Deflation

Here's another exciting new headline: Unlikely drug may block breast cancer in high-risk women. But then as you read it, you end up feeling deflated. Why? Because you find out at the end that it will take 10 years before the results of clinical trials will be available. And that it is based on a very small research pool. 

But here goes. So a drug, denosumab (or Prolia) used to to treat osteoporosis appears to prevent growth of breast cancer in high risk (read BRCA1+) women. This could be a prevention strategy for this group of women. This sounds like fantastic news. 

"For the study, 33 samples of breast tissue with no BRCA1 mutations and 24 samples of breast tissue with the mutations were analyzed."

So its a little tiny group. I am not sure that I am too impressed with the size of this group. And that the results were published based on such a small group. 

You would think that since the drug is approved already it would be fairly quick to be available for this use but since the clinical trials will take so long to see if cancer growth is prevented it will take ten years to get through trials and then FDA approval, and then finally available. 

As the article concludes it might be a solution for future generations. I am just a little deflated as I went from high expectations to a long wait.

Trying to scare or educate us?

I like these little articles found all over the internet: "signs of  [insert disease name here]". I just found one this morning for signs of oral cancer.

Oral cancer is not something that has crossed my mind really. A few years ago I had a pocket appear in the back corner of my mouth and the dentist (stupidly) said to me "Well it doesn't look like cancer but you really should have Dr F look at it to be sure." Note: never say that to someone with cancer.

But these are the signs of it so you should see your dentist regularly:

• A sore on the lips, gums, or inside of your mouth that bleeds easily and doesn't heal
  
• A lump or thickening in the cheek that you can feel with your tongue
• Loss of feeling or numbness in any part of your mouth
• White or red patches on the gums, tongue or inside of mouth
• Difficulty chewing or swallowing food
• Soreness or unexplained pain in your mouth, or feeling that something is caught in your throat with no known cause
• Swelling of the jaw causing dentures to fit poorly
• Change in voice

Now that I have this list, what should I do? Of course there are little lumps and bumps inside my mouth that I can feel with my tongue. I don't have dentures so that one is out.

Now that I have this list I can obsess over it for as long as I can remember it.... That's the biggest problem. We get a list of signs to look out for whatever the ailment is. We read it. We think about it. Then our brains are full and it falls out, or we convince ourselves we have it and rush off to the medical professional insisting that we are going to die!!!!

Scared or educated? I'm not sure.

Changing views on breast cancer

Treatment for breast cancer has changed over the past decades. This is a known fact but some of the newest changes are summarized in a recent article in the New York Times, "Outsmarting Breast Cancer". A couple of key points that hit home:

'“The size of the tumor and presence of positive nodes may not matter as much as we thought,” said Dr. Deborah M. Axelrod, a surgeon who directs breast cancer programs at the center. “It’s not even true that if the cancer is metastatic, it’s curtains.”'

While I do not have metastatic cancer, I have long thought that advances in treatment make cancer more of a chronic as opposed to a short life sentence.

'Instead of waiting for cancer to recur in certain high-risk patients, scientists are now developing techniques to outsmart the cancer cell’s aggressive tactics by prompting the patient’s immune system to launch a continuous attack that keeps the disease at bay indefinitely.

I like that one even better - preventing recurrence. Remember an ounce of prevention is worth a pound of cure.

Even lumpectomy could eventually become a thing of the past if these techniques achieve their early promise.'

I really like that. Three lumpectomies later, I am a little lumpy..

'...gone is the simplistic notion that cancer is a disease of abnormal cell division, said Dr. Larry Norton, deputy physician-in-chief for breast cancer programs at Memorial Sloan Kettering. “It’s a disease of abnormal relationships between the cancer cell and other cells in its environment.”'

The cells are hanging out in the bad neighborhood obviously. I had heard this a few years back when I heard Dr Susan Love speak. Bad friends lead to bad things - remember what your mother said about some of your friends?

So change for the good for once.

So what did I do wrong?

There is a new study out there saying that half of all breast cancers can be prevented. So what did I do wrong? That's what I feel. When I first read this I thought that its good news. But then I started thinking. What did I do wrong to get breast cancer before 50? Is it some how my fault?

I eat a good diet, I get exercise, blah, blah, blah. And there I end up with cancer. Twice. Maybe its my elementary school which is currently being turned down because its full of PCBs. Maybe because I stayed up late, smoked, and drank some. Who knows. But don't make it my fault.

But then I decided what I really don't like is the title of the article I first found: "Up To Half Of All Breast Cancers Are Preventable". That article was based on an article written in CA, A Cancer Journal for Clinicians where the original article is called "Priorities for the Primary Prevention of Breast Cancer" . Its all in the wording. Take the blame away from the patient please.

If you read the original article, it focuses on prevention options such as exercise, healthy weight, alcohol consumption, and more. Patients who drink alcohol, do not exercise, and/or maintain a healthy weight, have a greater risk of developing breast or other types of cancer. That's helpful.

Before breast cancer, I was thinner, exercised and I less to drink about, so go figure