Sympathy for the masses

BY SUSAN MCCLURE | MARCH 4, 2010

I was wandering down the aisle of my local drugstore, looking for a wrist brace for my terribly clumsy 15-year-old, when I happened upon something that stopped me in my tracks. There, in a bargain bin in the middle of the aisle, was an assortment of boxed greeting cards. Mixed among the "happy birthday" and "thinking of you" cards were a stack of boxed "sympathy" cards for $1.99. That's right, for only $1.99, you can be prepared for the death of a friend or loved one by having an assortment of cards at the ready for just such an occasion. But wait! Why not throw in a box of "get well soon" cards so you're covered just in case your friend pulls through? A set of two costs only $3.00!

I picked up the box of cards, examining the back to see the various sentiments contained therein, but there was no description. But hey, when shopping for bargain sympathy cards maybe the sentiment isn't that important. I opened the box with a card that carried a message stating, "I'm here if you need me." I think it should have said, "I'm here if it doesn't take too long or inconveniences me in any way."

Doesn't someone's death warrant just a little personal attention? Unless you're a pastor or have lots of relatives in Haiti, the boxed sympathy card idea just shouldn't be condoned. I've lost too many friends and loved ones to this disease since my diagnosis in 1997. Each loss was painful and personal. None warranted a generic card. We can't be this busy and overwhelmed as a society... can we?

Gilda's Club and The Wellness Community Join Forces

BY SUSAN MCCLURE | DECEMBER 14, 2009

The Wellness Community and Gilda's Club Worldwide have officially united and unveiled their new, combined identity--the Cancer Support Community. The Cancer Support Community will likely be the largest professionally-led network of cancer support worldwide. This is great news for cancer patients across the U.S. because it will expand the footprint of both organizations, thereby bringing more services to more communities. The new organization includes a network of nearly 50 local Gilda's Clubs and Wellness Community centers worldwide, more than 100 satellite locations and online support services that extend around the world.

"Our common history and commitment to the cancer community is what brought us together," said Kim Thiboldeaux, president and CEO of the Cancer Support Community. "This union creates a strong, vital, global network that will bring the highest quality cancer support to the millions of people touched by cancer."

These offerings include a comprehensive menu of personalized and essential services, including support groups, counseling, education and healthy lifestyle programs. Additionally, the organization is working to expand its vital services to meet the urgent needs of cancer patients and their loved ones. To ensure no one has to face cancer alone, these support services will soon be available to people in all 50 U.S. states and internationally through the Cancer Support Community's network of community-based centers, and at hospitals, community oncology practices and other non-profits, as well as online. The Cancer Support Community is also exploring the use of novel technologies, including mobile, to help extend the reach of these meaningful resources.

I have had the privilege of visiting the Gilda's Club in Dallas several times and am impressed by the variety of support services available to patients and their families. This new union will make those services even more spectacular.

I only have one problem with all of this... the new name. The Cancer Support Community? Really? Gilda's Club and The Wellness Community are such well-known brands in the cancer world. The new name doesn't play off either of them. It's like Coca-Cola and Pepsi joining forces to become Bubble Water. Can't we do better? My colleague, Jeremy Heath recommends changing the name to Wilda's Community. Hmmmm.

Triple negative breast cancer drug one step closer to approval

BY SUSAN MCCLURE | DECEMBER 13, 2009

On Friday, sanofi-aventis announced that the FDA has granted fast track approval to their investigational PARP1 inhibitor, BSI-201, and that accruals for their phase 3 clinical trial is on schedule and meeting expectations on patient accrual and trial site coverage in the United States. Investigators have enrolled 214 of their target number of 420 patients.

The "fast rack" process is designed to expedite the review of drugs being developed for serious diseases with the potential to address an unmet medical need.

BSI-201 entered a phase 3 clinical trial in the United States in July 2009 and is being evaluated in combination with chemotherapy in patients with metastatice triple-negative breast cancer (mTNBC), a condition defined by tumors lacking expression of estrogen, progesterone receptors and without overexpression of HER2. BSI-201 is a novel investigational targeted therapy that inhibits poly (ADP-ribose) polymerase (PARP1), an enzyme involved in DNA damage repair.

The decision to commence with the phase 3 study in July was based on the encouraging phase 2 study results presented at ASCO on May 31, 2009. In the phase 2 clinical trial, women with mTNBC were randomly assigned to receive gemcitabine and carboplatin (GC) in combination with the investigational agent BSI-201 or GC alone. Updated phase 2 data including overall survival were presented on Friday at a poster session during the San Antonio Breast Cancer Symposium.

The addition of BSI-201 to GC improved median overall survival from 7.7 months to 12.2 months. BSI-201 did not add to the frequency or severity of adverse events associated with chemotherapy. This is not a final analysis of the phase 2 data, but an updated analysis of overall survival. Median survival hasn't yet been reached in the BSI-201 arm, therefore the data cut-off period for the phase 2 trial was from September to November.

"The updated analysis from the phase 2 program, including data on overall survival, are consistent with the positive results presented earlier this year at ASCO," declared Marc Cluzel, executive vice president, R&D, sanofi-aventis. "We are very encouraged by the fast recruitment of patients in phase 3 trial. We hope the findings will lead to emerging strategy that may help women with metastatic triple negative breast cancer."

New mammography guidelines continue to spark debate

BY SUSAN MCCLURE | DECEMBER 12, 2009

You'll recall the public outcry that occurred in October when the U.S. Preventive Services Task Force issued a report that recommended significant changes to existing mammography guidelines. The debate continues among physicians, scientists, and advocates here in San Antonio.

Back in October, the 16-member committee recommended that most women in their 40s should not routinely get mammograms. Additionally, women 50 to 74 should get mammograms every other year until they turn 75, after which the risks and benefits are unknown. Women 75 and older should not get regular screening. The committee is also against teaching women to do regular self exams because "the value of breast exams by doctors is unknown and breast self exams are of no value."

The American Association for Cancer Research (AACR) released a response to the new guidelines which stated that they recognize that these are complex issues that encompass a broad range of areas - medical, scientific, public health, economic and sociological - and that the interpretation of these data can result in legitimate disagreement among respected leaders in their fields. Decisions on the delivery of screening methods and treatment of cancer should be evidence based and that the "state of the art" in the field is evolving and will continue to change as our understanding of the biology and genetics of cancer is better understood. They also recognized that mortality rates from breast cancer have been falling since the mid-1990, and they believe that this is attributable at least in part to the more widespread utilization of mammography screening and other factors. Their statement concluded by saying that the issues are simply too complex to make a clear statement at this time supporting either the existing guidelines or those proposed by the USPTF.

To me, that response equates to issuing a "no comment."

The Breast Cancer Network of Strength took a much more definitive stance. Margaret Kirk, the foundation's President and CEO said, "We know that earlier diagnosis and treatment of breast cancer leads to better outcomes. As an organization that hears from tens of thousands of women through our 24/7 YourShoes support center, we would be disappointed if this new recommendation became yet another barrier that women will have to overcome to get the care they need."

Over 7,000 people have sounded off about the new mammogram guidelines by signing Breast Cancer Network of Strength's petition. You can too by clicking here.

I was 35 when I found my lump and had it confirmed via mammography and biopsy. It's important to note that my mammogram was considered diagnostic and would still be covered under the new recommendations. However, had I done the mammogram two months earlier, when my doctor recommended it at my annual check up, it wouldn't have been because the tumor hadn't been detected then. At 35, and with no family history, I felt invinsible. I procrastinated.

I salute Margaret Kirk and the Breast Cancer Network of Strength for keeping the public's voice at the forefront of this issue.

Endocrine therapy passion gives three researchers rock star status

BY SUSAN MCCLURE | DECEMBER 10, 2009

This afternoon I attended a general session at SABCS where Susan G. Komen for the Cure awarded the Brinker Awards for Scientific Distinction to three researchers for their work in endocrine therapy. Huh? Ok, first, let me give you a definition of what endocrine therapy is. According the the National Cancer Institute, endocrine therapy is:

Treatment that adds, blocks, or removes hormones. For certain conditions (such as diabetes or menopause), hormones are given to adjust low hormone levels. To slow or stop the growth of certain cancers (such as prostate and breast cancer), synthetic hormones or other drugs may be given to block the body's natural hormones. Sometimes surgery is needed to remove the gland that makes a certain hormone. Also called hormonal therapy, hormone therapy, and hormone treatment.

The awards went to Geoffrey L. Greene, PHD of the University of Chicago, Benita Katzenellenbogen, PHD, University of Illinois-Urbana Champaign, and Professor Ian Smith of the Royal Marsden Hospital of London. In a nutshell, their combined resarch revolves around understanding estrogen receptors and how we can provoke them respond to treatment.

I'm no scientist, and I promise to stick to "color commentary" from this point forward, but what I can tell you is these guys are heavy hitters. They have not only changed the way cancer is dianosed and treated, but also how outcomes can be predicted.

In a packed hall with hundreds of docs hanging on every word, each researcher told the audience about their work in endocrine therapy. Dr. Greene's research determined that receptors exist. Dr. Katzenellenbogen's reseach focused on how receptors respond to various hormones. Dr. Smith's research involved early clinical development of anti-cancer drugs based on this research.

One of the first questions doctors want to know when assessing treatment options for their patients is whether the tumor is ER positive or negative. The answer will determine which treatment pathway to follow. This reasearch will also help doctors determine which patients will (and won't) respond to chemotherapy. More on that tomorrow.

The cure to cancer is complicated, but tonight's award-winners have helped us better understand this deadly disease by finding ways to trick hormones into working with us instead of against us.

The 32nd annual San Antonio Breast Cancer Symposium gets under way

BY SUSAN MCCLURE | DECEMBER 9, 2009

On November 11, 1978, a group of 141 physicians and surgeons from a five state area got together during Breast Cancer Awareness Week to discuss ways to reduce the death rate caused by breast cancer in San Antonio and surrounding counties.

Fast forward 31 years.

This year's symposium will host an estimated 8,500 participants from more than 90 countries and instead of gathering for a single day, attendees will stay for five. What began as a novel idea has gained unfathomable momentum. The overall objective of SABCS, however, remains the same. Its mission is to produce a unique and comprehensive scientific meeting that encompasses the full spectrum of breast cancer research, facilitating the rapid translation of new knowledge into better care for breast cancer patients.

For the next few days, the CURE team will be bringing you updates from this very important gathering of international thought leaders. Not only will we deliver the latest and greatest scientific news surrounding breast cancer, but will also be talking to survivors and advocates about their passionate causes. We'll be blogging, tweeting, writing, and filming daily so be sure to follow us here.

Follow us on facebook and twitter too!

Cancer's silver lining... Free housecleaning!

BY SUSAN MCCLURE | NOVEMBER 19, 2009

If you know a woman currently undergoing chemotherapy, tell her that there is a cleaning service that provides FREE housecleaning once per month for four months while she's in treatment. All she has to do is sign up and have her doctor fax a note confirming the treatment. Cleaning for a Reason will have a participating maid service in her area arrange for the service. Click here to to learn more http://www.cleaningforareason.org/ This organization serves the entire Country and has 547 partners to help take the tough work of housecleaning off of women in need. So spread the word and let them know that there are people out there that care-- and clean!

Federal task force says women need fewer mammograms. Sound reasoning or rationing?

BY SUSAN MCCLURE | NOVEMBER 17, 2009

Bewilderment. That's the only word I can use to describe how I felt upon reading an article in my daily newspaper this morning (Yes, I still read the daily paper). The story reported on an influential federal task force's recommendation that women have fewer mammograms. "We're not saying that women shouldn't get screened. Screening saves lives," said Diana Petitti, vice chairman of the U.S. Preventive Services Task Force. "But we are recommending against routine screening. There are important and serious negatives or harms that need to be considered carefully." The recommendations of this committee would set the standards for preventative health care services under health care reform and would be used to determine which tests would be covered by insurance plans. These guidelines are for the general population, not for those at high risk of breast cancer.

The 16-member committee recommended that most women in their 40s should not routinely get mammograms. Additionally, women 50 to 74 should get mammograms every other year until they turn 75, after which the risks and benefits are unknown. Women 75 and older should not get regular screening. The committee is also against teaching women to do regular self exams because "the value of breast exams by doctors is unknown and breast self exams are of no value."

Those who side with the task force's findings say that more testing, exams, and treatment are not always beneficial and may cause harm to patients. The article stated that in about 10 percent of cases, false positive results caused anxiety among patients and lead to unnecessary procedures such as disfiguring biopsies and in some cases, surgery, chemotherapy, and radiation.

Those on the opposing side said that this is a huge step in the wrong direction. Daniel Kopans, a radiology professor at Harvard Medical School said, "Tens of thousands of lives are being saved by mammography screening, and these idiots want to do away with it." Dr. Phil Evans, director of the Center for Breast Care at UT Southwestern Medical Center in Dallas predicted that conducting fewer mammograms would be a mistake. "Mammography is not a perfect test, but it's still the best test for finding breast cancer early," argued Evans.

The most ominous quote in the article came from Dr. Michael Grant, my breast surgeon at Baylor University Medical Center at Dallas. He said that the timing of this made him suspicious. "Ultimately, this may be how we provide rationale for rationing. They're not saying it isn't worth it -- just that the number of lives it saves is not counter balanced by the cost and trouble of doing it," said Grant. Roughly 39 million women in the U.S. have mammograms each year, costing the healthcare system more than $5 billion annually.

I think I need to dust off my old copy of George Orwell's, Animal Farm. This arguement is sounding vaguely familiar. "All animals are equal-- just some are more equal than others."

Fanged frogs cure cancer! You just wait... It could happen

BY SUSAN MCCLURE | SEPTEMBER 9, 2009

A friend of mine called me yesterday to tell me about an astonishing discovery. Forty new species, including fanged frogs, super-sized rats, and a grunting fish have been discovered in an extinct volcano in New Guinea. He was marveling at how cool our planet is while I was wondering to myself why these new discoveries couldn't include soft, cuddly new dog species. Maybe these discoveries were best left undiscovered. Then it dawned on me... What if the cure for cancer is contained in one of these new plant or animal discoveries? Could fanged frogs save us all? Many of cancer's most innovative treatments have been derived from plants, sea creatures, etc... Don't believe me? Check out our Summer 2006 cover story "Surf & Turf: Nature's Hidden Medicines."

To read more about the 40 new species, go to www.guardian.co.uk/environment/2009/sep/07/discovery-species-papua-new-guinea

Certain anti-depressants taken with tamoxifen pose risk

BY SUSAN MCCLURE | SEPTEMBER 8, 2009

In CURE's upcoming Fall issue we write about the importance of talking with your doctor if you are taking tamoxifen along with an anti-depressant such as Prozac, Paxil, or Zoloft--three widely prescribed serotonin reuptake inhibitors (SSRIs for short). Many women are prescribed anti-depressants to combat hot flashes--a well documented side effect of tamoxifen. New studies indicate that certain SSRIs may in fact put women at a much higher risk for recurrent breast cancer. It appears that not all SSRIs are alike, and while some demonstrated cause for alarm, others didn't pose a problem at all. Before you flush your anti-depressants down the toilet, however, let me give you a warning... Don't discontinue taking any anti-depressant without first consulting your doctor.

I was talking with a close friend recently who began taking Lexapro a couple of years ago to combat hot flashes. She lives in Brazil now and has discovered that it's very difficult to get her prescriptions filled in South America. She was spending a few hundred dollars each month to refill her prescription and decided to stop taking the Lexapro rather than battle the bureaucracy. In her mind, the benefit didn't outweigh the cost.

Fast forward a couple of weeks... She began to feel like she was getting the flu. She was achy, having chills, was feverish, and disoriented. She was incredibly depressed too. She slept all day and told me that she didn't even have enough energy to go outside. As her mystery illness progressed, she and her husband became very concerned. After a bit of investigative work (and an overdue trip to the doctor), they realized that she was experiencing withdrawal symptoms from her abrupt discontinuation of Lexapro. She was put back on the medication and after a few days, she felt normal again. Her doctor informed her that she should never stop taking her Lexapro without talking to him first and that she needed to gradually wean herself from the drug in order to minimize the risk of withdrawal symptoms.

All drugs are given with specific product information. It's a good idea to keep the package insert for future reference–-since some people experience the infrequent side effects, which can be major. And always discuss stopping a medication with your doctor-- don't just do it.