By: Shelagh McNally for Uterus1
In many ways 2005 has been a breakthrough year for breast cancer research.
The year ended with FDA approval of the cancer drug Letrozole (pronounced let row zoll). Sold under the brand name of Femara, this drug is an aromatase inhibitor that blocks estrogen production, the hormone responsible for tumor growth. The drug was approved after clinical trials in the United States, Europe and Australia. “These trials, with close to 30,000 participants, consistently demonstrate that treatment with an aromatase inhibitor alone or after Tamoxifen treatment is beneficial,” Dr. Sandra Swain of the National Cancer Institute in an October issue of New England Journal of Medicine. Femara is especially suited for post-menopausal women with early breast cancer and doctors are hopeful the combination of Femara and Tamoxifen will provide effective treatment and reduce re-occurrence.
| Know the signs of breast cancer: |
Change in the size or shape of a breast
Dimpling of the breast skin
The nipple becoming inverted
Swelling or a lump in the armpit
Be sure to do a monthly self examination of your breasts as well as schedule a yearly mammogram if you are age 40 or older. Early diagnosis is the best defense against breast cancer and mammography can detect early breast tumors that are too small to be felt.
In April 2005, the Mayo Clinic announced an important breakthrough with the drug trastuzumab (Herceptin). Already used in advanced cancer, Herceptin is a targeted treatment using a monoclonal antibody (a specific type of protein that attacks another protein). Herceptin goes after breast cancer cells. Two separate studies at the Mayo Clinic showed the drug was highly effective in reducing the rate of relapse by more than 50 percent with early stage breast cancer. “I feel happy for our patients. Happy because we have demonstrated that things are better,” said Dr. Edith Perez, a Mayo Clinic oncologist and a principal investigator on one of the studies, “We have not stopped our search, because we would like to cure breast cancer in our lifetime. There's a high probability that with this therapy, we're going to cure a lot of women.” More research is needed since not all women respond to the drug and it’s still unclear whether it should be taken with chemotherapy drugs. There is also evidence that this potent drug may also destroy healthy tissue leading to heart damage.
Progress towards developing a breast cancer vaccine also took a leap forward when researchers at Washington University School of Medicine and the Siteman Cancer Center in St. Louis discovered a protein called mammaglobin-A present in 80 percent of breast tumors. Using that discovery, researchers developed a DNA vaccine that destroys mammaglobin-A. “The protein is especially interesting for cancer immunotherapy because of its frequent occurrence and because breast tumors express it at high levels. Now that we've found how effectively an immune response can be generated to mammaglobin-A, we plan to conduct clinical trials in patients who are at very high risk for breast cancer and in patients who have had a relapse after initial treatment," said Thalachallour Mohanakumar, Ph.D., professor of Immunology and Oncology in the Department of Surgery at the Siteman Cancer Center. "We want to see if giving patients the DNA vaccine can prevent or eliminate breast cancer or at least slow its growth."
Another important cancer vaccine trial is being conducted at the University of Nebraska Medical Center (UNMC). The study is focusing on giving women with non-metastatic (early stage) breast cancer a vaccine containing modified dendritic cells. “We believe a cancer vaccine created from dendritic cells in the blood may be the most effective way to induce an immune response to fight breast cancer,” said Ken Cowan, M.D., Ph.D., director of the UNMC Eppley Cancer Center. Dendritic cells are found in all organs of the body and function as a warning system to the immune system. After identifying suspicious proteins, dendritic cells sends antigens that signal the immune system to mount an attack. While our immune system recognizes the antigens from viruses, bacteria and other organisms as dangerous, it can’t identify ones from cancer cells. The UNMC hopes to develop a vaccine that will help the immune system recognize cancer cells as they develop.
Fifty years ago the only available treatment for breast cancer was a full mastectomy done on the operating table. We’ve come a long way.
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