Fighting Breast Cancer in Savannah

Breast cancer was the third most common cancer in women living in the United States in 2006, behind skin and lung cancers. It is estimated that over 200,000 women will be diagnosed with invasive breast cancer this year and over 40,000 women will die of the disease.

We are entering a new era in the treatment of cancer. “Targeted therapy” has become the direction of research and drug development. Targeted therapy means that a defect in a cell’s growth pathway is identified and the medication is specifically developed to correct or block the defect. This generally results in treatments that have activity against the cancer but have much fewer side effects than standard “cytotoxic” chemotherapy because it can better tell the difference between cancer cells and normal cells.

One of the most widely used targeted drugs in breast cancer is Herceptin® which is an antibody that recognizes a protein on the surface of some breast cancer cells. This drug has been used for several years in the treatment of advanced breast cancer. Now through clinical research studies, we know that it also works to prevent recurrence in earlier stage breast cancers. Another new targeted agent being studied in breast cancer is Avastin®, which has recently been approved for colon cancer. Avastin® is an antibody that blocks new blood vessel growth, thereby preventing cancer from growing the needed blood supply to enlarge and metastasize. In addition, a new oral agent, Tykerb®, has shown promise in women with advanced breast cancer who have progressed while on Herceptin®. This will provide yet another option for women with the convenience of a well tolerated oral medication.

Other advances have been made with medications that effect estrogen, the hormone that can stimulate many breast cancers. For years, Tamoxifen® was the standard medication used in this setting, however, in the past several years Femara®, Arimidex® and Examestane® have been developed and are in use in various stages of breast cancer. These medications are called “aromatase inhibitors” and are oral drugs that block the production of estrogen. These newer medications are proven to be even more effective than Tamoxifen® and are associated with fewer side effects and are rapidly becoming the standard treatment for postmenopausal breast cancer.

Management of the side effects of standard chemotherapy has also taken great strides in the past several years, particularly with nausea. Better intravenous anti-nausea medications such as Aloxi® and the oral medication, Emend® have made nausea and vomiting much less of a problem for cancer patients. Medications to stimulate patients bone marrows to produce red and white blood cells have also allowed for fewer symptoms and permit patients to maintain a better quality of life through treatment.

One of the most difficult questions to face an oncologist is who needs treatment after surgery and who does not. That is, whose breast cancer has a high chance of recurring that treatment may prevent. Perhaps one of the most exciting areas of research involves taking the genetic information from a tumor and analyzing it to answer such questions. This technology has the potential of identifying the women most likely to benefit from treatment. In addition, treatments could be tailored specifically toward patients’ tumor characteristics, maximizing the likelihood of success. Knowing better who needs chemotherapy would spare thousands of women treatment that would be unlikely to benefit them. An exciting development is a new test called OncotypeDx® which has been developed to more accurately determine the risk for recurrence of breast cancer in certain women.

With more effective treatments that are better tolerated and knowing better who needs treatment, we are on the verge of making great leaps toward producing more and more cancer survivors. Here in our region, Summit has many clinical trials for breast cancer currently available involving such things as OncotypeDx® and targeted therapies thus providing access to the most modern therapies without requiring women to travel to major academic centers.  With Summit Cancer Care, breast cancer patients can have the best of breast cancer treatment in Palm Beach.