Research & Treatments
● By Robert Frey
Breakthroughs In Breast Cancer
By Hailey Hensgens Fleming
According to the National Cancer Institute, 1 in 8 women will be diagnosed with breast cancer at some point during their lifetime. Additionally, it is one of the leading causes of cancer-related deaths among women and accounts for approximately 12 percent of all cancers diagnosed globally each year. Although the risk factors are well-known - older age, family history and specific genetic mutations – simply being a woman is the greatest risk factor of all. Nevertheless, amidst these sobering statistics, women across the world can breathe sighs of relief as hope is on the horizon in the form of new technologies and medical advancements in the detection and treatment of breast cancer.
Since 1990, we have witnessed consistent declines in incidences and deaths from breast cancer according to data from the National Cancer Institute. Additionally, the U.S. Center for Disease Control reported that from 2002 to 2011 mortality decreased by 1.9 percent annually. This means that women with breast cancer are living longer – a success that can largely be contributed to these new technological breakthroughs in cancer care, some of which are detailed below.
There has been a movement in recent years toward more personalized cancer care. Advanced genomic testing is one way that is being accomplished by finding the most appropriate treatment for a patient’s specific tumor.
Genetic mapping has been around since the breakthrough study, the Human Genome Project, was completed in 2003. This discovery allowed researchers to map the entire human genetic code and subsequently link dozens of diseases to specific genes. In the case of cancer, genes BRCA1 and BRCA2 have been found to be associated with breast and ovarian cancer. Researchers have been able to create drugs for each specific type of breast cancer and inherited genetic abnormalities identified through genetic testing.
In recent years, however, these medical advancements have been taken to the next level with genomic testing of the cancer itself. These even more targeted assessments study the DNA profile of the patient’s tumor, allowing treatments to be tailored to target abnormalities that may be found in its DNA profile. This means its genetic abnormalities may be matched to a particular drug therapy that may not have otherwise been considered. While this process is not new, advanced gene mapping may provide new options to patients with cancers that are difficult to treat or those who did not respond well to conventional therapies.
Advances in Chemotherapy
Chemotherapy has come a long way since its introduction in the 1940s. Targeted therapy is one of the latest breakthroughs in that field, which takes the differences between cancer cells and healthy cells into account. Targeted drugs differ from typical chemotherapy drugs in that they zero in on the genetic mutations in a cancer cell. It targets the specific areas of the cancer cell that help it grow and spread, but leaves normal healthy cells untouched.
Hormonal therapies were the first targeted therapies to be approved for breast cancer treatment followed by targeted therapies to treat HER2-positive breast cancer. Currently, clinical trials are being conducted on new targeted therapies which would prohibit the development of blood vessels to cancer cells, be helpful against cancers caused by BRCA1 and BRCA2 gene mutations, as well as treat triple negative breast cancers.
Chemoembolization is another form of chemotherapy, which has traditionally been used to treat cancer of the liver, but is being used in some places as a breakthrough treatment for breast cancer. This method works in two ways. First, a very concentrated dose of anti-cancer drugs is delivered directly to the tumor through a catheter using image guidance. Second, the chemotherapy drugs are mixed with particles, called microspheres, which cut off the tumor’s blood flow thus trapping the anti-cancer drugs at the site and depriving the tumor of the nutrients it needs to grow. Because chemotherapy drugs are delivered directly to the tumor, exposure to surrounding healthy tissues is greatly reduced. Additionally, this method reduces common side effects of nausea and vomiting and enhances the cancer killing properties of the drug.
Advances in Radiation Therapy
Radiation therapy has evolved rapidly since it was first introduced in the early 1900s and is now an import part of the standard of care for patients with breast cancer. Recent advancements in the field have met the need for more precise treatment of cancerous tumors with lesser effects on the rest of the body. This new cutting-edge innovation is called Image Guided Radiation Therapy (IGRT) and is now being offered in Acadiana.
Dr. Jonathan Thompson, a Radiation Oncologist at Oncologics explains, “There have been a number of studies in last three to five years that have shown improved outcomes with more aggressive radiation therapies in certain settings. Along with that comes the need for more advanced techniques to minimize (radiation) doses to the lungs or heart.”
Tumors often move due to breathing and other movement in the body. This new technology allows physicians to track the tumor using infrared technology and other imaging techniques, thus delivering precise treatments to the tumor cells while avoiding the exposure of other critical structures.
Because radiation therapy is almost always required in breast cancer care and has been shown to decrease recurrence by nearly 50 percent, it is comforting to know this technological breakthrough is so close to home. “This machine is as advanced as it gets,” Dr. Thompson says. “People go to Houston for treatment and 95 percent of the time they come back because we have it here. Patients are going to get the same management here as they will anywhere in the U.S.” That is a fact the women of Acadiana can certainly take comfort in.
Hope for the Future
The future of cancer treatment holds great promise as clinical trials are currently being conducted for several innovative therapies.
Immunotherapy, one of these advances, has been named the Advance of the Year by the American Society of Clinical Oncology. This cancer treatment, also called biologic therapy, uses the body’s natural immunities to fight cancer cells. It uses either naturally made antibodies or substances made in a laboratory to boost the body’s immune system to halt the growth and spread of cancer cells. At this time, the FDA has approved three immunotherapies for breast cancer treatment and multiple others are showing promising results but undergoing further testing.
Cryoablation is another treatment that is currently being used to treat benign breast tumors, but is now being studied as an alternative to surgery in patients with early stage, invasive ductal breast cancer. This minimally invasive procedure uses image technology to guide a probe directly into the tumor and blast it with liquid nitrogen to freeze and destroy the cancerous tissue. The entire procedure takes less than thirty minutes and the incision requires only a mere band-aid.
This treatment truly seems too good to be true with advantages like no pain, no scarring and no downtime, but solid results are there too. In the trial, cryoablation killed 92% of cancers and 100% of tumors smaller than 1 cm. Additionally, researchers believe the reabsorption of the dead cancer cells may trigger an autoimmune response which will cause the immune system to attack cancer cells found anywhere else in the body as well as kill any cancer that attempts to recur. Only time will tell if this new treatment will prove to be a major breakthrough in breast cancer care, but for now it represents a great push in the right direction.