Every December, thousands of people gather in Texas to learn more about breast cancer at the San Antonio Breast Cancer Symposium (SACBS). Much of the research presented is mainly of interest to oncologists. However, as patients, it is good to follow the trends in cancer research, and some of the information is directly applicable to us. Three studies presented at SABCS in December, 2016, I found especially interesting.
Research on the link between exercise and cancer
One small study at Dana Farber Cancer Institute divided a group of 26 women into two groups in the time between their diagnosis and their surgery. One group had 180 minutes of aerobic exercise and 40 minutes of strength training a week, and one group practiced self-guided visualization exercises. Pathology reports after surgery showed no changes in the visualization group, but the exercise group showed changes in the immune and inflammatory pathways involved in breast cancer.
Such a small study needs follow-up, but it gives some clues as to why previous studies have found a correlation between exercise and reduction of breast cancer risk. Visualization, a popular technique used by people in cancer treatment, didn’t change the biology of the breast in this research, but it may be help people cope with the stress of a cancer diagnosis.
Research on dietary fat and breast cancer
Interest in how diet may affect breast cancer is high, but hard to study. Asking people to remember what they ate years ago is unreliable and getting them to eat a specific diet over a long period of time is difficult. Still, a large study as part of the Women’s Health Initiative did just that.
The study divided 48,835 postmenopausal healthy women into two groups. Almost 20,000 followed a diet that included no more than 20 per cent of their daily calories from fat and that had at least five servings of fruits and vegetables and six grain servings a day. This group had group sessions to help them understand and stay on the diet. The control group received dietary guidelines, but no special help to follow them. In the first year in the intervention group, the percentage of calories from dietary fat fell by almost 14 percent compared to their original eating habits and by the fifth year it was still eight percent lower than before the study started.
The results were a bit confusing. Overall the diet did not reduce deaths from breast cancer, but among those women who did get breast cancer, the diet appeared to lower mortality. This effect was still apparent 16 years after the beginning of the study. The dietary intervention appeared most effective for the women who started with higher waist circumference and high baseline levels of dietary fat.
While research on the connection between diet and breast cancer remains unclear, we do know that diets high in fruits and vegetables and lower in fat helps with all types of health problems, so it makes sense for pretty much everyone, unless advised otherwise by a physician, to follow this type of diet.
Research on predicting who needs more extensive treatment
One of the most frustrating aspects of cancer treatment is making decisions about treatment when the prognosis isn’t clear cut. One focus of recent research is in developing tools that can help doctors predict who needs more treatment. One example of this research presented at the 2016 San Antonio conference is a study of the efficacy of a biological risk profile called Prelude to predict which ductal carcinoma in situ (DCIS) patients should receive radiotherapy.
Researchers at the Kaiser Permanente Northwest Center for Health Research looked at the records of 455 women diagnosed with DCIS between 1990 and 2007 and compared those who had received radiotherapy with those who had not. They used the Prelude DCIS test on tissue samples of the women and found that it was able to predict women with both a low or high rate of recurrence. Additional studies are underway to confirm these preliminary findings. As more research finds better prognostic tools, cancer patients will find it easier to make decisions about radiation and chemotherapy.
In the Focus on IBC Newsletter January 2017, Ginny Mason, executive director of the IBC Research Foundation, commented on the main trends of the 2016 SACBS.
“Excitement continues to grow as data from immunotherapy studies mature,” Mason said. “While this clinical area isn't going to be the answer for all cancers, and does come with its own unique side effects, it appears some types of breast cancer might be good candidates. We will be watching for more data in 2017.
“There was a lot of talk about TIL's (tumor-infiltrating lymphocytes) as predictive and prognostic biomarkers in HER2 positive breast cancer. The validity of the biomarkers varies depending on factors such as hormonal status. Other sessions looked at the global cost of cancer care, diet and exercise effect on mortality, aromatase inhibitor side effects, and much more.”
Whether they attended the SABCS in 2016 or not, your doctors almost certainly have been following some of the main news in their professional journals. At your next appointment, ask if there were any studies that apply specifically to you. A clinical trial may be opening for which you would be a good candidate. Let your doctor know that you are interested in learning more about the latest research.