Cover Your Butt at Call on Congress

BY GUEST BLOGGER | MARCH 19, 2010

March is colorectal cancer awareness month. As someone who is living with stage 4 colon cancer, I'm painfully aware of the need for research, empowerment, and access. Colorectal Cancer Coalition gives us all of these and so much more.

I traveled to D.C. with Colorectal Cancer Coalition (C3) in order to share my voice and experience for a disease that is preventable, treatable, and beatable. Advocates from across the country joined together yesterday wearing Cover Your Butt t-shirts and descended upon Capitol Hill to encourage legislators to support the following three legislative proposals that will help us win the fight against colorectal cancer:

• The Colorectal Cancer Prevention, Early Detection, and Treatment Act of 2009 (H.R. 1189). This important legislation would establish a national colorectal cancer screening and treatment program administered by the Centers for Disease Control and Prevention (CDC). Approximately 30,000 to 44,000 lives a year could be saved if colorectal cancer screening was fully accessible and utilized. In addition to saving thousands of lives, this legislation has the potential to save billions in Medicare expenditures. According to an independent study by The Lewin Group, the provisions in this bill will save Medicare billions of dollars.

• The Colorectal Cancer Screening and Detection Act (H.R. 1330). This legislation would require all health insurance plans, both individual and group, to cover a colonoscopy for anyone age 50 or older. The coverage this important legislation requires is similar to the coverage that almost all states require health plans to provide for breast cancer screening. Enactment of this bill will help to increase population-based screening rates for colorectal cancer (currently less than half of those who should be screened do get screened).

• $50 million in funding for the Peer Reviewed Cancer Research Program (PRCRP) at the Department of Defense for Fiscal Year 2011. This program at the Department of Defense funds research for a number of cancers including colorectal cancer. The program supports high-quality cancer research, concentrating its resources on research mechanisms which complement rather than duplicate the research approaches of the major funders of medical research in the United States. Last year alone approximately 422,600 Americans were diagnosed with one of the cancers included in the PRCRP and 127,730 Americans lost their lives to one of these diseases.

I had positive meetings with both Senator Kay Bailey Hutchison and Senator John Cornyn's offices (both of Texas) and then was surprised by an amazing photo opportunity with Texas Representative Kay Granger, who is champion and sponsor of our cause. Judi Weiler Sohn (C3 vice president of operations), Sue Weiler, Carlea Bauman (C3 president), and Catherine Knowles (C3 director of policy) were also there. It was an emotional visit, filled with both tears and gratitude.

Representative Granger graciously gave each of us an official copy of the Congressional Record and then shared that she had lost her dad to colorectal cancer, making an already meaningful meeting even more poignant. There is nothing as momentous as a shared journey, especially when paths collide and lives are saved.

I visited Representative Jeb Hensarling's office next and was unable to meet with him because of a House vote. However, I spoke candidly to his legislative assistant and hope the importance of this legislation becomes a priority. I told him that his support is now on my bucket list! There is not only fiscal integrity involved but constituent lives at stake. I promised that there would be a deluge of phone calls on March 30 with one simple message--"Cover Your Butt!"--and the necessity of this issue would be well conveyed.

I owe a lot to Shelly Weiler's guidance, as I would not be alive without him. And without the efforts and encouragement of C3, I would not have had the courage to enter the halls of Congress. I paid tribute to that support when I recently testified before the Energy and Commerce Health Subcommittee. It was a testament to the value that research has provided in this past decade and will continue to exude in the future.

As Pam Seijo says, "Getting together each year motivates us to do more. This year's attendees were more determined and driven than ever!"

"Rejuvenation!" says Gordon Cole. "The first time attendees project an energy and then those of us who have attended before re-ignites the spark to do it again and again."

Each year advocates are assigned to mentor groups. This year Liz Itter was my mentor. She is an incredible survivor. I'm so happy to have gotten to spend some time with her. (She even convinced me to try the metro this year). Check out her website at www.runlizrun.com. What an incredible survivor!

Please help us ensure legislative support on March 30 by being a part of our Congressional Butt-In. It's easy! Call 866-615-3375, and when you reach your officials say, "I urge my Senator/Representative to support the colorectal cancer prevention, early detection, and treatment act."

Suzanne Lindley is a colorectal cancer survivor and advocate from Canton, Texas.

Pictured: Sue Weiler, Suzanne Lindley, Representative Kay Granger, and Judi Sohn.

Social media: The game changer

BY GUEST BLOGGER | MARCH 18, 2010

Almost 12 years past cancer, I'm in the best physical shape of my life. I've never felt better, had more energy, or intellectually felt so alive, yet at the same time been so discouraged by our country's inability to effectively tackle our collective health problem.

So I decided to change the channel. I signed on for the inaugural "SXSH Sharing. Exchanging. Social Health" event held on March 11 in Austin, an "unconference" that brought together an extraordinary group of social media/health care thinkers, enthusiasts, and leaders who talked about what can happen when social media and health care come together.

What a difference a day makes. Social media is stirring a level of change equivalent to the advent of the automobile in the last century. Just like the car changed life in the United States forever by providing people the ability to travel from place to place, social media makes it possible for different communities of individuals to exchange views and knowledge in real time. Right now. We no longer have to depend solely on our doctor or drive to the bookstore for critical information that may already be outdated. We can find what we need to know today.

Livestrong CEO Doug Ulman told the group that "social media will change the war on cancer and health care forever."

It already is, from institutions like the Mayo Clinic and National Cancer Institute exchanging tweets and information with followers to patients seeking input on the effects of chemotherapy.

In less than a year on Twitter, I've developed my own news network so I can monitor reports on cancer, patient advocacy groups, news, and literature, something that would be difficult to manage without social media. I talk to doctors, fellow survivors, writers, bloggers, and journalists. There's no way I could have met so many interesting people in such a short time through conventional means.

Another way of looking at social media's potential in addressing health care issues came from Greg Matthews, director of Humana's Innovation Center. Matthews says that "...the relationship revolution" created through social media will assist insurers in motivating people to change their lifestyle.

"I came to the realization that, as insurers, we are part of a sickness industry, as opposed to a health care industry," Matthews said. "So, one of our questions is how we engage people in healthy minded communities." When things we should do, like exercise, are transformed into something that's fun to do--via social media--then we can make significant steps toward disease prevention.

Given the current health of our population, the application of technology to move people to change is good news. But Humana's programs were just one aspect of the entire #SXSH dialogue. Even a week later, participants continue to write, discuss and elaborate on conversations initiated there. Social media accelerates ideas and good ideas accelerate change. So even if the actual number of those who physically attended was small--around 80--the idea avalanche is just beginning (for a fact recap, see http://reedsmith.posterous.com/a-week-after-recap-of-sxsh).

Some of the trends we'll see social media accelerate:

1) Patient driven
Social media provides cancer survivors a forum to have their concerns, problems, and questions heard, answered, and addressed. Jenn Texada of M.D. Anderson Cancer Center gave some incredible examples from her vantage point as M.D.A.'s Twitter "voice." More and more hospitals are beginning to use platforms like Twitter to address customer service issues.

2) Prevention, prevention, prevention
Doug Ulman also pointed out what many of us in the cancer arena already know, "it's about prevention. There is no one cure for cancer. Cancer is more than 400 different diseases." While we will see advances in treatments, the key will become the prevention of future disease.

3) Participatory Medicine
You can get real answers in real time. The more we, as health care consumers and advocates, learn and take responsibility for our own health, I can only believe that our health care will improve. While patients want their health care team to be accountable, we--in turn--need to do the same, and I don't mean financially. By this, I mean understanding and engaging in healthy behavior, preparing for appointments (do you keep a list of the vitamins and medications you take?), and keeping track of our records, tests, and results. And yes, electronic medical records will become a reality. To keep up-to-date on this topic follow @epatientDave at http://epatientdave.com/.

The "unconference" culture was the essential antidote I needed for a battery recharge. #SXSH is about the collective idea(s) and energy generated when ideas are shared among equals working on the same team. The experience moves, motivates, empowers, and engages everyone. Ideas flew like rockets throughout the day. I was welcomed like an old friend even though this is a new area to me, an attitude we can all carry to take on cancer wherever we are.

Note: #SXSH was organized by four individuals: Shwen Gwee (@shwen), Dana M. Lewis (@danamlewis), Reed Smith (@reedsmith), and Tom Stitt (@tstitt), who met through a virtual conversation held every Sunday evening about social media and health care. They met for the first time in Austin. Sponsors included St. David's HealthCare, MD2P.net, wegohealth, IMC health & wellness, and Vertex.

Jody Schoger is a writer and cancer advocate living in The Woodlands, Texas. She explores women's cancer news, information, and essays on her blog http://womenwcancer.blogspot.com. Follow her on Twitter: @jodyms.

To read more on how social media is changing the outlook for cancer patients, survivors, caregivers, and health care professionals, read "Friends in Need" from CURE's Spring 2010 issue.

Going home ... again

BY GUEST BLOGGER | MARCH 2, 2010

CURE invited Suzanne Harp, a recently diagnosed breast cancer survivor, to serve as a guest blogger during the 10th Annual Conference for Young Women Affected by Breast Cancer in Atlanta, February 26-28.

As we headed home from the Young Survivor's Conference I made a stop at the Atlanta airport's food court. As I waffled between Popeye's (fried chicken, biscuits, and baked sweet potatoes) or Au Bon Pain (salads and whole grain bread sandwiches), I froze.

Time stood still. To quote Yogi Berra, "It's deja vu all over again."

I actually said out loud to nobody, "When was I here before?" My mind was blank.

And then it hit me. I had been standing in this very spot, making this very same food choice in September, about 36 hours before I got my biopsy results.

Let me backtrack. Six months ago I didn't know much about cancer. I had never heard of ER+ or Oncotype tests. All I knew is I went for a mammogram, had a biopsy, and was told by my radiologist, "I'm about 95 percent sure this is cancer."

The next days were the hardest. Friends wanted to hold on to that hope that I would be in the 5 percent. But as a reporter, I am used to reading between the lines. The doctors knew what they were looking at. Still, I would have to wait through Labor Day weekend for the official verdict.

So I did what any sane New Yorker would do. I flew to Opelousas, Louisiana for the Zydeco music festival. I had interviewed the organizer back in 2000, and the festival had always been on my to-do list. I had no idea if I would ever have the chance again. Would I be healthy the next year? Would I even be alive?

That Thusday night I bought a ticket with an ugly NYC-Boston-Atlanta-Alexandria, Louisiana itinerary, and headed off for a weekend of amazing music in a place where cancer could not find me.

But come Sunday, I was back in the Atlanta airport, knowing my escape was ending. Time for one more meal in the South.

My devil said, "This could be the last meal you enjoy without knowing you have cancer. Have fried chicken." My angel said, "You have cancer. You need to start eating healthy."

In the end, I split the difference. I ate a salad and had one wing. But I won't forget that feeling of standing on the precipice between benign and malignant, the time ticking away on the game clock of my innocence.

However, this weekend, on the way home from the YSC conference, I was not alone. My friend Deb walked by, took one look at me and said, "What's wrong?" I explained the story, and said it was ironic, that after a weekend at a conference for women with breast cancer, the only thing that made me cry was a food court.

That September airport meal now seems like a lifetime ago. I have been operated on, radiated, and pumped full of pills. But I am now on the other side, and I hope to someday again dance in the fields of Louisiana, this time cancer-free.

Suzanne Harp spent 10 years as a television news anchor in Minnesota, Wisconsin, Maine, and New York. She was diagnosed with breast cancer in September. She lives in New York City with her husband Ethan, and blogs at www.joinourloop.blogspot.com.

I will survive

BY GUEST BLOGGER | FEBRUARY 28, 2010

CURE invited Suzanne Harp, a recently diagnosed breast cancer survivor, to serve as a guest blogger during the 10th Annual Conference for Young Women Affected by Breast Cancer in Atlanta, February 26-28.

There comes a moment during every party, at the end of the evening, where you hear that arpeggio on the keyboard then Gloria Gaynor's voice singing ... "At first I was afraid, I was petrified."

At most weddings and proms the playing of "I Will Survive," is a moment of musical camp, eliciting a mix of groans and "I love this song!" But at the Young Survivor's Conference, the golden oldie is more than a moment of disco nostalgia. It is a defiant anthem.

For the hundreds of breast cancer women singing along to the lyrics, it was a musical "line in the sand" stating:

We will be young--
We will still dance--
We will still enjoy ourselves.

When I was first diagnosed, I wondered if I would ever feel free again. Would cancer would cast a shadow over everything? So there is nothing superficial about discovering this disease does not have to take away your ability to have a good time. In fact, that was the "take-home" message of many of the speakers.

If you really want to learn how to live well with cancer, talk to someone who has a lot of practice. Paula Verna has been living with breast cancer for six years, and liver mets for three. But Saturday night, in a room of women with early-stage disease, her sense of acceptance stood out.

As we raided the VIP lounge's stash of snacks, the Folsom, California survivor shared some of her hard-won wisdom with us.

"If you live in fear that it's going to come back, you stop living."

Another of her sayings: "By just being here today, you beat it."

Verna says she comes to the YSC conference for a feeling of family and unity.

Of course, not every woman with advanced breast cancer wants to spend her energy comforting shaken early-stage sisters. It can be an awkward divide. One participant posted on Twitter, "each time I hear 'when your treatment is done' I wince a little. For some of us, treatment will never be 'done'."

But Verna, a former basketball coach, believes her advice is meaningful no matter what position we are playing.

"If you dwell on what's wrong with you ... you miss so much."

Suzanne Harp spent 10 years as a television news anchor in Minnesota, Wisconsin, Maine, and New York. She was diagnosed with breast cancer in September. She lives in New York City with her husband Ethan, and blogs at www.joinourloop.blogspot.com.

Yin, yang, and YSC

BY GUEST BLOGGER | FEBRUARY 27, 2010

CURE invited Suzanne Harp, a recently diagnosed breast cancer survivor, to serve as a guest blogger during the 10th Annual Conference for Young Women Affected by Breast Cancer in Atlanta, February 26-28.

Every day eight women under the age of 45 die of breast cancer in America. Yet here at the Young Survivor's Conference in Atlanta I am surrounded by joy. There are literally shiny, happy people all around, to quote R.E.M., a band from just down the road. I'm not sure I have ever been part of such a happy group. If we had a soundtrack it would be gospel music.

From time to time I will hear survivors say they believe slogans like "Save the Ta-Ta's" or "Feel your Boobies" trivialize breast cancer. I do understand where they are coming from. If you have mets, you need your life saved, not your breast.

But I don't think you have to check your sense of humor at the cancer center door. On Loop, my website, we try to balance serious information with a little fun.

While creative art projects and quirky fund raisers are no way, no how, going to save every life, there is something to be said for keeping your spirits up--which is my favorite part about the conference so far. The information, too, is excellent. I went to a very strong session about living a full life after cancer by Julia Rowland, PhD. She implored us to develop good post-treatment strategies and to "Live life on the edge."

But what really makes this experience great is that you only have to walk a few steps to actually see women doing just that.

Some survivors start small businesses fueled by their firsthand knowledge of what cancer patients need. Others are drawn to create foundations or awareness campaigns. A few ladies write books, the younger crowd tends to blog. We heard this morning from breast cancer survivor and Congresswoman Debbie Wasserman Schultz of Florida. For women who have had a brush with a deadly disease, we have a heck of a lot of life in us.

At moments I do get wrapped up in the realization that cancer will cost some of the women here their lives. I think we all wish we could be the "Catcher in the Rye" and save everyone. But I will say, they sure went down swinging.

It's not lost on me that we are here in the hometown of Dr. Martin Luther King, because we also have a dream. And just as the road to civil rights is bumpy and twisty, so too is the road to a cure. It is a path that includes both mourning losses and celebrating victories.

Suzanne Harp spent 10 years as a television news anchor in Minnesota, Wisconsin, Maine, and New York. She was diagnosed with breast cancer in September. She lives in New York City with her husband Ethan, and blogs at www.joinourloop.blogspot.com.

Setting sail into survivorship

BY GUEST BLOGGER | FEBRUARY 26, 2010

CURE invited Suzanne Harp, a recently diagnosed breast cancer survivor, to serve as a guest blogger during the 10th Annual Conference for Young Women Affected by Breast Cancer in Atlanta, February 26-28.

After six months of stumbling though a daze of diagnosis, surgery, and treatment, this weekend is marked on my calendar in red ink.

Even the "snow hurricane" swirling around the East Coast cannot keep me from attending the 10th Annual Conference for Young Women Affected by Breast Cancer in Atlanta. At the very least, all those waits at the hospital have taught me to be patient in the airport. But it's an odd sort of anticipation: there are still moments when I can't believe all this really happened to me.

I hope the event will symbolize my transition from "I have what?" to joining the company of women who are making the most of their lives and doing their part to help find a cure.

However, before I join this community of the bald, brave, and beautiful, there is apparently a lei ceremony. The last time I was "lei'ed" was 18 months ago on my honeymoon in Kauai. But upon arrival to the conference, we will receive a faux floral necklace color-coded to our status--years of survivorship, whether we have metastasis, and so on. For some reason, I have a bit of trepidation about this; perhaps I subconsciously think it will make the diagnosis more official?

Still, Shriners have hats, square dancers have crinolines, wearing something unique is part of being initiated into a group. Even though my last participation in a women's organization involved a green jumper and selling Thin Mints, I have always been fascinated with gatherings, like conventions of Mary Kay sales ladies and Alpha Kappa Alpha sorority members. Now, I am a card-carrying member of the cancer club.

Which brings me to my real question: What sort of survivor do I want to be?

While I like looking at pictures of women in resplendent pink breast cancer awareness outfits, I'm not comfortable wearing pink ribbons yet. I sometimes wonder if people expect me to live a perfect cancer-fighting lifestyle now. Some of my breast cancer buddies have made huge strides like going vegan and eliminating sugar. I'm still trying to cut down on hamburgers.

There has already been a little dust up on the YSC message boards about alcohol. One poster believes it's irresponsible for a cancer organization to offer cocktails, while another woman counters that after seven years with mets she's earned a margarita.

One thing I am sure of: I'm very grateful for this opportunity to write; it allows me to slip into a familiar role of being a journalist. While I have not figured out how pink or organic I will be, I know I believe in the power of communication.

United we stand, as long as our shoes are comfortable.

Suzanne Harp spent 10 years as a television news anchor in Minnesota, Wisconsin, Maine, and New York. She was diagnosed with breast cancer in September. She lives in New York City with her husband Ethan, and blogs at www.joinourloop.blogspot.com.

Unraveling the complexities of myeloma therapy

BY GUEST BLOGGER | DECEMBER 14, 2009

Diane Gambill, PhD, is CURE's senior scientific advisor and chief scientific officer for Physician's Education Resource and Cancer Information Group.

For years, debates over the right way to deliver therapies for cancer have included questions on whether to give one drug up front or two (or more), and whether to save your "best" drug for later if your disease returns. For myeloma, the emerging picture is that three drugs are better than two, and two are better than one such that using all your best drugs up front might be best. At this year's American Society of Hematology meeting, a plenary session paper showed that if a proven three-drug regimen is followed with additional therapy, termed maintenance therapy, patients do even better.

The study, conducted by Dr. Maria Mateos and colleagues in Spain, included 260 newly diagnosed patients who were at least 65 years old. The trial compared induction (or initial) therapy with Velcade/melphalan/prednisone (VMP) to Velcade/thalidomide/prednisone (VTP). One aim of the trial was to figure out whether you really need a type of drug called an anthracycline, so the comparator arm replaced the anthracycline melphalan with thalidomide, an immunomodulatory agent. One notable part of the design of this study was the use of Velcade on a weekly rather than twice-weekly schedule. The investigators wanted to know if by reducing the dose, they could reduce the overall adverse event profile without compromising efficacy.

The response rates were very similar between the two regimens in this part of the trial (80 percent versus 81 percent). VMP was associated with more hematologic toxicities, and VTP was associated with more cardiac toxicities. There was less Velcade-related peripheral neuropathy with the weekly schedule than you would expect to see with the twice-weekly schedule.

Once induction therapy was completed, patients in each arm were randomized to receive maintenance with either Velcade/prednisone (VP) or Velcade/thalidomide (VT). Adding maintenance therapy to the induction regimen increased the complete response rate, and the toxicity added by the extended therapy was low. The use of VT following either induction regimen improved progression-free survival by a statistically significant length of time compared to VP (not reached versus 33 months); however, this improvement did not translate into an increase in overall survival. Further, VMP followed by VT was found to be better than VTP followed by VP, which means the anthracycline (melphalan) component of induction therapy is important to keep.

The main take-home messages from this study are that a less intense regimen with follow-up maintenance therapy is safe and effective. These results reinforce the notion that duration of therapy is an important factor in getting the best results--if you can receive all of your planned therapy without dose reductions or skipping doses, your myeloma is more likely to respond--and that maintenance therapy adds to the benefit.

Highlights from SABCS 2009

BY GUEST BLOGGER | DECEMBER 13, 2009

Every year, CURE invites one advocate who is attending the San Antonio Breast Cancer Symposium to serve as a guest blogger. This year readers have been hearing from Bev Parker, PhD, a 24-year breast cancer survivor who is attending the symposium for the seventh year.

As I write this, I'm sitting in the final session of the symposium. These few days have been packed with information and activities. I gained new knowledge (e.g., taking oral bisphosphonates might reduce the risk of breast cancer recurrence), some of which could be useful personally (vitamin D might alleviate joint and muscle pain from aromatase inhibitor treatment).

I spent these days in a mix of physical and mental activity: rushing to and from the hotel, going to events and meetings, and sitting for long periods in the sessions. On the plane back to Chicago and in the coming days and weeks, I'll have time to reflect on all that happened in San Antonio.

Below--in no particular order--are some of the special memories I'll take with me:
>Meeting other advocates and reconnecting with old friends

>Posters to read at leisure and copies to take home

>Hot Topics mentor sessions put on by the Alamo Breast Cancer Foundation

>Getting away to relax and enjoy the Alamo gardens

>Shopping at the mall I had to cut through to get from the hotel to the convention center

>Talking with oncologists (and getting free second opinions!)

>Receptions and presentations just for advocates (put on by Novartis, Genomic Health, and Genentech)

>Meeting with others about the upcoming I-SPY 2 adaptive trial

>Lots of free food and drink (way too much for the weak willed!)

>Attending sessions of special interest and those given by researchers I particularly respect

Although "risk reduction" is the watchword rather than "cure" or "prevention," we all hope that one day prevention will be possible and, barring that, a cure. Hope abounds here, also synergy and energy. With the commitment, passion, and intellectual potential evident at this symposium, hope is well-justified. I look forward to next December and learning all the good things that will happen between now and then.

That's all from San Antonio!

To read more articles from CURE's coverage of SABCS 2009, visit sabcs2009.curetoday.com.

Advocates question the experts

BY GUEST BLOGGER | DECEMBER 12, 2009

Every year, CURE invites one advocate who is attending the San Antonio Breast Cancer Symposium to serve as a guest blogger. This year readers will be hearing from Bev Parker, PhD, a 24-year breast cancer survivor who is attending the symposium for the seventh year.

For advocates, a significant highlight of the symposium is always the evening "Hot Topics" sessions, now in their 12th year. Hot Topics is sponsored by the Alamo Breast Cancer Foundation, which this year awarded scholarships to 34 advocates to participate in the symposium. Slots to attend are highly sought after, and advocates may only apply every five years. (For more information, visit www.alamobreastcancer.org .)

The two-hour Hot Topics sessions are held during three evenings following the daily presentations. Several well-known individuals who hold MD and/or PhD degrees participate on a panel of experts. Each day features a different panel and each person on the panel gives a 10 to 15 minute overview of what he or she found most interesting during the day.

Afterward, advocates are encouraged to ask questions, to which the panel members respond. We advocates are free to pose those questions we might feel too "dumb" to ask in open sessions. In turn, the experts often remark that Hot Topics sessions are the high point of the symposium for them. Here are a few of the interesting off-hand comments made by a few of the panel members:

>"We ask one [research] question and get two more" (Hyman Muss, MD).

>We don't know "how long is long enough on an AI [aromatase inhibitor]" (Judy Garber, MD).

>"Pharmacogenomics is the wave of the future" (Peter Ravdin, MD, PhD).

>"The bone is the first site of recurrence in a third of patients." (Julie Gralow, MD).

>"It's hard to wait to get the results of clinical trials." (Steven Shak, MD).

Advocates have been brought into the scientific process more and more in recent years. We have talents, skills, and experience to offer, and we use them on grant review committees, institutional review boards, government committees, etc... In addition, one of our most valuable contributions is putting a "face" on the disease of breast cancer. We represent therapies that worked and are here to join with scientists and others to push for newer and better therapies that were not available for those who didn't make it, but will be for those who follow.

More tomorrow!

To read more articles from CURE's coverage of SABCS 2009, visit sabcs2009.curetoday.com.

Trial tests new drugs, male breast cancer detailed

BY GUEST BLOGGER | DECEMBER 11, 2009

Every year, CURE invites one advocate who is attending the San Antonio Breast Cancer Symposium to serve as a guest blogger. This year readers will be hearing from Bev Parker, PhD, a 24-year breast cancer survivor who is attending the symposium for the seventh year.

Breast cancer advocates at the San Antonio symposium have many opportunities to be involved and to learn. Two of my favorites today were the I-SPY 2 trial and posters on male breast cancer.

Laura Esserman, MD, of the University of California at San Francisco, is the dedicated principal investigator of I-SPY 2, and Jane Perlmutter, PhD, is the tireless champion of advocate involvement (among many others spending countless hours on the trial). These two individuals hosted a breakfast today to educate interested advocates. I-SPY 2 features a random, adaptive, neoadjuvant design that involves testing investigational drugs in women whose locally advanced breast cancer is at high risk of recurrence.

Prior to surgery, these women will undergo standard chemotherapy, and as many as 80 percent will also be given investigational drugs. Tissue from the surgery will rapidly identify the drugs that increase the chance that no cancer remains (referred to as "pathological complete response").

Many drugs will be tried (among the first, a PARP inhibitor) and each will be tested on 20 to 120 patients, based on biomarker profiles. Patients will be followed for three to five years. This trial design allows for learning while doing, enables earlier drug approval, and drastically reduces costs.

The trial will be conducted throughout the country with about 15 open sites by May 2010. The drugs that increase the chance that women will have a pathological complete response will go into phase 3 testing. One exciting part is that advocates have been involved at every step along the way.

Male breast cancer comprises about 1 percent of breast cancer cases diagnosed each year in the U.S. Of the more than 1,000 posters presented this year at the symposium, five featured male breast cancer. One study was conducted in each of the following countries: Canada, Germany, Sweden, the U.K., and the U.S.

Below are some of the study conclusions, alphabetical by country:
>Most men were prescribed adjuvant endocrine therapy, usually tamoxifen. Despite increased use of endocrine therapy, overall survival has not changed significantly over time.
>Luminal A is the most common type of male breast cancer. It shows a significant improved outcome compared with basal-like tumors.

>No difference exists in the distribution of stage at diagnosis between male and female breast cancer.

>Subtle differences exist between male and female breast cancer regarding hormone receptor profiles.

>Men and women may share common risk factors for breast cancer. The biology of male breast cancer resembles the late onset and ER-positive type of female breast cancer.

Mortality rates for breast cancer have improved over time, but progress for men lagged behind that for women.

More tomorrow!

To read more articles from CURE's coverage of SABCS 2009, visit sabcs2009.curetoday.com.