Exciting breakthroughs are in the works, and these women are giving us hope.
Fewer Side Effects
Kimberly Blackwell, M.D., director of the breast cancer program at the Duke Cancer Institute in Durham, North Carolina, is researching a targeted drug called T-DM1, which delivers chemo directly to cancer cells. Patients won't lose their hair or experience nausea or fatigue, she says. Meanwhile, Helena R. Chang, M.D., director of the Revlon/UCLA Breast Center in Los Angeles, is studying a new procedure that allows doctors to deliver radiation during lumpectomies, inside the cavity where tumors once grew, which may lessen side effects. "This eliminates the need for the standard five to six weeks of daily, whole-breast radiation," Dr. Chang says.
Highly Targeted Treatment
If brain cancer surgeons don't remove enough tissue when they operate, they risk leaving cancerous cells behind. If they remove too much, they could damage a patient's functions. So Jennifer Cochran, Ph.D., associate professor of bioengineering at Stanford University in California, created a new molecular tool that recognizes cancerous tissue in the body. A compound from squash seeds is engineered to bind to molecules on tumor cells and delivers a dye to the tumor that allows it to be illuminated to help guide surgeons. The hope is that the tool will work as well in cancer patients as it has in mice.
Heather McArthur, M.D., a medical oncologist at Memorial Sloan Kettering Cancer Center in New York City, is working on a way to make the immune system attack breast cancer: Pre-surgery, she freezes tumors to kill cancer cells. Then a drug called ipilimumab prods the immune system to recognize and attack cancer cells if they reoccur. Meanwhile, Eva Galanis, M.D., chair of the Mayo Clinic's department of molecular medicine in Rochester, Minnesota, is using engineered strains of the measles virus to wipe out several types of cancer. The virus selectively enters cancer cells, which then fuse with other malignant cells nearby and self-destruct, with no harm to the rest of the body.
Patient Research That Pays Off
Elana Simon of New York City was 12 when she was diagnosed with a rare form of liver cancer. Surgery cured her, but other patients with the disease weren't so lucky. Because rare cancers like hers often aren't well studied, Simon, now 18, began a research project in high school to learn more about the disease. With the help of the surgeon who operated on her, plus her father, a professor and head of the cellular biophysics lab at Rockefeller University in New York City, she was able to assemble a team of researchers. After studying malignant and normal liver tissue in 15 patients, Simon and her team spotted a genetic mutation that likely causes the disease.
Using Genes to Heal
Technology is allowing researchers to turn off genes that promote cancer growth and turn on genes that suppress it. Sangeeta Bhatia, M.D., director of the Laboratory for Multiscale Regenerative Technologies at the Massachusetts Institute of Technology, is using nanoparticle devices to suppress proteins that make ovarian tumors grow. In studies with mice, the tumors have shrunk and the animals have lived longer. And Cynthia¬†Zahnow, Ph.D., associate professor of oncology at Johns Hopkins Kimmel Cancer Center in Baltimore, is developing a drug to turn on genes that can help shrink tumors in several types of cancer.
Canine Screening Advances
Dina Zaphiris of Malibu, California, used to train dogs to search and rescue and to sniff out bombs and drugs. But after her mom died of breast cancer, she founded the InSitu Foundation, which trains dogs to detect early-stage cancer in humans. "We think dogs smell volatile organic compounds—found in blood, sweat, urine and breath—that are present in people with cancer," says Zaphiris. Dogs can detect scents in parts per trillion, akin to finding a drop of blood in two Olympic-sized pools. When dogs she trained sniffed breath samples from patients who were recently diagnosed with breast or lung cancer, they identified breast cancer 88 percent of the time and lung cancer 99 percent of the time.
Building Networks for Young Survivors
When her mother was diagnosed with breast cancer, Jennifer Merschdorf, then 36, recalls saying, "The one thing I have going for me is that young women don't get breast cancer." But seven months later, Merschdorf felt a lump in her own breast, which turned out to be malignant. A friend told her to go to a Young Survival Coalition support group—it was, she says, the best advice she ever got. "The doctors saved my body, but YSC saved my soul and my spirit," Merschdorf says. Now she's the CEO of YSC and on a mission to support and educate young women who have been affected by breast cancer. Breast cancer treatment and support services are typically geared towards older women, she says, but women her age have unique issues—many are put into medically induced menopause, and the disease can be more aggressive in younger women. Under her leadership, YSC has quadrupled its reach, expanded its services and programs, and worked with scientists to set research priorities young women with breast cancer. The hope: To advance treatment for young women and provide them with the support they need. Says Merschdorf, "We want to ensure that no young women with breast cancer is alone."
Creating Genetically Based Therapies
You've probably heard of one-size-fits-all therapy, but this highly personalized treatment is one-size-fits-one. As part of the Mayo Clinic's Breast Cancer Genome-Guided Therapy study, Judy Boughey, M.D., professor of surgery at the clinic, along with her study co-leader Matthew Goetz, M.D., professor of oncology, and their team biopsy a woman's breast tumors before and after chemotherapy, and inject the samples into a mouse. They then study both the tumor's genetic makeup and its response to chemo, hoping to find mutations that might tell them which drug or combination of drugs would be most effective. "Then, we can test the effectiveness of various drugs on the mouse instead of the patient," Dr. Boughey says, adding, "Breast cancer is not all one disease, and I believe there's no one drug that's perfect." The hope: Individualized therapy in which specific drugs are selected based on the genetic makeup of a woman's tumor.
Teaching Doctors to Talk to Young Women
"When I was 30, I was essentially laughed out of a radiologist's office when I asked to have an early mammogram because I had a strong family history of breast cancer," says Deborah Lindner, M.D., clinical instructor in the department of obstetrics and gynecology at Northwestern University's Feinberg School of Medicine. Knowledge has improved in the last decade, but not enough. As the chief medical officer of Bright Pink, an advocacy group focusing on prevention and detection of breast and ovarian cancer in young women, Dr. Lindner, now 40, launched a program to educate every ob/gyn resident across the country on how to advise young women about their risks. "For a lot of providers, there's a gap in knowledge about how to deal with breast and ovarian risk," she says. The hope: "My ultimate goal is for every woman, low risk or high risk, to leave their ob/gyn's office understanding what they can do to be proactive about their breast and ovarian health," Lindner says.
Extending the Lives of Lung Cancer Patients
Not long ago, lung cancer treatment had only one standard appraoch, and on average, most patients didn't live for more than a year after their diagnosis. Today, treatment is highly customized, based on the genetics of the different subtypes of lung cancer. "We target drugs to specific genetic alterations," says Alice Tsang Shaw, M.D., Ph.D., thoracic oncologist at the Massachusetts General Hospital Cancer Center in Boston and principal investigator on two drug trials that have won rapid approval from the FDA. One drug, crizotinib, is a life-prolonging therapy that is more effective and tolerable than chemotherapy in patients with an ALK mutation—about 5 percent of the 200,000 people who are diagnosed with lung cancer every year. The second drug, given after the first no longer is effective, can extend their lives even further. The hope: "That we can keep building on these advances to help people live even longer lives," Dr. Shaw says.
Data-Mining the Cure for Pancreatic Cancer
"Research on the genetics of pancreatic cancer is still in its infancy," says Gloria Petersen, Ph.D. a genetic epidemiologist at the Mayo Clinic. That's why she's built the largest databank of pancreatic patients' blood and tissue samples in the country, with over 3,000 families enrolled. Family registries for other major cancers have led to significant breakthroughs, and Dr. Peterson hopes that her registry will do the same for pancreatic cancer. To date, she's learned that individuals who carry mutations in one of about 10 genes so far discovered are at increased risk of developing pancreatic cancer. "These genes explain less than 10 percent of pancreatic cancers, so there is still much we need to learn," she says. The hope: To identify genes that increase risk, and develop early detection tests, risk assessments and preventive steps that people at high risk can take.
Designing a Better Mammogram
A new large-scale study found that using 3-D digital mammography can improve the detection rate of breast cancer and reduce false alarms. The test, called tomosynthesis, is already being used throughout the country, but a new multicenter study has confirmed results from smaller studies. By combining standard 2-D and 3-D digital mammographies, doctors were able to detect significantly more invasive cancers—the kind that are potentially more lethal—and fewer women had to return for additional testing. "We need to study subpopulations of patients to determine if there are some women who will benefit more than others," says lead study author Sarah Friedewald, M.D., medical codirector of the Caldwell Breast Center at Advocate Lutheran General Hospital in Park Ridge, Illinois. The hope: "That more women will gain access to the technology and not be afraid to be proactive about their breast health," she says.