Download After being diagnosed with breast cancer, I was referred to Dr

After being diagnosed with breast cancer I was referred to Dr. Waisman, a breast
medical oncologist, by a friend of mine and patient of Dr. Waisman. My first
consultation with Dr. Waisman was the beginning of my education in breast
cancer as he sat with his white board and marker and began diagramming and
teaching me about my specific cancer. I have continued on my own to learn
more about this disease and how it affects the lives of each person it touches.
For the past couple of years, I have been fortunate enough to have mentored
several breast cancer patients and share with them the knowledge I have gained
on this subject through my own research and reading. This has led me to do
more work on behalf of other breast cancer patients and survivors. I became
involved in my local American Cancer Society (ACS) group as well as Breast
Friends and I have attended several of the Wellness Lecture Series through
Breast Cancer Care and Research Fund (BCCRF). Through these lecture
series, I discovered the National Breast Cancer Coalition (NBCC) and was
encouraged to attend their Project LEAD Workshop. This workshop was the
jumping off point for me into the world of breast cancer research.
I felt truly honored to hear I would be a scholarship recipient through BCCRF for
this year’s San Antonio Breast Cancer Symposium (SABCS) and it was a great
privilege for me to be in attendance with so many great clinicians and scientists
who have converged in San Antonio for this one cause, to find a cure for breast
cancer.
For me, the SABCS was a non-stop whirlwind of information and the most
intense educational experience I have ever had. Scientists and physicians came
from all over the world to report on their latest findings in the field of breast
cancer research, and in attendance were over 9,000 clinicians, scientists, and
advocates who came to listen and learn from each presenter.
Attending this important annual medical symposium with experienced advocates
Michele Rakoff and Kim Tankersley as well as Drs. Link and Waisman (breast
medical oncologists), made this whole experience easier to navigate and their
valuable input helped in understanding the scientific language.
This year there were scientific research reports on lifestyle habits presented in
the plenary sessions. Recently there was a report written in a wine magazine
about the alcohol research study presented at SABCS that came out of the
Kaiser Permanente, Northern California study which I though was very exciting.
You can always find articles written about the studies conducted on the effects of
diet, exercise and breast cancer so I was pleased to see that this was one of the
“hot topics” at the Symposium this year. What we consume and how we treat our
bodies is the one element we have control over in the fight against breast cancer.
The Kaiser Permanente study looked at the effects of alcohol and breast cancer
and it suggests that moderate consumption of alcoholic beverages (at least three
to four drinks per week, no matter what type of alcohol) is associated with a 30%
increased risk of breast cancer recurrence and that post-menopausal or
overweight women may be most susceptible.
While previous research has shown that consumption of alcohol is associated
with an increased risk of breast cancer, there have been limited studies about
alcohol’s role in the patient prognosis and survival among those already
diagnosed.
The study looked at 1897 breast cancer survivors diagnosed with early-stage
invasive breast cancer between 1997 and 2000 from the Kaiser Permanente
Northern California Registry. The study compared breast cancer recurrence in
women previously diagnosed with breast cancer who drank with a control group
of women previously diagnosed with breast cancer who did not drink. The
results found 349 breast cancer recurrences and 332 deaths from cancer and
other causes in the group who consumed alcohol. The increased risk of
recurrence appeared to be greater among postmenopausal and overweight or
obese women.
Dr. Kwan suggests that “women previously diagnosed with breast cancer should
consider limiting their consumption of alcohol to less than three drinks per week,
especially women who are postmenopausal and overweight.”
Dr. Marianne Ewertz from The Danish Breast Cancer Co-operative Group out of
Copenhagen, Denmark presented a study on the effect of obesity after a
diagnosis of early breast cancer. This study examined the influence of obesity
on breast cancer recurrence and mortality in relationship to adjuvant treatment.
The group evaluated health information such as status at diagnosis, tumor size,
malignancy grade, number of lymph nodes removed, estrogen receptor status
and treatment regimen from almost 54,000 women. They were able to calculate
BMI (body mass index) for 35% of the women whose information about height
and weight was available. This was a 30 year study, 1977 through 2006 and the
researchers found that women with higher BMI (greater than 30) had more
advanced disease at diagnosis compared with those who had a lower BMI or
within normal range (25 or lower) The risk of distant metastases (10 years out)
was also increased with a higher BMI.
Women with a high BMI had an increased risk of dying from breast cancer; this
finding remained constant over the study period. Further, adjuvant treatment
seemed to lose its effect more rapidly in obese patients. Dr. Ewertz feels that
“more research is needed into the mechanisms behind the poorer response to
adjuvant treatment among obese women with breast cancer.”
During the Mini-Symposium 2 there was a very good presentation on “Obesity,
Insulin Resistance and Insulin” given by PJ Goodwin from Mount Sinai Hospital
out of Toronto, Canada. This research proves that there is a growing agreement
that being overweight or obese is associated with poor outcomes in early stage
breast cancer in both pre and postmenopausal women regardless of hormone
receptor status. These poor outcomes show a presence of cancer at a more
advanced stage with the under-dosing of chemotherapy and higher estrogen
levels in overweight and obese women and there is startling evidence that insulin
may play a key role in this outcome.
Being overweight or obese is associated with insulin resistance in both the
general population and in breast cancer patients; both insulin resistance and high
insulin levels have been associated with an increased risk of breast cancer
recurrence or death. Lifestyle changes such as weight loss, which reduces
insulin levels in the general public, and exercise, which helps to reduce the
insulin levels in breast cancer patients, can help to reduce these risks.
Recent interest has been focused on the use of Metformin which is used to treat
type-2 diabetes. It is shown to have a direct anti-tumor effect. Studies using
Metformin in breast cancer are ongoing as of this report and a new study will be
starting up early this year.
Another topic of interest to me was the subject matter on oral bisphosphonates
(bone strengthening medications used in preventing osteoporosis) and its effects
on lowering the risks of breast cancer. Also, the use of nanotechnology in cancer
diagnosis was very futuristic and seemed to be straight out of a science fiction
novel. I believe there is great potential for this type of technology in helping to
detect and treat breast cancer.
On our last day at the end the general session, there were a couple of
presentations on breast cancer stem cells. One study suggested that a certain
chemotherapy treatment may reduce the number of cancer cells that may have
still remained if not treated with this chemotherapy. The other research indicated
that white blood cells play a major roll in supporting stem cell growth during
mammary development.
There is so much great research currently being conducted and there is still a
great deal more to be discovered. My overall experience of the SABCS has
been tremendous and motivates me to pursue further into the field of advocacy.