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BY GUEST BLOGGER | DECEMBER 13, 2010
CURE invited Laura Nikolaides, director of research & quality care programs at the National Breast Cancer Coalition, to share her thoughts on the 2010 meeting of the San Antonio Breast Cancer Symposium and NBCC's Breast Cancer Deadline 2020.
One year I want to return home from the San Antonio Breast Cancer Symposium (SABCS) with great news for my daughter Kira, who is 11. I want to tell her that there were big new discoveries, and she won't need to worry about having breast cancer or going through the harsh treatments that her mom did.
But leaving this year's meeting, the 33rd, I think about what I can tell her. We may have some new combinations of drug treatment or some new schedules that are just as good as the old ones or maybe a little better. We found out that several drugs don't work like we thought they would. We may have some new options for treatment that will be less toxic. But I cannot tell her that we are any closer to knowing how to avoid the disease or how to make sure no woman will die of the disease.
If we meet the National Breast Cancer Coalition's Breast Cancer Deadline 2020, I will be able to deliver that news to Kira, just before her 21st birthday.
Ending breast cancer is not a new idea for NBCC. It has been our mission since 1991. But despite scientific progress, greater knowledge of the biology of breast cancer, great strides in many areas of technology and movement toward targeted, less toxic treatments, we are falling short in significantly reducing morbidity and mortality from the disease.
To harness the significant discoveries that have already been made, to shift the focus of resources, institutions and scientists to the work that will lead to ending this disease and to bring back a sense of urgency, NBCC has declared a deadline for ending the disease – January 1, 2020. We know that setting a deadline alone won't end breast cancer, but we believe a change in focus will. Business as usual is not working. A deadline will help us all reset the course.
To meet our deadline, NBCC advocates believe that efforts must be focused on learning how to prevent the disease and learning how to prevent or stop metastasis. How relevant was the research presented at this year's SABCS? Not so good on the first aspect, learning how to prevent the disease, a little better on the second. There was acknowledgement of the need to understand tumor dormancy and metastasis to significantly reduce mortality, but unfortunately, not a lot of answers yet.
The symposium was dominated, as it is each year, by sessions on variations in drug regimens and sessions on finding new drug targets to prevent cancer growth. But we've been following this approach for many years and gaining only incremental progress. We welcome any discussion and research on possible new approaches.
The first plenary on Day 1 did focus on a somewhat new area for cancer research. Rather than a focus on a genetic pathway for tumor growth, Dr. Chi Van Dang talked about pathways of tumor metabolism, specifically how tumors get and use their fuel or energy. Could this be a new approach that opens up possible treatments or even prevention tools? Maybe new knowledge of how tumors work could help us meet Breast Cancer Deadline 2020. Unfortunately, there was little discussion on the implications for therapy, whether there are existing therapies that could work, or whether there might be non-drug ways to interrupt the energy metabolism of tumor cells. And there was also no opportunity to ask questions - I wanted to ask if it is less likely that a tumor will develop resistance to the treatment if you target an energy metabolism pathway versus a growth pathway.
Eight presentations on therapy for ER-positive breast cancer - aromatase inhibitors (AI) and tamoxifen - followed the opening plenary. I was disappointed to see so much emphasis given to tweaking AI and tamoxifen therapy, though some of the data presented concerned reducing the amount of treatment received or finding solutions to treatment resistance, which are both important.
The last session of the morning was an award lecture on circulating tumor cells, given by Dr. Klaus Pantel. Dr. Pantel presented data to show that 36% of women who had previously treated early breast cancer and no clinical signs of disease, have tumor cells in their bone marrow. He also presented data to show that women who have circulating tumor cells in the blood were more likely to experience recurrences. Dr. Patel said a key factor in reducing deaths from breast cancer will be in learning more about these circulating tumor cells and tumor dormancy, which is currently poorly understood.
Speakers in the afternoon agreed that decreasing mortality from breast cancer will require having a better understanding of tumor dormancy and recurrence. Breast cancer has been known to recur up to 25 years after the primary tumor was removed. But unfortunately, more questions were asked than answered. What we don't know is how common is tumor dormancy, where the dormant cells reside in the body and what reawakens them, the speakers said. I was gratified to hear these discussions in the areas of focus that will be crucial to meeting the Deadline, but hope research will be focused over the next few years on answering these questions.
If the first day was about tweaking drug therapy for hormone receptor-positive breast cancer, the second day was about tweaking drug treatment for HER2-positive breast cancer. But I sat up and took notice during the first presentation of the day, when the speaker spoke of moving beyond drug therapy.
Dr. Neil Spector, of Duke University Medical School, spoke of the problems with resistance to current HER2-positive therapy and the possibilities of future combination therapies. But he finished his talk by saying that we can't keep continuing down this path of adding more and more expensive, targeted therapies - an approach that will make treatment out of reach for everyone but the very wealthy. He said instead, that he was convinced a better strategy would be to focus on immunology, particularly the development of a HER2 vaccine.
The remaining talks of the morning mostly focused on refining anti-HER2 treatment, either through combination therapy or neo-adjuvant (before surgery) therapy. Dr. Eric Winer, of the Dana-Farber Cancer Institute, followed the sessions with a discussion of the benefits of neoadjuvant studies, including the ability to look for biomarkers that will predict how well the drugs will work in a patient and the ability to compare different drugs to each other more quickly, but he cautioned that we don't know yet if a pathological complete response predicts better survival.
Finally, on Day 3 of SABCS, there were at least a few presentations on bigger change, beyond drug tweaking. Looking at things in a new way, and considering new approaches, is exactly what we will need to meet Breast Cancer Deadline 2020. The day began with a non-cancer researcher, Dr. Dan Ariely, talking about the "Upside of Irrationality." Dr. Ariely, professor of behavioral economics at Duke University, challenged the 10,000 clinical oncologists, cancer researchers and advocates at the symposium to reconsider what they think they know and recognize that often pursuing what we think is a rational approach, might be completely wrong. He presented research to show how things are not always as they appear to people, and that often, people must be willing to pursue what may seem irrational to get results.
I hope the group had Dr. Ariely's presentation in mind when they heard the William McGuire Memorial Lecture given by Dr. George Sledge, of the Indiana University Simon Cancer Center, later in the morning. The consensus among many cancer researchers is to continue down a path of pursuing research on genetic mutations and drivers of cancer growth and to look for drug targets. But Dr. Sledge points out that where cancer has been viewed as a biology problem, with a focus on genetics it is now increasingly clear that it is becoming a mathematical problem. He used the phrase "genomic chaos" in talking about the increasing complexity of cancer genomics - the multiple genetic drivers of each tumor and the variability among individuals.
The $1000 genome for individuals will most likely be available in the next three years, he said, making data cheap, but also leading to increased complexity. He demonstrated the mathematical difficulty of recruiting enough truly similar patients for a clinical trial of a targeted drug treatment, for instance, with this increase in genetic complexity.
Dr. Sledge's presentation reinforced for me that continuing down this pathway in breast cancer research, the approach that has dominated for decades, appears to be increasingly futile in terms of finding the major breakthroughs for prevention and treatment of breast cancer. And circling back to what Dr. Ariely said, maybe we need to reassess our assumptions and decide if what we think has been a rational approach in breast cancer research may have been all wrong.
Dr. Sledge finished his presentation by suggesting a few possible alternative approaches, including prevention approaches, an immune based approach or a metastasis suppression gene approach.
I look forward to next year's SABCS, and hope that I will be able to report to my daughter that our Deadline work has begun to cause a shift in focus. I hope I can tell her that researchers are focusing efforts on learning how to prevent breast cancer and learning how to prevent or stop metastasis of the disease from taking women's lives, the things that will matter most for her generation. If we change the focus of the extensive resources devoted to breast cancer research now, we will meet our Deadline, which will be great news for Kira and her friends.
You can find out more about NBCC's The Breast Cancer Deadline 2020 at www.stopbreastcancer.org.
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BY GUEST BLOGGER | DECEMBER 11, 2010
CURE invited Kathleen (Kat) Werner, a breast cancer survivor, to serve as a guest blogger during the 33rd annual San Antonio Breast Cancer Symposium, December 8-12. You can read her full story here.
There were two unique presentations today that were less about heady science and more about changing the paradigm of research and how doctors practice. It was a refreshing perspective on the big picture and how we can change direction to make bigger strides in research rather than the small baby steps that make some feel like we are standing still while the cancer world spins around us.
The morning talk was by Dan Ariely, an Israel-born professor of psychology and behavioral economics who teaches at Duke University. I'll admit I had never heard of him when he stepped up to the podium. His talk was a fascinating glimpse into a non-cancer specific examination of the decision-making practice that can be applied to health care providers and how they consult with their patients.
I wish he had had more time to speak, because he only just touched on the issues he has published in his bestsellers, Predictably Irrational and Upside of Irrationality. He explores that we are often trained into what becomes our "gut reaction," and that this instinct can often be guided by so many other societal pressures, and often it is flat-out wrong.
He challenged the audience of researchers, advocates and health care providers to consider a paradigm shift from status quo or standard practice and really think of what is best for each patient rather than what is easy, takes less work or may be counterintuitive. He gave an example of something called, "The Jam Study" in which people where given 24 choices as opposed to six choices of jam and the sheer quantity of choices made the person less likely to buy jam at all. The argument could be made that this is a study of people's choice in fruit preserves and not something nearly as important as major health care decisions, but his data actually proves otherwise.
Health care providers need to be mindful that a balance needs to be struck with patients in providing good viable options, but overwhelming the patient, without coming alongside them to make sure they are properly educated, can cause the patient to shut down and refrain from really considering the details and real cost of all options.
In the afternoon, Dr. George Sledge from Indiana University Simon Cancer Center (and current president of ASCO, the American Society of Clinical Oncology) gave the William L. McGuire Memorial Lecture (a honor given once a year in memory of Dr. McGuire, one of the founders of SABCS.)
By the title, "What would Bill do? Channeling your inner McGuire" it would seem, at first glance, like a witty discussion on the state of where research is going. Dr. Sledge did not mince words in really laying out some priority changes that need to happen within breast cancer research if we want to get serious about finding cures.
His seven point "rules" touched on some important issues that are being ignored by many researchers. His primary issue was the respect we need to have for the tissue sample itself; keeping it long term, obtaining demographics around it and collecting normal breast tissue for comparison. (For the record, Susan G. Komen for the Cure has established the Komen Tissue Bank at Indiana University for exactly this purpose.) Dr. Sledge also spoke to the importance of the research environment both in practice and the people who practice it. He chided the room to be serious in pushing for clinical trials rather than becoming dependent on diagnostic studies. He also sang the praises of how he had surrounded himself with "excellence" but working alongside great researchers who were always willing to challenge the status quo. Most importantly, Dr. Sledge reminded us that, "The clinic is the final laboratory."
This tremendously important issue calls to mind that just because something works in cell lines, mouse models or data sets, does not mean it will work in the human patient. The media is quick to jump on data showing huge promise in these models (see the excitement over breast cancer vaccine studies) but the reality is, we just have not seen most of these exciting advancements in the human being. Last time I checked I was not a rodent, and thankfully my research validity did not die after 14 days when I was dissected for research. These are, of course, important stepping stones in the research process, but they need to be considered for what they are--simply a start.
Kathleen "Kat" Werner is a cancer research advocate after being diagnosed with breast cancer at age 31. She travels the country and sits at the table with private and government agencies, fighting for the best treatments for newly diagnosed women and ultimately a cure for breast cancer. She lives is Blacksburg, Virginia with her husband of 11 years, Jeff, and her three young children. Read her blog, "Next Generation Research Advocate."
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BY GUEST BLOGGER | DECEMBER 10, 2010
CURE invited Kathleen (Kat) Werner, a breast cancer survivor, to serve as a guest blogger during the 33rd annual San Antonio Breast Cancer Symposium, December 8-12. You can read her full story here.
At the end of each day of the San Antonio Breast Cancer Symposium (SABCS) the Alamo Breast Cancer Foundation hosts a "Hot Topic" review session to give advocates a day in review of some of the stand-out information from each day's presented studies. It brings together noted figures in the field of breast cancer research, including doctors and basic science researchers who provide feedback and sometimes commentary on what we have learned that day. Attended mostly by advocates, this session is a snapshot of our progress made in various areas of drug use, surgical technique, basic science research, trial data, poster review and noted findings.
There is a clear bias in reporting in this country to publish data from cancer research that presents positive results. It may be more exciting, it may be to preserve funding sources, it may be professional affirmation, but the negative findings (or where a researcher does not prove their given hypothesis) is often hidden from view or not given as much attention. This negative data reporting is just as important as positive advances made in various areas. Without this data we are not steered away from treatment that may cause harm, treatments that are simply wasting our time and resources or spinning our wheels in looking in the same places for cures that just are not present. First, we must understand how we define success in a trial. There are several important measurements of success depending on the trial and how it is measured. Overall survival (OS) is the chance that someone will survive a disease. A five-year OS means, "What is the chance that the patient will be alive in five years?" Disease-free survival (DFS) means what are the chances that the patient will not only be alive, but will be disease-free in that time period. Progression-free survival (PFS) is often used in stage 4 measurements to indicated how long a patient's disease remains stable without indication of growing disease, spreading disease or progression of disease. Whether five years is long enough to truly measure the success of an intervention is a growing debate, and there is more support given to studies that show results in terms of 10 year or more. However, this is difficult to fund, report on and impractical in many research situations.
Today, there was data presented from the AZURE trial that a hopeful drug used traditionally for bone loss and osteoporosis issues, zoledronic acid (also known by the trade name Zometa), may not have the awesome promise of preventing breast cancer recurrence as we had hoped. There is some small data within this study that suggests it might still be a benefit for women who have been in menopause for five or more years, but more research is needed to confirm this sub-analysis.
A study looking at the drug capecitabine (trade name Xeloda) combined it with a commonly used chemotherapy, a taxane, also showed no more benefit that the current use of taxanes. It is still showing benefit in the metastatic setting, but the hope that this drug, which does not cause hair loss and can be less severe in side effects for early-stage cancers, is not the great alternative it was hoped to be.
A study examining the consistency of metastatic pathological results with the primary tumor gave a sobering result in a study that as much as 26% of metastatic tumors had a different pathology than the original primary tumor, with either loss of HER2 or hormone receptor changes. This result was particularly alarming because it is not standard of care to biopsy a metastatic lesion to make sure it matches the original tumor. Therefore, the risk of not using available treatments, or over treating a new and different tumor type, is a very real concern.
Several advocates, researchers, and physicians have made the observation that a great deal of studies being presented this week are from areas outside the United States. Some smaller countries like Finland, Austria, Norway and Spain are presenting big data and really putting the U.S. to shame in their patient accrual rates for trials. The U.S. can put a man on the moon or create the atomic bomb, but we are still trying to keep up with the ability of our smaller research counterparts to provide such great data from research. At the Hot Topics session, this question was briefly addressed with suggestions that perhaps this is because of socialized medicine in other countries, which encourage the governments to support research into cheaper and more effective treatments to get the best, "bang for their buck."
Perhaps it is the over-regulation in the U.S. that has made researchers and institutions become bogged down in 20-page waivers and lawyers hovering. It might be the government's terrible lack of funds in supplying funding for the administrative needs that come from trial oversight, registry, and maintenance. Whatever the reason, it is a clear area where advocates in the U.S. can and should demand better and push for a process and resources that can make the trial process and enrollment more accessible to patients and researchers.
Kathleen "Kat" Werner is a cancer research advocate after being diagnosed with breast cancer at age 31. She travels the country and sits at the table with private and government agencies, fighting for the best treatments for newly diagnosed women and ultimately a cure for breast cancer. She lives is Blacksburg, Virginia with her husband of 11 years, Jeff, and her three young children. Read her blog, "Next Generation Research Advocate."
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BY GUEST BLOGGER | DECEMBER 9, 2010
CURE invited Kathleen (Kat) Werner, a breast cancer survivor, to serve as a guest blogger during the 33rd annual San Antonio Breast Cancer Symposium, December 8-12. You can read her full story here.
There were three main sessions today at the San Antonio Breast Cancer Symposium (SABCS) that had some of my fellow advocates discouraged that we weren't getting very far on the fight against breast cancer. I saw the sessions a little differently, giving some of the power to the patient to decide how they are going to attack breast cancer without having to worry about overcomplicated issues clouding their decisions.
A session in the morning shared various endocrine treatments for hormone-positive cancers and their comparisons of effectiveness. Then I attended a mid-day heated discussion on the evidence for and against changing mammography guidelines for women ages 40 to 49. In the afternoon, we had a frank look at BMI (Body Mass Index) and survival outcomes for women with breast cancer.
At first glance, all three seemed to be a recycle of the same issues and no new really revolutionary findings, but what I saw in these sessions was the ability for the patient to have some control in screening, treatment and even long-term outcomes.
The first session presented data from eight trials looking at various endocrine therapies (primarily aromatase Inhibitors or "AIs") with trade names like: Arimidex, Aromasin and Femara. Each study wanted to examine the effectiveness of different AIs verses tamoxifin or each other or perhaps in different doses over different time periods. The simplified bottom line, to most of these studies, is that that new medicines are not working much more effectively than some of the old standards, and that most AIs can be interchangeable without sacrificing efficacy.
This may seem discouraging to those of us looking for the next great cure, but the silver lining in all this is that the old (and often much cheaper) drugs can work for patients. Also, it means that if patients are having issues with AIs, such as joint pain, they can try other AIs and not feel like they are sacrificing their long-term outcomes. This may seem like a step backward, but it is a short-term victory for patients who don't have access or funding for the latest and greatest drugs being offered on the market.
At the session on mammography guidelines, the audience knew it was in for some varied opinions just from the title, "Controversies in Screening for Breast Cancer." I don't think anyone walked into that room naïve enough to think the mammography debates would be solved within an hour's time, but some great diverging opinions (all fairly well supported with various studies) definitely emerged. The one area all seemed to agree on was that WAY more information was needed to assess the whether benefits outweigh the harms for patients, especially those in the 40-to-49 age group, before everyone can feel confident a concrete guideline can be set. The standard for success also needs to show the full range of outcomes including: surgery type, treatment, chemotherapy, node involvement and most often missed, quality of life.
Five-year survival rates are not the only outcome that is important. A question from the audience was very telling, "Can we trust already overburdened primary care doctors to be knowledgeable enough about what constitutes a high-risk patient when guidelines suggest they are suppose to help guide patients through this decision process?"
Applause erupted. At the end of the day, the burden falls to the patient. We are the ones that need to equip ourselves to know our family history, possible genetic counseling and our breast cancer risks. In this day and age, there is little excuse to access of information. A greater concern can definitely be put on the quality of this information, but this problem is one we can solve. The patient has the power to seek opinions to more knowledgeable providers if needed. The patient has the power to ask questions when they are unclear. The patient has the power to contact government programs, local advocacy groups and their insurers to get services if needed. These resources, while often strained, are available and can be a great catalyst to worthy change of the system.
Lastly, a sobering reality on the direction of general health concerns in our country. A session covering three studies looking at the role of obesity, as measured by BMI, and how it affects outcomes in effectiveness of treatment, recurrence rates, disease-free survival and overall survival. All three studies showed that for women who have hormone-positive breast cancer have worse outcomes in several areas. Even when they account for dosage and account for levels of medicine relative to body size, the women who had a BMI of 30 or greater had significantly worse outcomes than those who had a lower BMI.
Of those women who did have a recurrence, their average time of recurrence to death was also shorter. It can be hard not to feel like if you are an obese woman and you are diagnosed with breast cancer that you do not have a death sentence. However, this research has spurred researchers to look very seriously at lifestyle change, nutritional counseling and reducing BMI as a real viable option in helping women reduce their recurrence rates.
This should be looked at as a positive message that women have an issue that they can work at to make a real change in their outcomes. The power is in the patient to make healthy lifestyle choices and reduce their BMI to make a measureable change in reducing their future breast cancer risks. More research is needed in how quickly and to what level these changes can be made to make the most impact on these numbers.
Kathleen "Kat" Werner is a cancer research advocate after being diagnosed with breast cancer at age 31. She travels the country and sits at the table with private and government agencies, fighting for the best treatments for newly diagnosed women and ultimately a cure for breast cancer. She lives is Blacksburg, Virginia with her husband of 11 years, Jeff, and her three young children. Read her blog, "Next Generation Research Advocate."
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BY GUEST BLOGGER | DECEMBER 9, 2010
CURE invited Kathleen (Kat) Werner, a breast cancer survivor, to serve as a guest blogger during the 33rd annual San Antonio Breast Cancer Symposium, December 8-12. You can read her full story here.
There is a small population of women in the world who carry a gene mutation called BRCA 1 or BRCA 2. BRCA (a simple abbreviation from the first two letters of Breast and Cancer), is not the only gene mutation that can lead to higher incidence of breast cancer.
Unfortunately, not all families that have a strong family history of breast cancer also have a known or detectable gene mutation. So, if one falls into one of these high-risk groups that either has a strong family history of breast cancer or carries a gene mutation, what are they supposed to do?
I am part of one of those families.
I was diagnosed at age 31 with breast cancer, but I was aware before that time that our family line (on my mother's side) had not only a high incidence of breast cancer (I had had four aunts who had been diagnosed by the time I was diagnosed), but also that within our family line lingered this BRCA2 mutation. So, for the growing awareness clinicians have for the population of people (both men and women) who are learning they are positive for a gene mutation or are keenly aware of a strong family history of breast cancer, there is growing concern on how to treat these groups clinically.
On Wednesday at the San Antonio Breast Cancer Symposium three studies were presented that examine this growing controversy:
"Evaluation of breast cancer predisposition in different clinical venues" by Sharon E. Plon, MD, PhD, from Baylor College of Medicine
"Management of women with highly penetrant predisposition to breast cancer: State of the art 2010" by Susan M. Domchek, MD, University of Pennsylvania
"Challenges to clinical application of new discoveries in the genetics of breast cancer predisposition" by Mark E. Robson, Memorial Sloan-Kettering Cancer Center
All three presenters recognized that there is a vast difference in how the clinician has been handling these high-risk groups, and more evidence is needed to equip these doctors on how to deal with genetic mutation carriers.
Women are scared that their only option is that they will be asked to cut off their breasts or "rip out body parts," as one woman put it. They don't even realize that there are other prevention options and screening techniques that can give them an edge. For those who do choose prophylactic mastectomy, their risk for breast cancer is reduced by at least 90 percent. Depending on which gene mutation, some people can have a lifetime risk of developing breast cancer as high as 85 percent - this is a sobering reality. It was disappointing to learn that these studies show a huge variance not only in how these high-risk groups are being treated, but seemingly in how educated the clinicians are themselves on some of these risk factors. If we are going to continue to discover new gene mutations, we need to turn these discoveries into a two-fold action. First, the therapies or screening techniques that can address these variations, and second, we need to make sure that consistent guidelines are being developed to keep doctors up to date on how they can save lives and equip the patient to make the best decisions for the best possible long-term outcomes.
Simply mapping genomes is not enough. Dr. Robson mentioned that the possibility of a future where each individual could have a specific mapping of family mutations or gene mutations could be on the horizon. If we do this though, are we opening up a whole other can of worms? What if we find other mutations for other areas of the body? What if we find mutations that would have never caused harm? These are complex issues that require more research, consistent reporting, standards of care and a constant ear to the individualized patient's long-term outcomes.
Kathleen "Kat" Werner is a cancer research advocate after being diagnosed with breast cancer at age 31. She travels the country and sits at the table with private and government agencies, fighting for the best treatments for newly diagnosed women and ultimately a cure for breast cancer. She lives is Blacksburg, Virginia with her husband of 11 years, Jeff, and her three young children.
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BY GUEST BLOGGER | DECEMBER 9, 2010
CURE invited Kathleen (Kat) Werner, a breast cancer survivor, to serve as a guest blogger during the 33rd annual San Antonio Breast Cancer Symposium, December 8-12. You can read her full story here.
What do you get when you put 36 advocates, leaders from advocacy groups large and small, and survivors in a room with at least five representatives from the biggest pharmaceutical companies?
No, it's not the start of a bad joke; it's the start of the San Antonio Breast Cancer Symposium. Last night this group of advocates gathered for a welcome dinner. We shared our stories of what brought us to this day. How our advocacy journey started and what we hoped to do for the future. There was talk of the National Breast Cancer Coalition's (NBCC) 2020 breast cancer deadline campaign, mention of new mammography guidelines, friends lost, sisters saved and a general theme that all of our children need to be spared from the battle we have lived.
I have said it before, but if the cure to breast cancer was based on the character of the warriors fighting to end it, we would have found a cure a long time ago. Everyone in that room, around those tables and entering those doors had made a sacrifice to be there. A sacrifice in time, money, physical health, cultural barriers or sheer distance.
We had advocates from every corner of the world. From remote islands off of New Zealand, Egypt, Nigeria, Scotland, Australia and every corner of the United States. It is humbling to belly-ache about the health care or cancer problems in this country only to hear the story of a Nigerian woman whose sister died of breast cancer, having not told anyone of the lump she found because of lack of proper treatment and cultural stigma. The picture of how many people we are fighting for grows bigger. We suddenly realize the diversity of this non-biased disease and realize a cure in any country can have a worldwide impact on saving lives.
This morning (Wednesday) is the first day of the SABCS. For us advocates, our job starts early. The NBCC offers a free session for advocates called the "Project LEAD Advance Topic Session." (Project LEAD is a premiere science training course provided by NBCC to equip advocates to have an educated seat at the table with researchers in the ongoing dialogue of breast cancer science.) NBCC brings in top researchers from cutting edge institutions all over the country to give a brief overview of some of the highlights of research in the past year and being shared in coming days at the SABCS. It's an intense science session, with the correct assumption that most of the advocates in the room are highly trained and educated and don't need the information "dumbed down." Issues of genetics, metastasis, stem cells, biomarkers, personalized medicine, cell biology, radiation and major areas of concern are addressed in a quick overview to highlight some of the most promising new or developing science. Wednesday afternoon, SABCS officially began for the rest of the attendees. There will be several types of sessions over the next few days:
-Educational Sessions: Designed to provide people with a better understanding of the talks they hear using the techniques that will be described. They provide researchers with a guide to the techniques they should be considering for their studies.
-Panel Discussions: A group of researchers, health care providers, doctors and/or advocates that consult on clinical practices and best methods and collaborative ideas.
-Mentor Sessions: Exclusive to the advocacy community, these sessions match advocates with top researchers and clinicians to provide upcoming highlights and clarification on issues that may be and are being presented this week during the SABCS.
-Networking Sessions: Bringing together groups to foster collaboration, such as young investigators, like sciences, similar methods and like interests.
-Plenary Sessions: A large session that brings together all attendees. It often contains the highlights of the year, exciting new developments that would be of interest to the entire research community. It is a platform for awards and recognition of innovative research and researchers pushing the limits to make real advancements. On the last day, a "Year in Review" session brings together a synopsis of some of the research highlights from 2010.
-General Sessions: Researchers will present their individual studies and their latest findings. It is usually divided into several presenters with a set time to present their findings and slides. Most general sessions have a theme where groups of similar areas of research are presented in sequence as the same session.
-Clinical Science Forums: A dialogue amongst clinicians and researchers on some of the more controversial topics and how we should view the various sides and parties involved. Often contains a panel of various parties to comment on how these issues affect different demographics and decision makers.
-Poster Sessions: A room filled with posters lined on the walls, each representing an individual research project from a principal investigator, post-doctoral, pre-doctoral researcher, clinician or (in fewer instances) an advocacy group. A poster discussion pulls out some of the stand-out posters with positive or negative results from their original hypotheses to create a dialogue on the direction for future or ongoing research.
-Case Discussion: A panel of clinicians, researchers and advocates where actual patient scenarios are presented and arising problems address with the expertise of the panel with comments on new suggestions, perspectives of treatments, outcomes and novel approaches.
Please use these descriptions as your guide to the context the research is reported 1n, by myself and various other groups coming out of the SABCS this week.
Kathleen "Kat" Werner is a cancer research advocate after being diagnosed with breast cancer at age 31. She travels the country and sits at the table with private and government agencies, fighting for the best treatments for newly diagnosed women and ultimately a cure for breast cancer. She lives is Blacksburg, Virginia with her husband of 11 years, Jeff, and her three young children.
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