PUSHING THE BOUNDARIES OF RESEARCH – MAKING THE DIFFERENCE
The outlook for patients diagnosed with breast cancer has been changing for the better over time, with several significant advances coming through in the past few years. Along with more-effective therapies with fewer side effects than traditional treatment, a greater understanding of risk and accessible preventive measures has given women everyday tools to protect themselves against the disease. Some particular advances have made a notable impact on the lives of breast cancer patients-These include HER2-directed therapies, gene expression testing, hormonal therapy, and healthy lifestyle choices aimed at prevention. Therapies targeting HER2( human epidermal growth receptor 2), a protein that promotes the growth of cancer cells – has had an important impact on survival. Though not all breast cancers overexpress HER2, those that do, can be effectively treated with drugs that target this protein. New clinical trials are showing the benefits of combined drug therapies offering certain patients the dual therapy of Herceptin & now Tykerb( Lapatnib) with very promising results, where 50 % of tumours, in patients on a particular trial, have been eradicated. In time, one could envisage offering a combination of three or more drugs where a higher percentage of patients will be treated without the need for surgery thereby changing the disease from potentially fatal to treatable long term.
With advances in Gene Expression Testing – through a sophisticated test on the patients tumour, we can determine a patients risk of recurrence or spread of the disease based on the type of genes that the cancer expresses and therefore plan the best treatment to most effectively reduce the risk. This type of testing has been very effective in helping us see who would most benefit from Chemotherapy and who would better benefit with just( hormonal) therapy.
Arnie Hill is Professor and Chair of Surgery at the Royal College of Surgeons in Ireland and chairman of Breast Cancer Ireland.
In the case of Hormonal Therapy, this has been available for over 30 years, but continuing refinement of this type of treatment, has given patients more options. We are now able to effectively block estrogen over production, and treat many cancers using hormonal therapies without the need for Chemotherapy. Finally, there is an increased understanding of the role that weight, obesity and physical activity plays in terms of breast cancer risk. The benefits of a healthier lifestyle choice can certainly reduce the risk of recurrence and also assist in the prevention of such a diagnosis for others. Across the board, maintaining a healthy weight and exercising are beneficial for patients. With all the efforts being employed across the research arena, patients facing the disease today have many promising options, as therapies become more tailored to suit personal situations with lessened side effects. Breast Cancer Ireland has recently donated the first Intraoperative Radio Therapy Device in Ireland to Beaumont Hospital. This piece of equipment will significantly enhance a certain co-hort of breast cancer patients in that they will be able to have their radiation therapy administered at the time of the surgery, by extending the surgical time for twenty minutes, thereby eliminating the need for them to return daily, for five consecutive weeks to the hospital. All in all the outlook is favourable and progress is to be celebrated!