focused on women who are in a different age range or menopausal status than you are. Ask your doctor if a report on a particular treatment fits your circumstances.
Information from a study may be hard to interpret and implement. For example, researchers with the Women’s Intervention Nutrition Study have been following a large group of breast cancer patients for 15 years to see if a low-fat diet might increase survival rates. At first it seemed that the women in the low-fat diet group did not fare significantly better than the control group. However, as the researchers continued to follow the group, they found that the estrogen receptor negative and estrogen/progesterone receptor negative patients who had a low-fat diet did do better with as much as a median 2.3-year increase in median survival.
At first glance this might suggest that a low-fat diet is the way to go for hormone receptor negative and triple negative women. However, some caution is needed. Although the original study was large with over 2,000 women, less than a quarter of the women were in the group that saw benefits. Statistics based on this smaller number may be less reliable. The results suggest that hormone receptor negative patients may want to consider a low-fat diet, but the information needs to be put into the context of recent information about the overall benefits of certain fats now considered to be healthy such as olive oil and nuts. Women will want to consider all of their health issues in choosing the best diet.
Research may be in the early stages. When you hear about trials of new drugs, notice what phase the trials are in. The earliest research is done in lab dishes or in animals. Research that seems promising at this stage may make big headlines, but it often doesn’t work out when it moves to human trials. Phase I trials are in small groups of people to make sure that the drug is safe. Phase II trials work with a larger group of patients to see if the drug is effective. Phase III trials are the first ones in large groups of patients, so when you are reading about new treatments, pay attention where it is in the research cycle. Many drugs that look promising in animals never make it to humans, and many drugs never survive Phase III trials to make it to market.
One promising avenue for breast cancer treatment is using the body’s immune system to protect itself against cancer. Some of these studies were presented this year at SACBS, but they are still in the early stages of research. They are hopeful news, but it will be years, if ever, before they arrive in most oncologists’ offices. You can ask your doctor if you are eligible for a clinical trial of some of the new treatments presented at SABCS. A clinical trial could be especially useful if standard treatments aren’t working for you.
Some of the reporting you see will be slanted. Breast cancer patients and their doctors are not the only people interested in the presentations at the San Antonio Breast Cancer Symposium. I subscribe to an email alert for certain news topics, including the SABCS. Several weeks before the December conference opened, my email started filling up with news for investors about how pharmaceutical companies’ current and potential products have been doing.
Drug companies want their research presented positively because they want investors to buy their stock. Researchers and the institutions they work for want their work to be seen in the best possible light so that they can attract more grant money. That doesn’t mean they have sinister motives. Without funding, neither pharmaceutical firms nor research institutions like universities can do the research that will eventually cure cancer. A report may be perfectly truthful while spinning information in a favorable manner.
Some slanting happens because a news source has a particular bias. Some of the articles I looked at about the low-fat study had headlines that did not mention that the low-fat diet was helpful only for some subtypes of breast cancer. I don’t know if these sources wanted to push a particular agenda about cancer and diet or if the reporter just didn’t read the original research carefully. It is difficult for the average layperson to analyze science news for possible bias. Most of us will need a guide.
As consumers of health news, we need to read carefully. Sometimes we will be able to understand the research and its implications for our own health options. Still it is a good practice to show our doctor a news article and ask, “Does this research apply to me?”
Azolinsky, A. Immunotherapy Yields Response in Triple-Negative Breast Cancer. December 11, 2014. CancerNetwork. Accessed from http://www.cancernetwork.com/sabcs-2014/immunotherapy-yields-response-triple-negative-breast-cancer Dec. 18, 2014.
Francis, P. Adjuvant Ovarian Suppression in Premenopausal Breast Cancer. New England Journal of Medicine Dec. 11, 2014. Accessed from http://www.nejm.org/doi/full/10.1056/NEJMoa1412379#t=articleResults Dec. 18, 2014.
Lawrence, L. Decreased Fat Intake May Improve Survival in Some Breast Cancers. Dec. 12, 2014. CancerNetwork. Accessed from http://www.cancernetwork.com/oncology-nursing/decreased-fat-intake-may-improve-survival-some-breast-cancers Dec. 18, 2014.
Love, S. The View from San Antonio--Part One. Dr. Susan Love Research Foundation. Accessed from http://blog.dslrf.org/?p=2232 Dec. 18, 2014.